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Psychiatric Nursing Practice Test Part 1: Multiple Choice Questions and Answers, Exams of Psychiatry

British Columbia Institute of TechnologyPsychiatry

psychiatric nursing exam reviewer

Typology: Exams

2019/2020

Uploaded on 12/06/2021

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Psychiatric Nursing
Practice Test Part 1
1. Marco approached Nurse Trish asking
for advice on how to deal with his alcohol
addiction. Nurse Trish should tell the client
that the only effectivetreatment for
alcoholismis:
a. Psychotherapy
b. Alcoholicsanonymous(A.A.)
c. Total abstinence
d. Aversion Therapy
2. Nurse Hazel is caring for a male client
who experience false sensory perceptions
with no basis in reality. This perception is
known as:
a. Hallucinations
b. Delusions
c. Loose associations
d. Neologisms
3. Nurse Monet is caring for a female
client who has suicidal tendency. When
accompanying the client to the restroom,
Nurse Monet should…
a. Give her privacy
b. Allow her to urinate
c. Open the window and allow her
to get some fresh air
d. Observe her
4. Nurse Maureen is developing a plan of
care for a female client with anorexia nervosa.
Which action should the nurse include in the
plan?
a. Provide privacy during meals
b. Set-up a strict eating plan for the
client
c. Encourage client to exercise to
reduce anxiety
d. Restrict visits with the family
5. A client is experiencing anxiety attack.
The most appropriate nursing intervention
should include?
a. Turning onthe television
b. Leaving the client alone
c. Staying with the client and
speaking in short sentences
d. Ask the client to play with other
clients
6. A female client is admitted with a
diagnosis of delusions of GRANDEUR. This
diagnosis reflects a belief that one is:
a. Being Killed
b. Highly famous and important
c. Responsible for evil world
d. Connected to client unrelated to
oneself
7. A 20 year old client was diagnosed
with dependent personality disorder. Which
behavior isnotmost likely to be evidence of
ineffectiveindividualcoping?
a. Recurrent self-destructive
behavior
b. Avoiding relationship
c. Showing interest in solitary
activities
d. Inability to make choices and
decision without advise
8. A male client is diagnosed with
schizotypal personality disorder. Which signs
would this client exhibit during social
situation?
a. Paranoid thoughts
b. Emotional affect
c. Independence need
d. Aggressive behavior
9. Nurse Claire is caring for a client
diagnosed with bulimia. The most appropriate
initial goal for a client diagnosed with bulimia
is?
a. Encourage to avoid foods
b. Identify anxiety causing
situations
c. Eat only three meals a day
d. Avoid shopping plenty of
groceries
10. Nurse Tony was caring for a 41 year
old female client. Which behavior by the client
indicates adult cognitive development?
a. Generates new levels of
awareness
b. Assumes responsibility for her
actions
c. Has maximum ability to solve
problems and learn new skills
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pf4
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Partial preview of the text

Download Psychiatric Nursing Practice Test Part 1: Multiple Choice Questions and Answers and more Exams Psychiatry in PDF only on Docsity!

