PLT College Inc
College of Nursing
REMEDIAL EXAMINATION (10-28-10)
Name: ________________________________________________________ Score: ____________________________
Instructions: Kindly shade the letter of your choice on the answer sheet given. Erasures and
Superimpositions are not allowed. Goodluck!
Basic Concepts of Psychiatric Nursing
1. As a Psychiatric Nurse, you must be
aware that there are tools being utilized to
classify and diagnose illnesses in mental
health according to their presenting
symptoms. The DSM-IV is a tool utilized for
diagnosis in mental health settings. This
multi-axial system includes:
a) Nursing and medical diagnosis
b) Frameworks of specific theories
c) Specific critical pathways
d) Assessments for several areas of
functioning
2. The nurse meets with the client daily.
The client stays mostly in his room and
speaks only when addressed, answering
briefly and abruptly while keeping his eyes
on the floor. In this stage of their
relationship, the nurse focuses on the
client’s ability to
a. make decisions
b. relate to other clients
c. express himself verbally
d. function independently
3. The client has tearfully described her
negative feelings about herself to the nurse
during their last three interactions.
Which of the following goals would be most
appropriate for the nurse to include in the
care of plan at this time? The client
will
a. Increase her self-esteem
b. Verbalize three things she likes about
herself
c. Write her negative feelings in a daily
journal
d. Verbalize her work-related
accomplishments.
4. Crisis inflicts us in different ways. Some
would come to us in expected ways and
majority would come in as a surprise.
During crisis, the most important
assessment data for the nurse to gather
from the client would be:
a. the specific circumstances surrounding
the perceived crisis situation
b. The client’s work habits
c. Any significant physical health data
d. A past history of any emotional, social
and mental problems in the family
5. Buckley Tah is admitted for surgery.
Although not physically distressed, the
client appears apprehensive and alienated.
A nursing action that may help the client to
feel more at ease and comfortable includes:
a. Telling her that everything is all right
b. Giving her a copy of hospital
regulations and protocols
c. Reassuring her that staff will be
available if she becomes upset and
anxious with the surgery
d. Orienting her to the environment and
unit personnel
6. On arrival for admission to a voluntary
unit, Ema B. Shusa loudly announces:
“Everyone kneel, you are in the presence of
the most beautiful and gorgeous Queen of
England.” This is:
a. A delusion of self-belief
b. A delusion of self-appreciation
c. A delusion of grandeur
d. A nihilistic delusion
7. Jhumel refuses to eat food sent up on
individual trays from the hospital kitchen.
He shouts, “You want to kill me.”
The client has lost 8 pounds in 4 days. In
discussion of this problem, with the
assigned staff member, which statement by
the nurse indicates an accurate
interpretation of this client’s needs?
a. “The client is malnourished and may
require tube feedings.”
b. “The client is terrified. Ask the kitchen
to send foods that are not easily
contaminated such as baked potatoes
c. “Continue to observe the client. When
the client gets hungry enough, the
client will eat.”
d. The client appears frightened. Spend
more time with the client, showing a
warm affection.”
8. One of the responsibilities of a nurse is to
secure a non-judgmental and smooth
flowing Nurse-Patient Interaction. The
nurse is discussing the orientation phase.
The student nurse asks what the primary
goal between the nurse and the client
should be achieved during this phase. The
nurse should respond that the primary goal
is to:
a. Establish trust and support
a. Explain unit rules and regulations
b. Establish a relationship
c. Formulate a mutual plan of action
9. Auditory hallucination or Command
hallucination is very common to psychotic
patients and it is believed to contribute in
suicide attempts and suicide gambles. A
nurse is talking with a client who is hearing
voices. The nurse states, “The only voices I
hear are yours and mine.” This is
an example of:
a. Presenting reality
b. Restating
c. Clarification
d. Focusing
10. The parents of a child who had open-
heart surgery are informed that their child
is in the recovery room and is stable. The
mother is crying. The nurse can best help
allay the mother’s anxiety by:
a. Allowing her to continue to express her
feelings
b. Reassuring her that their child is doing
well
c. Bringing her and her husband to the
recovery unit for several minutes
d. Encouraging them both to go have a
cup of coffee and return in 2 hours
Therapeutic Communication
11. Eduardo Tho Pack, a 24-year old man
with a diagnosis of chronic schizophrenia is
admitted to the psychiatric unit. He is
talking loudly as the nurse approaches him.
