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Theories and Principles on Psychiatric Nursing

1. The psychiatric nurse is providing care for a newly admitted client who is
homeless and has not been able to bathe or change clothes for 2 weeks. Which
of the following theorists would the nurse apply, using a needs approach to
guide the nursing interventions for this client situation?
a. Leininger
b. Orem
c. Peplau
d. Roy
2. The nurse refers a client with a nursing diagnosis of Dysfunctional Grieving
related to the death of a spouse to a grief support group. The nurse's
recommendation emphasizes coping mechanisms in adaptation, illustrating
which of the following nursing theories?
a. Levine
b. Henderson
c. Peplau
d. Roy
3. The psychiatric nurse focuses on the use of self as a therapeutic tool and
evaluates nursing actions according to client response. Which of the following
best describes this nurse's practice?
a. Interaction oriented
b. Eclectic
c. Needs oriented
d. Outcome oriented
4. Nursing theorists concur in viewing humans as beings who are primarily which
of the following?
a. Biologic
b. Holistic
c. Psychological
d. Sociological

5. A client is admitted to a mental health unit. The client backed out when the
nurse approached him and shouts let me out, theres nothing wrong with me, I
dont belong here. This behavior is an example of:
a. intellectualization
b. denial
c. rationalization
d. regression
6. A supervisor reprimands a nurse for failing to come on time. Later that day, the
reprimanded nurse accuses the nursing aid for wasting hospital supplies. This
behavior is:
a. suppression
b. denial
c. displacement
d. repression
7. A female client who has reported rape and brought to the emergency room for
examination appears very calm and quiet. The nurse analyzes this behavior as:
a. projection
b. denial
c. rationalization
d. intellectualization
8. Signs of child abuse that appears only during adulthood can best be explained
by the ego defense mechanism of:
a. rationalization
b. repression
c. regression
d. reaction formation
9. When security is threatened, the individual protects the personality by:
a. affective reactions
b. defense mechanisms

c. ritualistic behaviors
d. withdrawal patterns
10.A male college student who fails to be accepted in the basketball team
because of his height becomes the president of his class. The defense
mechanism used is:
a. introjection
b. sublimation
c. compensation
d. reaction formation
11.An 18 year old girl with anorexia nervosa is able to discuss in great detail the
nutritional values of the menu she elaborately prepared for her family is using
what defense mechanism:
a. projection
b. intellectualization
c. dissociation
d. displacement
12.Sublimation is a defense mechanism that helps the individual:
a. act out the opposite of ones true feeling
b. engage in earlier mode of behavior
c. exclude from the conscious thoughts that causes anxiety
d. express unacceptable thoughts and wishes into socially
approved behavior
13.The nurse is aware that Freuds phallic stage of psychosocial phase of initiative
vs. guilt, is best seen at:
a. adolescence
b. 6 to 12 years
c. birth to 1 year
d. 3 to 5 years
14.The most important relationship in the development of personality is that of:

a. parent-child
b. sibling
c. heterosexual
d. peer
15.Which is true of personality development:
a. personality development occurs from birth to death
b. the personality can only develop until adulthood, after which, mental
illness will develop if it is not completely developed
c. personality characteristics are firmly fixed at birth because of heredity
d. by the end of the first 6 years, the personality has reached its adult
16.According to psychosexual theory, the primary emergence of the personality is
demonstrated around the age of:
a. 6 months
b. 9 months
c. 24 months
d. 48 months
17.Independence is developed during the period of:
a. infancy
b. toddler
c. pre school
d. school age
18.During pre school period, the child:
a. develops ambivalence to the mother
b. has strong affections towards the parent of the same sex
c. is strongly attached to the parent of the opposite sex
d. turns towards peers for acceptance and security