Psychiatric Nursing

Practice Test Part 1

  1. Marco approached Nurse Trish asking for advice on how to deal with his alcohol addiction. Nurse Trish should tell the client that the only effective treatment for alcoholism is: a. Psychotherapy b. Alcoholics anonymous (A.A.) c. Total abstinence d. Aversion Therapy
  2. Nurse Hazel is caring for a male client who experience false sensory perceptions with no basis in reality. This perception is known as: a. Hallucinations b. Delusions c. Loose associations d. Neologisms
  3. Nurse Monet is caring for a female client who has suicidal tendency. When accompanying the client to the restroom, Nurse Monet should… a. Give her privacy b. Allow her to urinate c. Open the window and allow her to get some fresh air d. Observe her
  4. Nurse Maureen is developing a plan of care for a female client with anorexia nervosa. Which action should the nurse include in the plan? a. Provide privacy during meals b. Set-up a strict eating plan for the client c. Encourage client to exercise to reduce anxiety d. Restrict visits with the family
  5. A client is experiencing anxiety attack. The most appropriate nursing intervention should include? a. Turning on the television b. Leaving the client alone c. Staying with the client and speaking in short sentences d. Ask the client to play with other clients 6. A female client is admitted with a diagnosis of delusions of GRANDEUR. This diagnosis reflects a belief that one is: a. Being Killed b. Highly famous and important c. Responsible for evil world d. Connected to client unrelated to oneself 7. A 20 year old client was diagnosed with dependent personality disorder. Which behavior is not most likely to be evidence of ineffective individual coping? a. Recurrent self-destructive behavior b. Avoiding relationship c. Showing interest in solitary activities d. Inability to make choices and decision without advise 8. A male client is diagnosed with schizotypal personality disorder. Which signs would this client exhibit during social situation? a. Paranoid thoughts b. Emotional affect c. Independence need d. Aggressive behavior 9. Nurse Claire is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is? a. Encourage to avoid foods b. Identify anxiety causing situations c. Eat only three meals a day d. Avoid shopping plenty of groceries 10. Nurse Tony was caring for a 41 year old female client. Which behavior by the client indicates adult cognitive development? a. Generates new levels of awareness b. Assumes responsibility for her actions c. Has maximum ability to solve problems and learn new skills

d. Her perception are based on reality

  1. A neuromuscular blocking agent is administered to a client before ECT therapy. The Nurse should carefully observe the client for? a. Respiratory difficulties b. Nausea and vomiting c. Dizziness d. Seizures
  2. A 75 year old client is admitted to the hospital with the diagnosis of dementia of the Alzheimer’s type and depression. The symptom that is unrelated to depression would be? a. Apathetic response to the environment b. “I don’t know” answer to questions c. Shallow of labile effect d. Neglect of personal hygiene
  3. Nurse Trish is working in a mental health facility; the nurse priority nursing intervention for a newly admitted client with bulimia nervosa would be to? a. Teach client to measure I & O b. Involve client in planning daily meal c. Observe client during meals d. Monitor client continuously
  4. Nurse Patricia is aware that the major health complication associated with intractable anorexia nervosa would be? a. Cardiac dysrhythmias resulting to cardiac arrest b. Glucose intolerance resulting in protracted hypoglycemia c. Endocrine imbalance causing cold amenorrhea d. Decreased metabolism causing cold intolerance
  5. Nurse Anna can minimize agitation in a disturbed client by? a. Increasing stimulation b. limiting unnecessary interaction c. increasing appropriate sensory perception d. ensuring constant client and staff contact
    1. A 39 year old mother with obsessive- compulsive disorder has become immobilized by her elaborate hand washing and walking rituals. Nurse Trish recognizes that the basis of O.C. disorder is often: a. Problems with being too conscientious b. Problems with anger and remorse c. Feelings of guilt and inadequacy d. Feeling of unworthiness and hopelessness
    2. Mario is complaining to other clients about not being allowed by staff to keep food in his room. Which of the following interventions would be most appropriate? a. Allowing a snack to be kept in his room b. Reprimanding the client c. Ignoring the clients behavior d. Setting limits on the behavior
    3. Conney with borderline personality disorder who is to be discharge soon threatens to “do something” to herself if discharged. Which of the following actions by the nurse would be most important? a. Ask a family member to stay with the client at home temporarily b. Discuss the meaning of the client’s statement with her c. Request an immediate extension for the client d. Ignore the clients statement because it’s a sign of manipulation
    4. Joey a client with antisocial personality disorder belches loudly. A staff member asks Joey, “Do you know why people find you repulsive?” this statement most likely would elicit which of the following client reaction? a. Depensiveness b. Embarrassment c. Shame d. Remorsefulness
    5. Which of the following approaches would be most appropriate to use with a client suffering from narcissistic personality disorder
  1. Linda is pacing the floor and appears extremely anxious. The duty nurse approaches in an attempt to alleviate Linda’s anxiety. The most therapeutic question by the nurse would be? a. Would you like to watch TV? b. Would you like me to talk with you? c. Are you feeling upset now? d. Ignore the client
  2. Nurse Penny is aware that the symptoms that distinguish post traumatic stress disorder from other anxiety disorder would be: a. Avoidance of situation & certain activities that resemble the stress b. Depression and a blunted affect when discussing the traumatic situation c. Lack of interest in family & others d. Re-experiencing the trauma in dreams or flashback
  3. Nurse Benjie is communicating with a male client with substance-induced persisting dementia; the client cannot remember facts and fills in the gaps with imaginary information. Nurse Benjie is aware that this is typical of? a. Flight of ideas b. Associative looseness c. Confabulation d. Concretism
  4. Nurse Joey is aware that the signs & symptoms that would be most specific for diagnosis anorexia are? a. Excessive weight loss, amenorrhea & abdominal distension b. Slow pulse, 10% weight loss & alopecia c. Compulsive behavior, excessive fears & nausea d. Excessive activity, memory lapses & an increased pulse
  5. A characteristic that would suggest to Nurse Anne that an adolescent may have bulimia would be: a. Frequent regurgitation & re- swallowing of food b. Previous history of gastritis c. Badly stained teeth d. Positive body image
    1. Nurse Monette is aware that extremely depressed clients seem to do best in settings where they have: a. Multiple stimuli b. Routine Activities c. Minimal decision making d. Varied Activities
    2. To further assess a client’s suicidal potential. Nurse Katrina should be especially alert to the client expression of: a. Frustration & fear of death b. Anger & resentment c. Anxiety & loneliness d. Helplessness & hopelessness
    3. A nursing care plan for a male client with bipolar I disorder should include: a. Providing a structured environment b. Designing activities that will require the client to maintain contact with reality c. Engaging the client in conversing about current affairs d. Touching the client provide assurance
    4. When planning care for a female client using ritualistic behavior, Nurse Gina must recognize that the ritual: a. Helps the client focus on the inability to deal with reality b. Helps the client control the anxiety c. Is under the client’s conscious control d. Is used by the client primarily for secondary gains
    5. A 32 year old male graduate student, who has become increasingly withdrawn and neglectful of his work and personal hygiene, is brought to the psychiatric hospital by his parents. After detailed assessment, a diagnosis of schizophrenia is made. It is unlikely that the client will demonstrate: a. Low self esteem b. Concrete thinking c. Effective self boundaries