When asked who he is talking to, he said, “I
hear God’s voice, He’s telling me to save
everyone from Earth.” Which of these
responses by the nurse would be best?
a. “I don’t hear a voice, but I know it’s real
to you.”
a. “It must make you think important to
talk with God.”
b. “Why do you think you’re hearing a
voice?”
c. “What could be God’s reason for talking
to you?”
12. Martyr Nievera who has a borderline
personality disorder asks the nurse on a
psychiatric unit if he may stay up beyond
the designated bedtime. When the nurse
says no, the patient says, “The nurse on
duty last night let me stay up late.” Which
of these responses by the nurse would be
therapeutic?
a. “You shouldn’t have been given that
privilege.”
b. “Everyone is required to go to bed,
now.”
c. “You can stay up for one more hour.”
d.“Direct his focus away from his
symptoms.”
13. Electro Convulsive Therapy has been a
treatment long before believed to reset the
mind and be “normally” functional for some
time. A patient tells a nurse, “I really don’t
want to have these shock treatments but
my doctor insists.” Which of the following
responses by the nurse would be
therapeutic?
a. “We should cancel the procedure until
you feel better.”
b. “It’s normal to every patient who
experienced dissatisfaction with this
procedure.”
c. “Have you talked to your doctor about
your fears?”
d. “This procedure is the best treatment
for your condition.”
14. During the admission procedure a client
appears to be responding to voices. The
client cries out at intervals, “No, no, I didn’t
kill him. You know the truth; tell that
policeman. Please help me!” The nurse
should :
a. Sit there quietly and not respond at all
to the client’s statements
b. Respond to the client by asking,
“Whom are they saying you killed?”
c. Saying. “Do not become so upset. No
one is talking to you; the accusing
voices are part of your illness.
d. Respond by saying, “I want to help you
and I realize you must be very
frightened.”
15. A client on the unit believes another
client has stolen his watch, and they want
to discuss this with the nurse. What is the
nurse’s best response?
a. “Tell me what you believed
happened.”
b. “I’ll meet with each of you
individually.”
c. “I’m sure no one here would do a thing
like that.”
d. “Be careful when you accuse
someone.”
16. During the nurse’ conversation with the
client, the client states, “I have no reason to
be sad. I have a great job and a
wonderful wife and family.” Which of the
following comments are would be best for
the nurse to make at this time?
a. “Why do you think you’re depressed?”
b. “Depression can be caused by
chemical imbalances in the brain
c. “Think about how fortunate you are.”
d. “You have many positive qualities.”
SITUATION: Sheera Ohlo was admitted to
the psychiatric unit yesterday. The nurse
observes that her head is bowed in a
dejected manner, her facial expression is
sad, and she isolates herself in her room.
17. After a few minutes of conversation, the
client wearily asks the nurse, “Why pick me
to talk to when there are so many other
people here?” Which reply by the nurse
would be best?”
a. “I’m assigned to care for you today, if
you’ll let me.”
b. “Why shouldn’t I want to talk to you,
as well as the others?”
c. “You have a lot of potential, and I’d
like to help you.”
d. “You’re wondering why I’m interested
in you, and not in others?”
18. The client begins to attend group
sessions daily. She explains to the group
how she lost her job. Which of the following
statements by a group member would be
most therapeutic for the client?
a. “Tell us about what you did on your
job?”
b. “It must have been very upsetting for
you.”
c. With your skills, finding another job
would be easy.”
d. “The company must have had some
reason for letting you go.
19. The client admits to having thoughts of
suicide, he is lethargic, withdrawn and
irritable. In conversations with the nurse,
he stresses his faults. When he starts to
point out the things he can’t do, which of
the following responses by the nurse would
provide best intervention?
a. “You can do anything you out your
mind to.”
b. “Try to think more positively about
yourself.”
c. “Let’s talk about your plans for the
weekend.”
d. “You were able to write a letter to your
friend today.”