19.Role identification occurs during the:

a. oral stage
b. oedipal stage
c. genital stage
d. latency stage
20.The child has overcome the phallic stage when the child:
a. rejects the parent of the same sex
b. introjects behaviors of both parents
c. identifies with the parent of the same sex
d. identifies with the parent of the opposite sex
21.An elderly perceives a three outside the window as a person is manifesting:
a. an illusion
b. a delusion
c. hallucination
d. an idea of reference
22.The superego is that part of the psyche that:
a. says I want what I want
b. is the source of instinct to engage in self-defense when in face of
c. evaluates the circumstances before making decisions
d. makes the person feels great after giving alms to mass
23.A person who gets nervous whenever he goes to the theater for unknown
reasons is manifesting influence of:
a. conscience
b. de ja vu
c. unconscious
d. subconscious

24.Surgery can be most traumatic, according to Piaget during which stage of

cognitive development?
a. sensorimotor
b. preoperational
c. concrete operational
d. formal operational
25.The real attitudes, feelings, and desires are best portrayed in the:
a. conscious
b. unconscious
c. preconscious
d. foreconscious
26.The ability to tolerate frustration is an important function of the:
a. id
b. ego
c. superego
d. defense mechanism
27.A well adjusted personality is manifested when the:
a. super ego is stronger than the id so the person will not violate rules
and regulations
b. ego and superego development is very strong and the id is weak so the
person will not be compulsive
c. the ego allows the superego and id to dominate the personality
d. ego mediates between the pressures of the id and superego
28.An elderly client remarks to the nurse in one of their interactions I realized I
have not been a good husband and father, I wish I could turn back time and
undo things. The client has probably failed to accomplish Eriksons
developmental task of:
a. autonomy versus shame and doubt

b. identify versus role confusion

c. generativity versus stagnation
d. ego integrity versus despair
Psychiatric Nursing Concepts
Situation: Amy, 35 year old, formerly an executive secretary of brokerage firm
complaints of difficulty falling asleep, headache, fatigue and inability to
concentrate. She has been separated from her husband since a year ago.
29.During a nurse-patient interaction, Elena explains how she lost her job. The
nurse responds therapeutically by saying which of the following:
a. What do you think is the reason for losing your job?
b. It must have upset you so much.
c. Tell me more about your job.
d. Do not worry, there will be other opportunities.
30.In her plan of care, Nurse Via, includes a short term goal which is one of the
a. develop problem solving skills
b. able to participate in scheduled activities
c. takes the initiative of interacting with other patients
d. talks with the nurse regularly in a weeks time
31.Elena compliments her boss, but unconsciously does not like him because he
terminated her. She is exhibiting one of the following defense mechanisms:
a. displacement
b. reaction formation
c. introjection
d. sublimation
32.The termination phase of nurse-patient relationship is best described in one of
the following statements:
a. establish trust as basis for a therapeutic relationship
b. identify and resolve patients problems

c. explore patients thoughts, feelings and concern

d. review progress of therapy and attainment of goals
33.The ability to enter into the life of another person and perceive his current
feelings and their meaning is known as the one of the following:
a. empathy
b. respect
c. genuineness
d. sympathy
34.A major intervention designed to assist the patient in meeting his/her need for
love and belonging is:
a. initiate nurse-patient relationship
b. conduct health teaching
c. obtained the informed consent
d. provide adequate nutritional intake
35.Which of the following data relate to the need for love and belonging?
a. my children live over 200 km away, so I dont see much of them
b. its hard to breathe sitting up
c. its scary to go out alone
d. the pain goes down the back of my leg like streak
36.Therapeutic use of self is best described as:
a. the ability to effect change in the patient by imposing ones spiritual
b. being accurate in the administration of medication
c. the ability to consciously structure nursing intervention and
establish relatedness
d. being skillful and artistic in giving treatment
37.Which of the following is a therapeutic technique in communication?
a. changing the subject when the client appears depressed