d. Weak ego

  1. A 23 year old client has been admitted with a diagnosis of schizophrenia says to the nurse “Yes, its march, March is little woman”. That’s literal you know”. These statement illustrate: a. Neologisms b. Echolalia c. Flight of ideas d. Loosening of association
  2. A long term goal for a paranoid male client who has unjustifiably accused his wife of having many extramarital affairs would be to help the client develop: a. Insight into his behavior b. Better self control c. Feeling of self worth d. Faith in his wife
  3. A male client who is experiencing disordered thinking about food being poisoned is admitted to the mental health unit. The nurse uses which communication technique to encourage the client to eat dinner? a. Focusing on self-disclosure of own food preference b. Using open ended question and silence c. Offering opinion about the need to eat d. Verbalizing reasons that the client may not choose to eat
  4. Nurse Nina is assigned to care for a client diagnosed with Catatonic Stupor. When Nurse Nina enters the client’s room, the client is found lying on the bed with a body pulled into a fetal position. Nurse Nina should? a. Ask the client direct questions to encourage talking b. Rake the client into the dayroom to be with other clients c. Sit beside the client in silence and occasionally ask open-ended question d. Leave the client alone and continue with providing care to the other clients
  5. Nurse Tina is caring for a client with delirium and states that “look at the spiders on the wall”. What should the nurse respond to the client? a. “You’re having hallucination, there are no spiders in this room at all” b. “I can see the spiders on the wall, but they are not going to hurt you” c. “Would you like me to kill the spiders” d. “I know you are frightened, but I do not see spiders on the wall”
  6. Nurse Jonel is providing information to a community group about violence in the family. Which statement by a group member would indicate a need to provide additional information? a. “Abuse occurs more in low- income families” b. “Abuser Are often jealous or self- centered” c. “Abuser use fear and intimidation” d. “Abuser usually have poor self- esteem”
  7. During electroconvulsive therapy (ECT) the client receives oxygen by mask via positive pressure ventilation. The nurse assisting with this procedure knows that positive pressure ventilation is necessary because? a. Anesthesia is administered during the procedure b. Decrease oxygen to the brain increases confusion and disorientation c. Grand mal seizure activity depresses respirations d. Muscle relaxations given to prevent injury during seizure activity depress respirations.
  8. When planning the discharge of a client with chronic anxiety, Nurse Chris evaluates achievement of the discharge maintenance goals. Which goal would be most appropriately having been included in the plan of care requiring evaluation? a. The client eliminates all anxiety from daily situations b. The client ignores feelings of anxiety

consistent approach by the staff is necessary to decrease manipulation.