20. The client states, “I’m looking forward
to going back to work, but I wonder if I’ll be
able to keep up with the demands of my
job.” Which of the following statements by
the nurse would be most helpful?
a. “You’ll do well. You have an excellent
work record.”
b. “I wouldn’t worry about it. The main
thing to remember is that you can
work.”
c. “You might need extra breaks at first
until you feel better.”
d. “You sound concerned. I want to hear
more about how you are feeling.”
21. Long Coughtin has been hospitalized for
major depression and suicidal ideation.
Which of the following statements indicates
to the nurse that the client is improving?
a. “I’m of no use to anyone anymore.”
b. “I know my kids don’t need me
anymore since they’re grown.”
c. “I couldn’t kill myself because I don’t
want to go to hell.”
d. “I don’t think about killing myself as
much as I used to.”
22. Nurse John is talking with a client who
has been diagnosed with antisocial
personality about how to socialize during
activities without being seductive. Nurse
John would focus the discussion on which
of the following areas?
a. Discussing his relationship with his
mother
b. Asking him to explain reasons for his
seductive behavior
c. Explaining the negative reactions of
others toward his behaviour
d. Suggesting to apologize to others for
his behavior
23. The nursing assistant tells nurse Ronald
that the client is not in the dining room for
lunch. Nurse Ronald would direct the
nursing assistant to do which of the
following?
a. Tell the client he’ll need to wait until
supper to eat if he misses lunch
b. Invite the client to lunch and
accompany him to the dining room
c. Inform the client that he has 10
minutes to get to the dining room for
lunch
d. Take the client a lunch tray and let the
client eat in his room
24. The initial nursing intervention for the
significant-others during shock phase of a
grief reaction should be focused on:
a) Staying with the individuals involved
b) Presenting full reality of the loss of the
individuals
c) Directing the individual’s activities at
this time
d) Mobilizing the individual’s support
system
25. She tearfully tells the nurse “I can’t take
it when she accuses me of stealing her
things.” Which response by the nurse will
be most therapeutic?
a) ”Don’t take it personally. Your
mother does not mean it.”
b. “Have you tried discussing this with
your mother?”
c. “Next time ask your mother where her
things were last seen.”
d.This must be difficult for you and your
mother.”
Psychiatric Disorders and Conditions
26. The situation in which individuals have
excessive worry or belief that they are
suffering from a physical illness despite
lack of medical evidence is known as:
a. Pain disorder
 b. Phobic disorder
c. Somatoform disorder
d. Dissociative disorder
27. A newly admitted client states, “No one
cares, everyone is against me.” This type of
statement is consistent with what
disorder?
a. Schizoid personality disorder
b. Paranoid personality disorder
c. Schizotypal personality disorder
d. Antisocial personality disorder
28. Your client states, “I work for the
government, and I am so important in my
office that that the other people will not be
able to work without me.” This is
characteristic of:
a. A narcissistic personality disorder
b. A histrionic pepersonality disorder
c. An antisocial personality disorder
d. multiple personality disorder
29. An appropriate nursing diagnosis of a
client with a major depression is:
a. Alteration in affect
b. Alteration in activity
c. Alteration in perceptions
d. Alteration in social activity
30. A client is diagnosed with catatonic
schizophrenia. Which is the highest priority
nursing diagnosis?
a. Self-care deficit
b. Noncompliance
c. Impaired communication
d. Ineffective coping
31. A disorder where an individual may
manifest a personality that is opposite to a
previous identity is:
a. Psychogenic fugue
b. Psychogenic amnesia
c. Somatoform disorder
d. La belle indifference
32. All the major disorders except
personality disorders and mental
retardation on the multi-axial diagnosis,
appear in:
a. Axis I
b. Axis II
c. Axis III
d. Axis IV
33. For clients with paranoid disorders,
which would be an initial goal?
a. The clients will diminish suspicious
behavior.
b. The clients will develop a sense of trust
of reality that is validated by others
c. The clients will express thoughts and
feeling verbally.
d. The clients will establish trusting
relationships with staff
34. Parents are at the clinic with a child
diagnosed with attention deficit
hyperactivity disorder. Which group of
characteristics would the nurse most likely
observe in the waiting room of the clinic?