b. sharing observation and giving information to clients

c. agreeing and disagreeing with clients values and beliefs
d. approving and disapproving clients plan of action
38.Which one of the following ways can a nurse create a therapeutic environment
for her patient?
a. telling patients not to cry while expressing their thoughts and feelings
b. providing opportunities for patients to experience acceptance
and recognition
c. giving sanction to his behavior at all time
d. spending more time socializing with patients in order to establish
intimate relationship
39.One morning, Sheila says, I do not like to eat. The nurse asks her, You dont
like to eat? this therapeutic technique of communication is which one of the
a. reflecting
b. giving information
c. summarizing
d. restating
40.A patient tells the nurse, Im too depressed to talk to you. Leave me alone.
Which of the following responses by the nurse would be most therapeutic?
a. Ill be back in two hours
b. Why are you so depressed?
c. Ill sit here with you for a moment
d. call me when you feel like talking to me
41.Which of the following comments by the nurse would be used to encourage a
patient who is schizophrenic and withdrawn to participate in activity therapy?
a. you must go to group right now
b. Ill walk with you to activity therapy
c. if you dont go to group, youll be put on seclusion

d. if you go to activity therapy, Ill increase your privilege

42.A middle aged patient says to the nurse I dont deserve to live. The most
therapeutic initial response by the nurse would be to:
a. continue to listen to the patient while maintaining direct eye contact
b. remain with the patient until she states she feel better
c. say to the patient you sound depressed and lean forward to her
d. Ask the patient what she means by I dont deserve to live.
43.Which of the following actions should a nurse take during the pre-interaction
phase of the nurse-patient relationship?
a. exploring personal feelings regarding care of the mental
health patient
b. establishing boundaries for the patient and the nurse
c. determining if the patients problems result from stressors
d. identifying goal and strategies
44.A patient says to the nurse, I want to tell you something, but you mustnt tell
anyone else. Which of the following responses by the nurse would be
a. Im glad you can trust me
b. I have to reveal anything that would be essential to your
c. the nurse and patient have a special relationship
d. I am bound to keep it secret because of confidentiality
45.A patient who has schizophrenia of the paranoid type says to the nurse, the
FBI is out to get me and youre one of them. Which of the following responses
by the nurse would be most therapeutic?
a. you seemed scared
b. What makes you think that the FBI is here?
c. you should go to your room to rest
d. How would the FBI agent get in here?

46.A patient tells the nurse, The group therapist doesnt like me. which of the
following interventions should a nurse give priority?
a. Why do you say that?
b. I wouldnt take it personally
c. would you like me to talk to the therapist for you
d. You need to discuss that concern with the therapist.
47.A patient has been acting out most of the day. To which of the following
interventions should a nurse give priority?
a. inform the patient if rules and regulations must be followed
b. tell the patient to control the feelings motivating the behavior
c. isolate the patient until the patient gains self control
d. try to elicit the feelings behind the patients behavior
48.When assessing the psychiatric patent, a nurse should recognize which of the
following strengths as essential to successful living?
a. knowledge about medications
b. ability to work
c. ability to drive
d. social skills
49.A patient has an obsessive compulsive disorder is admitted for major surgery.
The patient counts to 95 at each step of procedure. Which of the following
actions by the nurse would demonstrate a correct understanding of the
patients needs?
a. explaining the necessity of maintaining the operating room schedule
b. assisting the patient with other ways of decreasing anxiety
c. making a contract with the patient to eliminate the rituals
d. proceeding with the preparation for the surgery
50.The adult child of a patient who has dementia of Alzheimers type tearfully tells
a nurse I cant take it another day. Now Im being accused of stealing my
mothers underwear. Which of the following responses by the nurse would be
most therapeutic?

