A1 PASSERS TRAINING, RESEARCH REVIEW AND DEVELOPMENT COMPANY

COMPETENCY APPRAISAL
NURSING PRACTICE V Care of Clients with Physiologic and Psychosocial Alterations
GENERAL INSTRUCTIONS:
1. This test booklet contains 100 test questions
2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheet.
3. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your
answer.
4. AVOID ERASURES.
INSTRUCTIONS:
1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set.
2. Write the subject title Nursing Practice V on the box provided.
3. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B.
SAFE AND QUALITY NURSING CARE
Situation. Nurse Loila is assigned in patient confronted with various neurologic problem. In delivering her care, she
sees to it that her patients accepts the holistic care that they rightly deserve
1. A mother arrives at the ER with her 5 year- old child and states that the child fell off the ebd. A head injury is suspected
and the nurse checks the child for signs of increased ICP. Which of the following is the late sign of increased ICP?
a. Nausea
c. bulging fontanel
b. projectile vomiting
d. widening pulse pressure
2. In the event of increased ICP, which of the following activities will nurse Loila as much as possible avoid in taking care of
the child?
a. Tepid sponge bath in case of fever
d. Administration of Mannitol as ordered by the
b. Log rolling the client in changing position
physician
c. suctioning the client q4h to clear the airway
3. The following are manifested in a 74 year old client with Parkinsons disease except:
a. bradykinesia
c. involuntary tremors
b. mask- like appearence
d. tardive dyskinesia
4. A nurse is assisting in collecting data on an 8 month- old infant with a diagnosis of hydrocephalus. Nurse Loila checks for
the major symptoms associated with hydrocephalus which includes which of the following?
a. taking the apical pulse
d. testing the urine for the presence of Benceb. palpating the anterior fontanel
Jones protein
c. taking the blood pressure
5. Nurse Loila is aware that which of the following position is indicated for a post- supra tentorial craniotomy patient?
a. semi- fowlers
c. dorsal recumbent
b. flat in bed
d. side- lying position
6. Another patient was admitted in the unit with the diagnosis of multiple sclerosis. Which of the following symptoms will be
seen as initial sign of this disease?
a. diplopia
c. dumping syndrome
b. muscle weakness
d. decreased level of consciousness
7. Nurse Loila is aware that which of the following signs presented by the patient with myasthenia gravis who is presenting
symptoms as side effect of cholinergic drugs?
a. dry mouth, urinary retention, broncho-dilation, vasoconstriction
b. broncho-constriction, dry mouth, vasoconstriction
c. broncho- constriction, vasodilation, papillary constriction
d. broncho- constriction, vasoconstriction, papillary constriction
8. Another patient was admitted in the unit with Guillane- Barre syndrome. Nurse Loila review the history of the client and
expects to note which of the following?
a. history of sexually transmitted disease
c. history of alcoholism
b. history of upper respiratory tract and
d. chronic cigarette smoking
gastrointestinal infections
9. Nurse Loila also has the correct understanding of the above disease process when she stated which of the following in
the health teaching, except?
a. complete recovery is possible
b. the resolution of ascending paralysis follows a descending pattern
c. there is a period of remission and exacerbation
d. respiratory depression is one of its presenting symptoms
10. What is the priority nursing diagnosis for clients with Guillane- Barre syndrome?
a. Ineffective breathing Pattern
c. Impaired Physical Mobility
b. Altered Nutrition: less than body requirements
d. Risk for Impaired Tissue Integrit
Situation: Nurse Fiona is assisting a client with Eyes and Ears disorders. She is using her proper judgment in
taking care of her patients and sees to it that they are comfortable and recovers in the disease process without
complications.