The child:
a. Plays with 2 children in the waiting
room
b. Constantly wiggles a leg when waiting
to take a turn at the board game
c. Puts the toy truck back into the
playbox only after visiting with three
other children and their parents
d. Runs over and turns on the video
player without listening to parents’
directions
35. The nurse is careful not to act rushed or
inpatient with the client and gradually
learn that the client is very down and
feel worthless and unloved. In view of the
fact that the client had previously made a
suicidal gesture, which of the
following interventions by the nurse would
be a priority at this time?
a. Ask the client frankly if she has thought
of or plans of committing suicide
b. Avoid bringing up the subject of
suicide to prevent giving the client
ideas of self-harm
c. Outline some alternative measures to
suicide for the client to use during
periods of sadness
d. Mention others the nurse has known
who have felt like the client and
attempted suicide, to draw her out
36. Malou Nau is diagnosed with major
depression spends majority of the day lying
in bed with the sheet pulled over his head.
Which of the following approaches by the
nurse would be the most therapeutic?
a. Question the client until he responds
b. Initiate contact with the client
frequently
c. Sit outside the clients room
e. Wait for the client to begin the
conversation
37. Patty Wakal who is very depressed
exhibits psychomotor retardation, a flat
affect and apathy. The nurse in charge
observes Patty to be in need of grooming
and hygiene. Which of the following nursing
actions would be most appropriate?
a. Waiting until the client’s family can
participate in the client’s care
b. Asking the client if he is ready to take
shower
c. Stating to the client that it’s time for
him to take a shower
d. Explaining the importance of hygiene
to the client
38. Terry with mania is skipping up and
down the hallway practically running into
other clients. Which of the following
activities would the nurse in charge expect
to include in Terry’s plan of care?
a. Watching TV
b. Leading group activity
c. Reading a book
b. Cleaning dayroom tables
39. When assessing a male client for
suicidal risk, which of the following
methods of suicide would the nurse identify
as most lethal?
a. Wrist cutting
b. Head banging
c. Aspirin overdose
d. Use of gun
40. When planning care for Dory with
schizotypal personality disorder, which of
the following would help the client become
involved with others?
a. Attending an activity with the nurse
b. Leading a sing a long in the afternoon
c. Being involved with primarily one to
one activities
d. Participating solely in group activities
41. Which statement about an individual
with a personality disorder is true?
a. The individual typically remains in the
mainstream of society, although he has
problems in social and occupational
roles
b. Psychotic behavior is common during
acute episodes
c. Prognosis for recovery is good with
therapeutic intervention
d. The individual usually seeks treatment
willingly for symptoms that are
personally distressful.
42. When developing a plan of care for a
female client with acute stress disorder
who lost her sister in a car accident.
Which of the following would the nurse
expect to initiate?
a. Facilitating progressive review of the
accident and its consequences
b. Postponing discussion of the accident
until the client brings it up
c. Telling the client to avoid details of the
accident
d. Helping the client to evaluate her
sister’s behavior
43. The nursing assistant tells nurse
Ronald that the client is not in the dining
room for lunch. Nurse Ronald would direct
the nursing assistant to do which of the
following?
a. Invite the client to lunch and
accompany him to the dining room
b. Tell the client he’ll need to wait until
supper to eat if he misses lunch
c. Inform the client that he has 10
minutes to get to the dining room for
lunch
d. Take the client a lunch tray and let the
client eat in his room
44. The initial nursing intervention for the
significant-others during shock phase of a
grief reaction should be focused on:
 a. Staying with the individuals involved
b. Presenting full reality of the loss of the
individuals
c. Directing the individual’s activities at
this time
d. Mobilizing the individual’s support
system
45. Joy’s stream of consciousness is
occupied exclusively with thoughts of her
father’s death. Nurse Ronald should plan to
help Joy through this stage of grieving,
which is known as:
a. Resolving the loss
b. Shock and disbelief
c. Developing awareness
d. Restitution
46. When taking a health history from a
female client who has a moderate level of
cognitive impairment due to dementia, the
nurse would expect to note the presence of:
a. Enhance intelligence
b. Accentuated premorbid traits
c. Increased inhibitions
d. Hyper vigilance
47. What is the priority care for a client
with a dementia resulting from AIDS?