a. this must be a difficult time for you and your mother

b. Dont take it personally. Your mother doesnt mean it
c. Have you tried discussing this with your mother?
d. Ask your mother where the underwear was last seen.
51.A patient who has anorexia nervosa says to the nurse I feel fat and ugly.
Which of the following responses by the nurse would be most therapeutic?
a. dont be so hard on yourself
b. it sounds as if youre feeling bad about your body
c. you look fine to me
d. Id love to be in your size
52.Temper tantrums can be dealt with therapeutically by:
a. cuddling the child
b. ignoring the behavior
c. threatening the child
d. giving candy to the child
53.Mental health is defined as:
a. a disturbance in a persons thoughts, feelings and behavior
b. a state of well being where a person can realize his or her own
abilities, to cope with the normal stresses of life and work
c. a science which deals with measures employed to promote mental
health, to reduce the incidence of mental illness through preservation
and early treatment
d. in concerned with the promotion of mental health prevention or mental
disorders, and the nursing care of patients during mental illness and
54.When initiating a nurse patient relationship it is best to:
a. show keen interest to his needs
b. talk in his own language

c. relate with him as equal

d. find a common interest to talk about
55.Which of the following statements about self-concept is correct?
a. change in self-concept is a normal response to illness
b. ones self-concept is ready available
c. coping strategies promotes recovery
d. it is easy to modify self-concept than change it
56.The initial step for a person to attain positive self-concept is to:
a. self-care
b. self-reflection
c. self awareness
d. self-confidence
57.Trust may be developed 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 consistence in approaching the client
58.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 the agreedupon 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. Lets continue
c. What would you like to talk about today?
d. Nothing and wait for the client to introduce a topic.
59.After a week long nurse-client relationship, the clinic nurse observes that the
client continuously shouts, mocks and displays bursts of anger during the
termination. Based on your understanding of this phase, the client:

a. Requires further treatment and is not ready to be discharged

b. Is displaying a typical behavior that can occur during
c. Needs to be admitted to the hospital
d. Needs to be referred to the psychiatrist as soon as possible
60.Upon visit to a client admitted to the hospital with a nursing diagnosis of
dysfunctional grieving r/t the loss of spouse, the nurse assessed that the client
progresses well and is approaching discharge. Which of the following is not
appropriate outcome of this nursing diagnosis?
a. The client verbalizes the stages of grief and has no plans to attend a
community grief group
b. The client identifies the meaning of his or her lost
c. The client verbalizes a decreased desire of self harm and discusses two
alternatives to suicides
d. The client does not seek any professional help anymore
61.After 2 days of being admitted to the psychiatric ward, Jocy a 38 y/o client still
appears severely depressed. She does not initiate conversation and seldom
answers with a barely audible one- or two word responses. The nurse sits with
the client and makes no demands. The nurses intervention is based on the
premise that:
a. The nurse should spend time with all assigned clients
b. This demonstrates that the nurse is caring and has genuine
interests for the patient
c. One-to-one interaction is expected in an acute care unit

The depressed client needs stimulation from the environment

62.Ricky a 25 y/o medical student has exhibited inappropriate affect and apathy. A
diagnosis of acute schizophrenia is made. Considering the diagnosis, a
symptom that a nurse would expect to observe in the clients communication
or behavior is:
a. Suicidal preoccupation
b. Absence of self criticism
c. Autistic magical thinking

d. Abstract and deduction

63.Lucy, a flight stewardess who was recently admitted to the hospital, is pacing
the floor and acting aloof and suspicious. According to her husband, she
laughed in a silly manner when told that her mother is critically injured, and
she has difficulty with her coworkers, accusing them of backstabbing her. The
client has stated that she is being manipulated by others. The nurse, to be
most helpful, should first:
a. Obtain a complete copy of clients history
b. Review a textbook with the description of a schizophrenic patient
c. Observe and evaluate the behavior in terms of the clients
d. Meet with the clients husband to learn more about the client
64.Lanie, a patient diagnosed with personality disorder is observed that at times
clings to the nurse and at other times maintains a noticeable distance. The
nurse realizes that this pattern of behavior illustrates that the client is in what
stage of Ericksons psychosocial development?
a. Shame vs. autonomy
b. Initiative vs. guilt
c. Generativity vs. stagnation
d. Trust vs. mistrust
65.Clevy is assigned as the nurse counselor in a community mental health clinic
and is working with a couple and their two kids. The couples son has been in
trouble in school because of fighting and poor grades and their daughter
appears quiet and withdrawn. But the parents report no problems. The father
has been and out of jobs in the last 3 years and the mother works as a
waitress. They have severe marital problems for the past 10 years. The priority
nursing diagnosis for this family at this time would be:
a. Impaired parenting r/t marital problems
b. Impaired adjustments r/t children growing older
c. Disabled family coping r/t sons school problem
d. Impaired social interaction r/t an inability to form relationships
Mental Health Nursing