  1. B. Any suicidal statement must be assessed by the nurse. The nurse should discuss the client’s statement with her to determine its meaning in terms of suicide.
  2. A. When the staff member ask the client if he wonders why others find him repulsive, the client is likely to feel defensive because the question is belittling. The natural tendency is to counterattack the threat to self image.
  3. B. The nurse would specifically use supportive confrontation with the client to point out discrepancies between what the client states and what actually exists to increase responsibility for self.
  4. C. The nurse would most likely administer benzodiazepine, such as lorazepan (ativan) to the client who is experiencing symptom: The client’s experiences symptoms of withdrawal because of the rebound phenomenon when the sedation of the CNS from alcohol begins to decrease.
  5. D. Regular coffee contains caffeine which acts as psychomotor stimulants and leads to feelings of anxiety and agitation. Serving coffee top the client may add to tremors or wakefulness.
  6. D. Vomiting and diarrhea are usually the late signs of heroin withdrawal, along with muscle spasm, fever, nausea, repetitive, abdominal cramps and backache.
  7. D. Moving to a client’s personal space increases the feeling of threat, which increases anxiety.
  8. A. Environmental (MILIEU) therapy aims at having everything in the client’s surrounding area toward helping the client.
  9. C. Children who have experienced attachment difficulties with primary caregiver are not able to trust others and therefore relate superficially
  10. A. Children have difficulty verbally expressing their feelings, acting out behavior, such as temper tantrums, may indicate underlying depression.
  11. D. The autistic child repeat sounds or words spoken by others.
  12. D. The client statement is an example of the use of denial, a defense that blocks problem by unconscious refusing to admit they exist.
  13. A. Discussion of the feared object triggers an emotional response to the object.
  14. B. The nurse presence may provide the client with support & feeling of control.
  15. D. Experiencing the actual trauma in dreams or flashback is the major symptom that distinguishes post traumatic stress disorder from other anxiety disorder.
  16. C. Confabulation or the filling in of memory gaps with imaginary facts is a defense mechanismused by people experiencing memory deficits.
  17. A. These are the major signs of anorexia nervosa. Weight loss is excessive (15% of expected weight).
  18. C. Dental enamel erosion occurs from repeated self-induced vomiting.
  19. B. Depression usually is both emotional & physical. A simple daily routine is the best, least stressful and least anxiety producing.
  20. D. The expression of these feeling may indicate that this client is unable to continue the struggle of life.
  21. A. Structure tends to decrease agitation and anxiety and to increase the client’s feeling of security.
  22. B. The rituals used by a client with obsessive compulsive disorder help control the anxiety level by maintaining a set pattern of action.
  23. C. A person with this disorder would not have adequate self-boundaries.
  24. D. Loose associations are thoughts that are presented without the logical connections usually necessary for the listening to interpret the message.
  1. C. Helping the client to develop feeling of self worth would reduce the client’s need to use pathologic defenses.
  2. B. Open ended questions and silence are strategies used to encourage clients to discuss their problem in descriptive manner.
  3. C. Clients who are withdrawn may be immobile and mute, and require consistent, repeated interventions. Communication with withdrawn clients requires much patience from the nurse.The nurse facilitates communication with the client by sitting in silence, asking open- ended question and pausing to provide opportunities for the client to respond.
  4. D. When hallucination is present, the nurse should reinforce reality with the client.
  5. A. Personal characteristics of abuser include low self-esteem, immaturity, dependence, insecurity and jealousy.
  6. D. A short acting skeletal muscle relaxant such as succinylcholine (Anectine) is administered during this procedure to prevent injuries during seizure.
  7. C. Recognizing situations that produce anxiety allows the client to prepare to cope with anxiety or avoid specific stimulus.
  8. D. Electroconvulsive therapy is an effective treatment for depression that has not responded to medication.
  9. B. In an emergency, lives saving facts are obtained first. The name and the amount of medication ingested are of outmost important in treating this potentially life threatening situation.