a. Planning for remotivational therapy
b. Providing basic intellectual stimulation
c. Arranging for long term custodial care
d. Assessing pain frequently
48. Jerome who has eating disorder often
exhibits similar symptoms. Nurse Lhey
would expect an adolescent client with
anorexia to exhibit:
a. Dishered, unkempt physical
appearance
b. Affective instability
c. Depersonalization and derealization
d. Repetitive motor mechanisms
49. The primary nursing diagnosis for a
female client with a medical diagnosis of
major depression would be:
a. Situational low self-esteem related
to altered role
b. . Impaired verbal communication
related to depression
b. Powerlessness related to the loss of
idealized self
c. Spiritual distress related to
depression
50. When developing an initial nursing care
plan for a male client with a Bipolar I
disorder (manic episode) nurse Ron should
plan to?
a. Isolate his gym time
b. Provide foods, fluids and rest
b. Encourage his active participation in
unit programs
c. Encourage his participation in
programs
51. Grace is exhibiting withdrawn patterns
of behavior. Nurse Johnny is aware that this
type of behavior eventually produces
feeling of:
a. Repression
b. Anger
c. Loneliness
d. Paranoia
52. One morning a female client on the
inpatient psychiatric service complains to
nurse Hazel that she has been waiting for
over an hour for someone to accompany
her to activities. Nurse Hazel replies to the
client “We’re doing the best we can. There
are a lot of other people on the unit who
needs attention too.” This statement shows
that the nurse’s use of:
a. Reality reinforcement
b. Limit-setting behaviour
c. Defensive behavior
d. Impulse control
53 . A nursing diagnosis for a male client
with a diagnosed multiple personality
disorder is chronic low self-esteem
probably related to childhood abuse. The
most appropriate short term client
outcome would be:
a. Verbalizing the need for anxiety
medications
b. Recognizing each existing personality
c. Engaging in object-oriented activities
d. Eliminating defense mechanisms and
phobia
54. A 25 year old male is admitted to a
mental health facility because of
inappropriate behavior. The client has been
hearing voices, responding to imaginary
companions and withdrawing to his room
for several days at a time. Nurse Monette
understands that the withdrawal is a
defense against the client’s fear of:
a. Phobia
b. Powerlessness
b. Rejection
c. Punishment
55. When asking the parents about the
onset of problems in young client with the
diagnosis of schizophrenia, Nurse Linda
would expect that they would relate the
client’s difficulties began in:
a. Early childhood
b. Late childhood
c. Adolescence
d. Puberty
56. Jose who has been hospitalized with
schizophrenia tells Nurse Ron, “My heart
has stopped and my veins have turned to
glass!” Nurse Ron is aware that this is an
example of:
a. Depersonalization
b. Hypochondriasis
c. Echolalia
a. Somatic delusions
57. In recognizing common behaviors
exhibited by male client who has a
diagnosis of schizophrenia, nurse Josie can
anticipate:
a. Slumped posture, pessimistic out look
and flight of ideas
b. Grandiosity, arrogance and
distractibility
b. Disorientation, forgetfulness and
anxiety
c. Withdrawal, regressed behavior and
lack of social skills
58. One morning, nurse Diane finds a
disturbed client curled up in the fetal
position in the corner of the dayroom. The
most accurate initial evaluation of the
behavior would be that the client is:
a. Physically ill and experiencing
abdominal discomfort
b. Attempting to hide from the nurse
c. Tired and probably did not sleep well
last night
d. Feeling more anxious today
59. Nurse Bea notices a female client sitting
alone in the corner smiling and talking to
herself. Realizing that the client is
hallucinating. Nurse Bea should:
a. Invite the client to help decorate the
dayroom
b. Ask the client why he is smiling and
talking
b. Tell the client it is not good for
c. him to talk to himself
d. Leave the client alone until he stops
talking
60. When being admitted to a mental
health facility, a young female adult tells
Nurse Mylene that the voices she hears
frighten her. Nurse Mylene understands
that the client tends to hallucinate more
vividly:
a. While watching TV
b. During meal time
c. During group activities
b. After going to bed
61. Nurse John recognizes that paranoid
delusions usually are related to the defense
mechanism of:
a. Projection
b. Identification
c. Repression
d. Regression
62. When planning care for a male client
using paranoid ideation, nurse Jasmin
should realize the importance of:
a. Giving the client difficult tasks to
provide stimulation
b. Providing the client with activities in
which success can be achieved