66.A client is admitted to a psychiatric hospital because of a recurrent mental

health problem. During the admission, the nurse identifies expected client
outcomes. The nurse understands that expected outcomes are:
a. Variances of care
b. Clinical pathways
c. Long term objectives
d. Measurable, realistic goals
67.A 13 y/o boy, who recently was suspended from school for consistently bullying
other children, is brought to the pediatric mental health unit by his mother. The
child is assessed by the psychiatric and referred to a psychologist for
psychologic testing. The day after the tests are completed the mother returns
to the clinic and asks the nurse for results of the tests. The nurse should:
a. Refer the mother to the psychiatrist
b. Explain to the mother the results of the tests
c. Suggest that the mother call the psychologist
d. Teach the mother about the variety of tests administered
68.After caring for a terminally ill client for several weeks, the nurse becomes
increasingly aware of a need to get away from this assignment. The nurse best
initial action should be to:
a. Request vacation time for a few time
b. Seek support from colleagues on the unit
c. Withdraw emotional involvement with the client
d. Stay with the client while trying to work through feelings
69.A nurse has been working double shifts to pay for a new car. These are stopped
when frequent headaches and fatigues ensue. The nurse manager notices that
the care the nurse is providing is barely adequate, even when staying an extra
hour every day. The nurse manager should handle this situation by stating:
a. Dont you think you are trying to do too much?
b. What can I do to help you finished on time?
c. Ive noticed youve been staying late every night
d. Ill help you get more organized so you can leave on time

70.A client with moderate dementia often assaults the nursing staff, and the staff
decides to develop a plan that will make this clients personal care less of a
problem. The plan should include:
a. Limiting the staff and client spend together
b. An outline of the consequences for uncooperative behavior
c. Identification nursing staff members whom the client prefers
d. The clients likes and dislikes for use as a reward punishment
71.A nurse should first discuss terminating the nurse-client relationship with a
client during the:
a. Working phase when the client brings it up
b. Orientation phase when a contract is established
c. Working phase when the client shows some progress
d. Termination phase when discharge plans are being made
72.on a home visit to an older adult who has chronic heart failure, the nurse
observes that a 6 month old grandchild lies quietly in a crib, rarely smiles or
babbles, and barely has basic needs attended. The client is the primary
caregiver for the infant. The nurse should:
a. advise purchasing appropriate toys designed for this age level
b. inform the client that the child will be retarded if not stimulated
c. explain the need for the family to hire a mothers helper for the home
d. initiate a referral to an appropriate agency to assess the need
for a home health aide
73.When planning nursing care for a client with severe agoraphobia, the nurse
should first:
a. Determine the clients degree of impairment
b. Support the clients self esteem through verbal interaction
c. Teach the client biofeedback techniques for reducing anxiety provoking
d. Expose the client gradually to anxiety provoking situations