Psychiatric Nursing

Practice Test Part 2

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.”

  1. Which of the following activities would Nurse Trish recommend to the client who becomes very anxious when thoughts of suicide occur? a. Using exercise bicycle b. Meditating c. Watching TV d. Reading comics
  2. 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)
  3. 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? a. Giving the client canned supplements until the delusion subsides b. Asking what kind of poison the client suspects is being used c. Serving foods that come in sealed packages d. Allowing the client to be the first to open the cart and get a tray
  4. A client is suffering from catatonic behaviors. Which of the following would the nurse use to determine that the medication administered PRN have been most effective? a. The client responds to verbal directions to eat b. The client initiates simple activities without direction c. The client walks with the nurse to her room d. The client is able to move all extremities occasionally
    1. Nurse Hazel invites new client’s parents to attend the psycho educational program for families of the chronically mentally ill. The program would be most likely to help the family with which of the following issues? a. Developing a support network with other families b. Feeling more guilty about the client’s illness c. Recognizing the client’s weakness d. Managing their financial concern and problems
    2. 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. Participating solely in group activities d. Being involved with primarily one to one activities
    3. Which statement about an individual with a personality disorder is true? a. Psychotic behavior is common during acute episodes b. Prognosis for recovery is good with therapeutic intervention c. The individual typically remains in the mainstream of society, although he has problems in social and occupational roles d. The individual usually seeks treatment willingly for symptoms that are personally distressful.
    4. 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. Suggesting to apologize to others for his behavior d. Explaining the negative reactions of others toward his behavior

  1. Tina with a histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner. Nurse Trish would recommend which of the following activities for Tina? a. Baking class b. Role playing c. Scrap book making d. Music group
  2. Joy has entered the chemical dependency unit for treatment of alcohol dependency. Which of the following client’s possession will the nurse most likely place in a locked area? a. Toothpaste b. Shampoo c. Antiseptic wash d. Moisturizer
  3. Which of the following assessment would provide the best information about the client’s physiologic response and the effectiveness of the medication prescribed specifically for alcohol withdrawal? a. Sleeping pattern b. Mental alertness c. Nutritional status d. Vital signs
  4. After administering naloxone (Narcan), an opioid antagonist, Nurse Ronald should monitor the female client carefully for which of the following? a. Respiratory depression b. Epilepsy c. Kidney failure d. Cerebral edema
  5. Which of the following would nurse Ronald use as the best measure to determine a client’s progress in rehabilitation? a. The way he gets along with his parents b. The number of drug-free days he has c. The kinds of friends he makes d. The amount of responsibility his job entails
    1. A female client is brought by ambulance to the hospital emergency room after taking an overdose of barbiturates is comatose. Nurse Trish would be especially alert for which of the following? a. Epilepsy b. Myocardial Infarction c. Renal failure d. Respiratory failure
    2. Joey who has a chronic user of cocaine reports that he feels like he has cockroaches crawling under his skin. His arms are red because of scratching. The nurse in charge interprets these findings as possibly indicating which of the following? a. Delusion b. Formication c. Flash back d. Confusion
    3. Jose is diagnosed with amphetamine psychosis and was admitted in the emergency room. Nurse Ronald would most likely prepare to administer which of the following medication? a. Librium b. Valium c. Ativan d. Haldol
    4. Which of the following liquids would nurse Leng administer to a female client who is intoxicated with phencyclidine (PCP) to hasten excretion of the chemical? a. Shake b. Tea c. Cranberry Juice d. Grape juice
    5. 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

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. Defensive behavior b. Reality reinforcement c. Limit-setting behavior d. Impulse control