c. Removing stress so that the client can
relax
b. Not placing any demands on the client
63. Nurse Gerry is aware that the defense
mechanism commonly used by clients who
are alcoholics is:
a. Displacement
b. Undoing
c. Denial
d. Compensation
64. Within a few hours of alcohol
withdrawal, nurse John should assess the
male client for the presence of:
a. Disorientation, paranoia, tachycardia
b. Tremors, fever, profuse diaphoresis
c. Irritability, heightened alertness, jerky
movements
d. Yawning, anxiety, convulsions
65. Obsessive Compulsive Personality
Disorder is characterized as:
a. Pervasive pattern of preoccupation to
orderliness and perfectionism
b. Pervasive pattern of grandiosity, and
need for admiration
c. pervasive and excessive need to be
taken cared of
d. Pervasive pattern of excessive
emotionality and attention seeking
behavior
Situation: San Chai, age 42 is brought to the
hospital by Daoming Su, who reports that
she has been neglecting her house works
and family responsibilities, eating very little
and has not left the house for the past 2
months. San Chai’s history reveals that her
7 month old daughter recently died of SIDS.
She is admitted to the psychiatric unit with
a diagnosis of depression.
66. Immediately after admission, San Chai
isolates herself in her room. the nurse
approach her with the understanding that:
a) San Chai believes she is not ill and
therefore will not socialize with others
at this point.
b) Depressed patients like her are
commonly suicidal and establishing a
trusting relationship is the key to
prevent suicide.
c) San Chai is isolating herself because
her family is not available to support
her
d) San Chai’s illness and hospitalization
for emotional problems have a
negative impact on her and her family.
67. The nurse helps San Chai to settle in.
While observing her unpack, the nurse
expects her to exhibit.
a. Fast hurried movement
b. Desire to initiate a conversation with
roommates
c. Slow, retarded movement
d. Desire to arrange belongings without
assistance
68. Early that evening, San Chai carefully
tells the nurse, “I feel so guilty. I left the
window open in my daughter’s room.
Maybe she got chilled during the night.
How should the nurse respond?
a) “You are still young. You and your
husband can have another child if you
want”
b) “I don’t think that’s what caused your
daughter’s death. You have other
children you should be concerned
about”
c) “You shouldn’t feel guilty, Why don’t
you try to forget about such sad
memories”
d) “Your daughter died of SIDS, It was not
your fault.”
69. The following day, the nurse finds San
Chai pacing the hallways, writing her
hands, picking at her hair and skin, and
saying, “ I don’t know what to do.” the most
appropriate nursing action at this time
would be:
a) encourage the patient to help water
the plants in the dayroom
b) Take the patient back to her room and
encourage her to rest
c) Calmly tell the patient to pull herself
together
d) Permit the patient to continue her
behaviour until she feels less anxious
70. After 1 week, San Chai states, “now
that my baby is dead and I’m too old
to have another one, I don’t want to
live anymore.” the nurse should
respond by saying.
a) “You shouldn’t feel so hopeless. Many
women are having babies at forties”
b) “Life doesn’t look promising to you
right now, but let’s talk about this”
c) “I care about you and I want you to
live”
d) “ What about your husband and other
children, why don’t you think of them”
71. San Chai does not respond to
medication. At a team conference, staff
members recommend ECT. When
should nursing interventions begin?
a) the night before ECT is scheduled
b) Immediately after ECT is administered
c) As soon as patient and her family are
presented with this treatment
alternative
d) when the patient returns to the unit
after ECT therapy
72. Most people respond emotionally to
the thought of electric current passing
thought their brain. When discussing
the subject with the patient, the nurse
should:
a) use the term “shock” in a neutral, calm
manner
b) Refer to the procedure as the patient’s
“treatment” instead of shock therapy
c) explain how the convulsions are
artificially induced
d) refer to it as ECT
73. San Chai and Dao Ming Su begin to
express concern about the proposed
ECT treatment. Which nursing action is
most appropriate initially:
a) Listen for misconceptions and clarify
any confusing information
b) Refer all questions to the physician
who will administer the ECT
c) Orient patient to the ECT unit so they
become familiar with the
surroundings
d) provide them with booklets
explaining the procedure in
understandable terms
74. San Chai asks the nurse, “Why do I have
to sign a consent form?” which response
is most appropriate?