74.When a nurse revises a clients nursing care plan based on the clients
responses that show evidence that goals were not attained, the phase of the
nursing process being applied is:
a. Planning
b. Evaluation
c. Assessment
d. Implementation
75.After speaking with the parents of a child dying from leukemia, the physician
gives a verbal DNR order but refuses to put it in writing. The nurse should:
a. Follow the order as given by the physician
b. Refuse to follow the order, unless the nursing supervisor approves it
c. Ask the physician to write the order in pencil on the clients chart
before leaving
d. Determine whether the family is in accord with the physician
while following hospital policy
76.The nurse manager of an emergency department who is helping a nurse with
burnout should facilitate confrontation of the problem by urging the nurse to:
a. Work on a primary nursing care unit
b. Choose a nursing position on a low stress unit
c. Attend educational programs as often as possible
d. Identify personal responses to daily work stresses
77.One afternoon the nurse on the unit overhears a young female client having an
argument with her boyfriend. A while later, the client complains to the nurse
that dinner is always late and the meals are terrible. The nurse recognizes that
the defense mechanism the client is using is:
a. Projection
b. Dissociation
c. Displacement
d. Intellectualization

78.Although upset by a young clients continuous complaints about all aspects of

care, the nurse ignores them and attempts to divert the conversation.
Immediately following this exchange with the client, the nurse discusses with a
friend the various stages of development of young adults. The defense
mechanism the nurse is using is:
a. Substitution
b. Sublimation
c. Identification
d. Intellectualization
79.The nurse is aware that according to Erickson, a childs increased vulnerability
to anxiety in response to separation or pending separations from significant
others results from failure to complete the developmental task called:
a. Trust
b. Identity
c. Initiative
d. Autonomy
80.The nurse knows that Erickson identified the developmental conflict of the
preschool child from 3-5 years as:
a. Initiative vs. guilt
b. Industry vs. inferiority
c. Breaking away vs. staying at home
d. Sexual impulses vs. psychosexual development
81.According to Erikson, a young adult must accomplish the tasks associated with
stage known as:
a. Trust vs. mistrust
b. Intimacy vs. isolation
c. Industry vs. inferiority
d. Generativity vs. stagnation
82.A 23 y/o female client is admitted to a psychiatric unit after several episodes of
uncontrolled rage at her parents home. She is diagnosed as having borderline

personality disorder. While watching a television newscast describing an

incident of violence in the home, the client states people like that need to be
put away before they kill someone. The nurse recognizes that the client is
a. Denial
b. Projection
c. Introjection
d. Sublimation
83.A 65 y/o individual who emigrated from Cuba 25 yrs ago is admitted to the
hospital with a history of depression. The client, who speaks little English and
has few outside interests since retiring states I feel useless and unneeded.
According to Erikson, the client is in the developmental stage of:
a. Initiative vs. guilt
b. Integrity vs. despair
c. Intimacy vs. isolation
d. Identity vs. Role confusion
84.A 7 y/o hospitalized boy wakes up crying because he has wet his bed. It would
be most appropriate for the nurse to:
a. Allow him to change his bed and pajamas
b. Change his bed while he changes his pajamas
c. Take him to the bathroom and change his pajamas
d. Remind him that he should call for the nurse for the next time
85.A mother of an 18 y/o male comes to the mental health unit. She is extremely
upset because her son has returned from his freshman year in college and is
uncontrollable. He takes his brothers clothing comes in at all hours, and
refuses to get a job. Sometimes, he is happy and outgoing, and other time he
is withdrawn. The mother asks why her son is withdrawn. The mother asks why
her son is like this and speculates college has done this to him. While
contemplating this situation, the nurse understands that adolescents are
a. Anxious and unhappy
b. Angry and irresponsible