  1. 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
  2. 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 c. Punishment d. Rejection
  3. 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
  4. 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. Somatic delusions b. Depersonalization c. Hypochondriasis d. Echolalia
    1. 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 c. Withdrawal, regressed behavior and lack of social skills d. Disorientation, forgetfulness and anxiety
    2. 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. Tired and probably did not sleep well last night c. Attempting to hide from the nurse d. Feeling more anxious today
    3. 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. Leave the client alone until he stops talking c. Ask the client why he is smiling and talking d. Tell the client it is not good for him to talk to himself
    4. 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 d. After going to bed
    5. Nurse John recognizes that paranoid delusions usually are related to the defense mechanism of:

a. Projection b. Identification c. Repression d. Regression

  1. 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 d. Not placing any demands on the client
  2. Nurse Gerry is aware that the defense mechanism commonly used by clients who are alcoholics is: a. Displacement b. Denial c. Projection d. Compensation
  3. 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

Answers and Rationale

Psychiatric Nursing

Practice Test Part 2

  1. C. When the nurse and client agree to work together, a contract should be established, the length of the relationship should be discussed in terms of its ultimate termination.
  2. B. The nurse should initiate brief, frequent contacts throughout the day to let the client know that he is important to the nurse. This will positively affect the client’s self-esteem.
  3. D. The client with depression is preoccupied, has decreased energy, and is unable to make decisions. The nurse presents the situation, “It’s time for a shower”, and assists the client with personal hygiene to preserve his dignity and self-esteem.
  4. C. Foods high in tyramine, those that are fermented, pickled, aged, or smoked must be avoided because when they are ingested in combination with MAOIs a hypertensive crisis will occur.
  5. A. Anticholinergic effects, which result from blockage of the parasympathetic (craniosacral) nervous system including urine retention, blurred vision, dry mouth & constipation.
  6. B. Dysthymia is a less severe, chronic depression diagnosed when a client has had a depressed mood for more days than not over a period of at least 2 years. Client with dysthymic disorder benefit from psychotherapeutic approaches that assist the client in reversing the negative self image, negative feelings about the future.
  7. D. Flight of ideas is speech pattern of rapid transition from topic to topic, often without finishing one idea. It is common in mania.
  8. B. The client with mania is very active & needs to have this energy channeled in a constructive task such as cleaning or tidying the room.
  9. C. A crucial factor is determining the lethality of a method is the amount of time that occurs between initiating the method & the delivery of the lethal impact of the method.
  10. D. The statement “I don’t think about killing myself as much as I used to.” Indicates a lessening of suicidal ideation and improvement in the client’s condition.
  11. A. Using exercise bicycle is appropriate for the client who becomes very anxious when thoughts of suicidal occur.
  12. C. The drug of choice for a client experiencing extra pyramidal side effects from haloperidol (Haldol) is benztropine mesylate (cogentin) because of its anti cholinergic properties.

feelings & memories and to begin the grieving process.

  1. B. The nurse instructs the nursing assistant to invite the client to lunch & accompany him to the dinning room to decrease manipulation, secondary gain, dependency and reinforcement of negative behavior while maintaining the client’s worth.
  2. C. This provides support until the individuals coping mechanisms and personal support systems can be immobilized.
  3. C. Resolving a loss is a slow, painful, continuous process until a mental image of the dead person, almost devoid of negative or undesirable features emerges.
  4. A. A moderate level of cognitive impairment due to dementia is characterized by increasing dependence on environment & social structure and by increasing psychologic rigidity with accentuated previous traits & behaviors.
  5. C. This action maintains for as long as possible, the clients intellectual functions by providing an opportunity to use them.
  6. A. Individuals with anorexia often display irritability, hospitality, and a depressed mood.
  7. D. Depressed clients demonstrate decreased communication because of lack of psychic or physical energy.
  8. C. The client in a manic episode of the illness often neglects basic needs, these needs are a priority to ensure adequate nutrition, fluid, and rest.
  9. B. The withdrawn pattern of behavior presents the individual from reaching out to others for sharing the isolation produces feeling of loneliness.
  10. A. The nurse’s response is not therapeutic because it does not recognize the client’s needs but tries to make the client feel guilty for being demanding.
  11. B. The client must recognize the existence of the sub personalities so that interpretation can occur.
  12. D. An aloof, detached, withdrawn posture is a means of protecting the self by withdrawing and maintaining a safe, emotional distance.
  13. C. The usual age of onset of schizophrenia is adolescence or early childhood.
  14. A. Somatic delusion is a fixed false belief about one’s body.
  15. C. These are the classic behaviors exhibited by clients with a diagnosis of schizophrenia.
  16. D. The fetal position represents regressed behavior. Regression is a way of responding to overwhelming anxiety.
  17. B. This provides a stimulus that competes with and reduces hallucination.
  18. D. Auditory hallucinations are most troublesome when environmental stimuli are diminished and there are few competing distractions.
  19. A. Projection is a mechanism in which inner thoughts and feelings are projected onto the environment, seeming to come from outside the self rather than from within.
  20. B. This will help the client develop self- esteem and reduce the use of paranoid ideation.
  21. B. Denial is a method of resolving conflict or escaping unpleasant realities by ignoring their existence.
  22. C. Alcohol is a central nervous system depressant. These symptoms are the body’s neurologic adaptation to the withdrawal of alcohol.