a) “Your physician should have
explained this to you yesterday”
b) “It indicates that you have been fully
informed about the procedure &risks
involved”
c) “It’s a hospital rule. Just sign in
please”
d) “Most of the medications used can be
dangerous. Your consent is required”
75. When San Chai returns to her room
after awakening from the ECT
treatment, the nurse should:
a) Place a “No Visitor” sign on the
door so she can rest undisturbed
b) perform a complete Physical
Assessment
c) Orient her to place, time and
person
d) remain with her until all
confusion disappears
Psychiatric Drugs
76. Based on the knowledge of electro-
convulsive treatment, the nurse explains to
the student nurse that atropine is given
before the treatment primarily to:
a. Minimize intestinal contractions
b. Decrease anxiety
c. Dry up body secretions
e. Prevent aspiration
77. Lithium, the drug of choice for bipolar
disorders, has a narrow therapeutic range
of:
a. 0.5 mEq/L to 1.5 mEq/L
b. 0.6 mEq/L to 1.0 mEq/L
c. 0.7 mEq/L to 1.3 mEq/L
d. 1.0 mEq/L to 2.o mEq/L
78. A client is receiving monoamine oxidase
inhibitors (MAOIs) as part of the treatment.
Which food would be most important for
the nurse to stress to avoid?
a. Organ meats
b. Sardines
c. Shellfish
d. Legumes
79. A patient receiving lithium carbonate
complains of blurred vision and appears
confused. The nurse also notices that the
client is having difficulty maintaining
balance. Which of these nursing actions are
appropriate?
a. Administer a PRN antiparkinsonism
drug and hold all other drugs
b. Take the client’s vital signs and
administer high-potassium foods
c. Hold the client’s next dose of
medication and notify the physician
immediately
d. Sit with client to talk and teach the side
effects of lithium
80. Many of the major tranquilizers display
untoward side effects. The one side effect
displaying irreversible, abnormal,
involuntary movements of the tongue and
mouth is:
a. Akathisia
b. Tardive dyskinesia
c. Agranulocytosis
d. Dystonia
81. Which classification of drugs may be
used in children to treat enuresis?
a. Tricyclic antidepressant
b. Major tranquilizers
c. Antianxiety agents
d. Hypnotic
82. A client has been medicated with
trifluperazine HCl (Stelazine) for a
prolonged period of time. How would the
nurse
check for early signs of tardive dyskinesia?
a. Akathisia of the lower extremities
b. d. Vermiform movements of the tongue
c. Cogwheel rigidity at the elbow
d. Drying of the mucous membranes
83. When the nurse checks the lithium level
of a client on the unit, it is 2.0 mEq/L. What
would the interpretation/action
by the nurse be?
a. The level is within therapeutic range;
do nothing.
b. The level is below therapeutic range;
call the physician.
c. This level is high; the client should be
assessed for manifestation of toxicity.
d. The level is slightly elevated but does
not require any nursing action.
84. The nurse judges correctly that a client
is experiencing an adverse effect from
amitriptyline hydrochloride (Elavil) when
the client demonstrates
a. An elevated blood glucose level
b. Insomnia
c. Hypertension
d. Urinary retention
85.. The client has been taking lithium
carbonate (Lithane) for hyperactivity, as
prescribed by his physician. While the
client
is taking this drug, the nurse should ensure
that he has adequate intake of
a. Sodium
b. Iron
c. Iodine
d. Calcium
Treatment Modalities and Therapies
86. What is the expected outcome when
working with a client who has experienced
a crisis?
a. Stabilization of moods with
medications and return to previous
levels of functioning
b. Recovery from the crisis with total
adjustment at pre-crisis events
c. Recovery from the crisis and return to
pre-crisis levels of functioning
d. Recovery from the crisis with intense
out-client therapy
87. An actively psychotic client is being
assessed by the nurse for a participation in
a milieu group. Which is the most
appropriate group for this client?