c. Impulsive and self-centered

d. Hyperactive and self-destructive
86.According to Erikson, an individual who fails to master the maturational crisis
of adolescence will most often:
a. Rebel at parental orders
b. Experience role confusion
c. Be interpersonally isolated
d. Resort to substance abuse as an escape
87.A constructive and lengthy method of confronting stress of adolescence and
preventing a negative and developmental outcome is:
a. Role experimentation
b. Adherence to peer standard
c. Sublimation through school work
d. Development of dependency on parents
88.The parents of an overweight adolescent female tell the nurse that they are
concerned that their daughter feels inferior to her sister who is an attractive,
successful college senior. They asked the nurse what they can do about this
problem. The nurse should:
a. Tell them to avoid talking about their older childs accomplishment
b. Suggest that they appear to be creating a problem where none exist
c. Encourage them to give the adolescent recognition for strong
d. Advise them to tell the adolescent to view her sisters success as a
89.The nurse, along with an adolescent girl and her parents, set bolstering the
adolescents self esteem as a high priority goal. The nursing action would
contribute to the achievement of this goal is:
a. Telling the adolescent how much her parents love her
b. Urging the adolescent to join a neighborhood social group

c. Supporting the adolescents interest in enrolling in a baby

sitting course
d. Encouraging the adolescent to talk about feelings of pride in her
successful siblings
90.A nurse identifies that a client has successfully resolved the task of
adolescence associated with Eriksons development theory when the client
a. Drive and hope
b. Affiliation and love
c. Devotion and fidelity
d. Purpose and direction
91.A nurse evaluates that the plan for bolstering an overweight adolescents self
esteem was effective when, 3 months later, the adolescents mother reports
that the adolescent:
a. Seems to be doing average work in school
b. Has asked her how to bake bread and cookies
c. Joined a dirt bicycle club that meets at the school
d. Imitates an older siblings manner of speech and dress
92.According to Erikson, a persons adjustment to the period of senescence will
depend largely on the adjustments the individual made to the developmental
stage of:
a. Trust vs. mistrust
b. Industry vs. inferiority
c. Generativity vs. stagnation
d. Identity vs. Identity diffusion
93.When helping the older adult (age 65-75) successfully complete Eriksons task
of this stage, the nurse should assist the client to:
a. Invest creative energies in promoting social welfare
b. Redefine a role in society that offers something of value
c. Look to recapture those opportunities that were not reexperienced

d. Feel a sense of satisfaction when reflecting on ones past

94.The nurses role in maintaining or promoting the health of the older adult
should be based on the principle that:
a. some of the physiologic changes that occur as a result of aging are
b. thoughts of impending deaths are frequent and depressing to most
older adults
c. older adults can better accept the dependent state that chronic illness
often causes
d. there is a strong correlation between successful treatment and
maintaining good health
95.When planning care for an older client, the nurse is aware that normal aging
has little effect on clients:
a. Sense of taste or smell
b. Gastrointestinal motility
c. Muscle or motor strength
d. Ability to handle lifes stresses
96.Survivors of a major earthquake are being interviewed on admission to the
hospital. The nurse notes that they exhibit a flattened affect. Make minimal eye
contact, and speak in a monotone voice. This would be indicative of the
defense mechanism known as:
a. Splitting
b. Isolation
c. Introjection
d. Compensation
History and Trends in Psychiatric mental Health Nursing
97.Which of the following statements about causation of mental illness would the
nurse identify as incorrect?
a. Life circumstances can influence one's mental health from birth.

b. The inability to deal with environmental stresses can result in mental

c. Mental health is influenced by relationships between persons who
either love or refuse to love one another.
d. Inherited characteristics exert minimal to no influence on one's
mental health
98.Which of the following would the nurse expect as the least likely reason for
using defense mechanisms?
a. Improved insight
b. Protection of self-esteem
c. Reduced anxiety
d. Resolution of a mental conflict
99.A client talks to the nurse about safe, neutral topics, without revealing feelings
or emotions. The nurse determines that the client's motivation for remaining
on this superficial level of communication is most likely which of the following?
a. Fear of rejection by the nurse
b. Lack of awareness of feelings
c. Poor communication ability
d. Poor emotional maturity
100. Which of the following nursing functions is different in current psychiatric
mental health nursing practice when compared with practice from 1915 to
a. Careful client assessment
b. Concerns about the effect of environmental conditions
c. Focus on understanding the causes of mental illness
d. Use of nursing diagnosis