Psychiatric Nursing

Practice Test Part 3

  1. Francis who is addicted to cocaine withdraws from the drug. Nurse Ron should expect to observe: a. Hyperactivity b. Depression c. Suspicion d. Delirium
  2. Nurse John is aware that a serious effect of inhaling cocaine is? a. Deterioration of nasal septum b. Acute fluid and electrolyte imbalances c. Extra pyramidal tract symptoms d. Esophageal varices
  3. A tentative diagnosis of opiate addiction, Nurse Candy should assess a recently hospitalized client for signs of opiate withdrawal. These signs would include: a. Rhinorrhea, convulsions, subnormal temperature b. Nausea, dilated pupils, constipation c. Lacrimation, vomiting, drowsiness d. Muscle aches, papillary constriction, yawning
  4. A 48 year old male client is brought to the psychiatric emergency room after attempting to jump off a bridge. The client’s wife states that he lost his job several months ago and has been unable to find another job. The primary nursing intervention at this time would be to assess for: a. A past history of depression b. Current plans to commit suicide c. The presence of marital difficulties d. Feelings of excessive failure
  5. Before helping a male client who has been sexually assaulted, nurse Maureen should recognize that the rapist is motivated by feelings of: a. Hostility b. Inadequacy c. Incompetence d. Passion
    1. When working with children who have been sexually abused by a family member it is important for the nurse to understand that these victims usually are overwhelmed with feelings of: a. Humiliation b. Confusion c. Self blame d. Hatred
    2. Joy who has just experienced her second spontaneous abortion expresses anger towards her physician, the hospital and the “rotten nursing care”. When assessing the situation, the nurse recognizes that the client may be using the coping mechanism of: a. Projection b. Displacement c. Denial d. Reaction formation
    3. The most critical factor for nurse Linda to determine during crisis intervention would be the client’s: a. Available situational supports b. Willingness to restructure the personality c. Developmental theory d. Underlying unconscious conflict
    4. Nurse Trish suggests a crisis intervention group to a client experiencing a developmental crisis.These groups are successful because the: a. Crisis intervention worker is a psychologist and understands behavior patterns b. Crisis group supplies a workable solution to the client’s problem c. Client is encouraged to talk about personal problems d. Client is assisted to investigate alternative approaches to solving the identified problem
    5. Nurse Ronald could evaluate that the staff’s approach to setting limits for a demanding, angry client was effective if the client: a. Apologizes for disrupting the unit’s routine when something is needed