a. A highly structured task-oriented
group
b. An activity group
c. A group is not appropriate
d. A movement therapy group, after a
short period of isolation
88. The role of the nurse in environmental
therapy includes:
a. a Referring others to work with
families, observing in groups
b. Coordinating medical care, selecting
programs
c. Observing community meetings
leading groups
d. . Coordinating team activities,
maintaining the environment 24 hrs. a
day
89. The activity therapy the nurse would
select to promote reminiscing in a group
with age over 70 is:
a. Music
b. Poetry
c. Art
d. Movement
90. The registered nurse is discussing with
a student the guidelines for the use of
restraints. Which of the statements by the
students indicates a need for clarification?
a. An adequate number of staff are needed
before restraints are attempted.
b. The use of restraints requires the
supervision of a licensed and certified
professional
c. Being restrained may help the client
gain physical control
d. A physician’s order is required initially,
followed by frequent renewal
91. A client seeks counselling from the
nurse for marital conflict that includes a
history of physical abuse. What would be
the initial intervention in this client’s plan
of care?
a. Assist the client in identifying aspects of
the client’s life that are under the
control of the client
b. Discuss issues of the use of stereotypic
gender role behavior and the effect of
violence in the family
c. Facilitate the client’s desire to gain
knowledge of the democratic family
process
d. Explain theories of family violence so
the client understands patterns in the
marital conflict
92. A client is to receive his first electro-
convulsive treatment (ECT). He states, “I’m
afraid because my roommate told me
I’ll forget everything and my memory will
never return.” What is the best response?
a. Don’t worry about it. You will get your
memory back.”
b. You may not experience memory loss,
but you still need ECT to get better.”
c. It may be best if you can’t remember
certain things.”
d. There is memory loss, but it will return
over a 2-3 week period
93. A therapist is leading in a client group.
Which is most important to the
development of the group process?
a. Goal setting
b. Planning
c. Problem-solving
d. Reality orientation
94. Therapeutic treatment of a female client
with ritualistic behavior should be directed
toward helping her to:
a. Redirect her energy into activities to
help others
b. Understand her behavior is caused by
unconscious impulses that the fears
c. Learn that her behavior is not serving
a realistic purpose
d. Forget her fears by administering
antianxiety medications
95. A client is participating in a crafty
therapy session when suddenly he begins
to shout at another client, “Stop watching
me. I know what you’re up to. I’ll get you…”
What will be the best immediate action for
the nurse to take?
a. Disband the group immediately
 b. Tell the client that no one is watching a. Giving the client canned supplements
her until the delusion subsides
c. Instruct the client to follow the nurse b. Asking what kind of poison the client
to her room suspects is being used
b. Ask the other clients to stop looking c. Serving foods that come in sealed
at this person packages
d. Allowing the client to be the first to open
96. For a male client with dysthymic the cart and get a tray
disorder, which of the following approaches
would the nurse expect to implement?
a. ECT
b. Psychoanalysis
c. Antidepressant therapy
d. Psychotherapeutic approach
97. Danny who is diagnosed with bipolar
disorder and acute mania, states the nurse,
Many of life's
“Where is my daughter? I love Louis. Rain, failures are men
rain go away. Dogs eat dirt.” The nurse
interprets these statements as indicating who did not
which of the following?
a. Flight of ideas realize how close
b. Echolalia
c. Neologism they were to
d. Clang associations
98.. Which of the following activities would
success when
Nurse Trish recommend to the client who
becomes very anxious when thoughts of
they gave up.
suicide occur?
a. Meditating Exam Prepared By: Prince Rener V. Pera, R.N.
b. Using exercise bicycle
c. Watching TV
d. Reading comics
99. When developing the plan of care for a
client receiving haloperidol, which of the
following medications would nurse Monet
anticipate administering if the client
developed extra pyramidal side effects?
a. Olanzapine (Zyprexa)
b. Paroxetine (Paxil)
c. Benztropine mesylate (Cogentin)
d. Lorazepam (Ativan)
100. Jon a suspicious client states that “I
know you nurses are spraying my food with
poison as you take it out of the cart.” Which
of the following would be the best response
of the nurse?