d. Decreased respiratory rate

  1. Initial interventions for Marco with acute anxiety include all except which of the following? a. Touching the client in an attempt to comfort him b. Approaching the client in calm, confident manner c. Encouraging the client to verbalize feelings and concerns d. Providing the client with a safe, quiet and private place
  2. Nurse Jessie is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety is: a. Uticaria b. Vertigo c. Sedation d. Diarrhea
  3. When performing a physical examination on a female anxious client, nurse Nelli would expect to find which of the following effects produced by the parasympathetic system? a. Muscle tension b. Hyperactive bowel sounds c. Decreased urine output d. Constipation
  4. Which of the following drugs have been known to be effective in treating obsessive- compulsive disorder (OCD)? a. Divalproex (depakote) and Lithium (lithobid) b. Chlordiazepoxide (Librium) and diazepam (valium) c. Fluvoxamine (Luvox) and clomipramine (anafranil) d. Benztropine (Cogentin) and diphenhydramine (benadryl)
  5. Tony with agoraphobia has been symptom- free for 4 months. Classic signs and symptoms of phobia include: a. Severe anxiety and fear b. Withdrawal and failure to distinguish reality from fantasy c. Depression and weight loss d. Insomnia and inability to concentrate
    1. Which nursing action is most appropriate when trying to diffuse a client’s impending violent behavior? a. Place the client in seclusion b. Leaving the client alone until he can talk about his feelings c. Involving the client in a quiet activity to divert attention d. Helping the client identify and express feelings of anxiety and anger
    2. Rosana is in the second stage of Alzheimer’s disease who appears to be in pain. Which question by Nurse Jenny would best elicit information about the pain? a. “Where is your pain located?” b. “Do you hurt? (pause) “Do you hurt?” c. “Can you describe your pain?” d. “Where do you hurt?”
    3. Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for: a. General anesthesia b. Cardiac stress testing c. Neurologic examination d. Physical therapy
    4. Jose who is receiving monoamine oxidase inhibitor antidepressant should avoid tyramine, a compound found in which of the following foods? a. Figs and cream cheese b. Fruits and yellow vegetables c. Aged cheese and Chianti wine d. Green leafy vegetables
    5. Erlinda, age 85, with major depression undergoes a sixth electroconvulsive therapy (ECT) treatment. When assessing the client immediately after ECT, the nurse expects to find: a. Permanent short-term memory loss and hypertension b. Permanent long-term memory loss and hypomania c. Transitory short-term memory loss and permanent long-term memory loss

d. Transitory short and long term memory loss and confusion

  1. Barbara with bipolar disorder is being treated with lithium for the first time. Nurse Clint should observe the client for which common adverse effect of lithium? a. Polyuria b. Seizures c. Constipation d. Sexual dysfunction
  2. Nurse Fred is assessing a client who has just been admitted to the ER department. Which signs would suggest an overdose of an antianxiety agent? a. Suspiciousness, dilated pupils and incomplete BP b. Agitation, hyperactivity and grandiose ideation c. Combativeness, sweating and confusion d. Emotional lability, euphoria and impaired memory
  3. Discharge instructions for a male client receiving tricyclic antidepressants include which of the following information? a. Restrict fluids and sodium intake b. Don’t consume alcohol c. Discontinue if dry mouth and blurred vision occur d. Restrict fluid and sodium intake
  4. Important teaching for women in their childbearing years who are receiving antipsychotic medications includes which of the following? a. Increased incidence of dysmenorrhea while taking the drug b. Occurrence of incomplete libido due to medication adverse effects c. Continuing previous use of contraception during periods of amenorrhea d. Instruction that amenorrhea is irreversible
  5. A client refuses to remain on psychotropic medications after discharge from an inpatient psychiatric unit. Which information should the community health nurse assess first during the initial follow-up with this client? a. Income level and living arrangements b. Involvement of family and support systems c. Reason for inpatient admission d. Reason for refusal to take medications
  6. The nurse understands that the therapeutic effects of typical antipsychotic medications are associated with which neurotransmitter change? a. Decreased dopamine level b. Increased acetylcholine level c. Stabilization of serotonin d. Stimulation of GABA
  7. Which of the following best explains why tricyclic antidepressants are used with caution in elderly patients? a. Central Nervous System effects b. Cardiovascular system effects c. Gastrointestinal system effects d. Serotonin syndrome effects
  8. A client with depressive symptoms is given prescribed medications and talks with his therapist about his belief that he is worthless and unable to cope with life. Psychiatric care in this treatment plan is based on which framework? a. Behavioral framework b. Cognitive framework c. Interpersonal framework d. Psychodynamic framework
  9. A nurse who explains that a client’s psychotic behavior is unconsciously motivated understands that the client’s disordered behavior arises from which of the following? a. Abnormal thinking b. Altered neurotransmitters c. Internal needs d. Response to stimuli
  10. A client with depression has been hospitalized for treatment after taking a leave of absence from work. The client’s employer expects the client to return to work following inpatient treatment. The