11. Melrose is having a difficulty in her hearing and balance. Upon assessment, nurse Fiona would most likely pay particular
attention to the functioning of what cranial nerve?
a. CN 4
c. CN 8
b. CN 5
d. CN 10
12. Tonometry is performed on the client with suspected diagnosis of glaucoma. The nurse Fiona is aware that the normal
intraocular pressure is:
a. 10-20 mmHg
c. 22- 30 mmHg
b. 2-7 mmHg
d. 31-35 mmHg

13. A client is being discharged after cataract removal and the nurse reinforces instruction regarding home care. Which of
the following , if stated by the client indicates understanding of the instruction?
a. I will not lift anything if it weighs more than 10 lbs
b. I will take aspirin if I have any discomfort
c. I will wear my eye shield at night and my glasses during the day
d. I will wear an eye patch to prevent my affected eye from bleeding
14. A nurse assigned to care for client hospitalized with Menieres disease the nurse expects that which of the following
would be most likely be prescribed for the client?
a. low cholesterol diet
c. low carbohydrate diet
b. low sodium diet
d. low fat diet
15. A client with Menieres disease is experiencing severe vertigo. The nurse instructs the client to do which of the following
to assist in controlling the vertigo.
a. Increased fluid intake to 3000 mL/day
c. lie still and listen to rock music
b. avoid sudden head movements
d. increase sodium in the diet
Situation:There is an increasing incidence of eating disorders in the country. As a nurse assigned to take care of
these clients, Nurse Bulemya is well- versed in addressing their needs as well as upholding a rightful care.
16. The nurse realizes that a typical characteristic of clients with anorexia nervosa is they:
A. have problems with self control
C. exercise relentlessly
B. do poorly in school
D. are truthful in reporting their eating habits
E. 17. Nurse Bulemya is aware that the signs & symptoms that would be most specific for diagnosis
anorexia are?
A. Excessive weight loss, amenorrhea & abdominal
C. Compulsive behavior, excessive fears & nausea
distension
D. Excessive activity, memory lapses & an increased
B. Slow pulse, 10% weight loss & alopecia
pulse
E. 18. Nurse Kathy is aware that the major health complication associated with intractable anorexia nervosa would
be?
A. Cardiac dysrhythmias resulting to cardiac arrest
C. Endocrine imbalance causing cold amenorrhea
B. Glucose intolerance resulting in protracted
D. Decreased metabolism causing cold intolerance
hypoglycemia
E. 19.
Nurse Bulemya 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
C. Eat only three meals a day
B. Identify anxiety causing situations
D. Avoid shopping plenty of groceries
E. 20. A characteristic that would suggest to Nurse Bulemya that an adolescent may have bulimia would be:
A.
Frequent regurgitation & re-swallowing of food
C.
Badly stained teeth
B.
Previous history of gastritis
D.
Positive body image
E.
F.
Situation: Nurse Rhea is dealing with patients with mood disorders. In every patients, she sees to it that
their needs are addressed based on their developmental levels.
G.
21. A priority nursing intervention for a client experiencing an acute manic episode?
A. discourage the clients use of vulgar language
C. maintain the clients contact with his/her family
B. protect the client from impulsive behavior
D. redirect excessive energy to creative tasks
E. 22. After 6 months on l ithium (lithane), the physician determines that the client is no longer responding
well. After discontinuing the lithium, the physician prescribes valproicacid (depakote), an
anticonvulsant that is also effective in bipolar disorders. What special instructions should the nurse
give the client about valproic acid?
A. a pre-treatment EEG must be done and repeated in six months
B. The white blood count must be monitored regularly
C. liver function and hematology levels must be monitored regularly
D. thyroid function tests must be done every six months
F. 23. The nurse knows an appropriate short term goal for a client exhibiting manic behavior is for the
client to:
A. identify three strengths
C. chair the units self-government meeting
B. compete in a unit volley ball game
D. paint alone for 15 minutes
E. 24. A client is admitted with a history of extremely elevated, irritable mood for a week. On assessment the
nurse notes grandiosity, insomnia, flight of ideas, and psychomotor agitation. The nurse sets as a priority
short term goal: the client will demonstrate:
A. improvement in judgement
C. understanding of medication regimen
B. adequate nutrition and rest
D. stability of mood
E. 25. Nurse Michaela is aware that one of the best approach to the client who is showing an aggressive
behavior and insisting that the television be switched on the channel that is not amenable to the other
members of the group would be:
A. tell him that his request could not be granted because others are also watching T.V
B. allow him to switch the channel for 1 hour
C. tell him to go to the room and never come out unless told to do so
D. call the guard and restrain him
F.
Situation: Dementia is one of the most difficult and trying conditions that a patient will ever experience. It
gives them the feeling of being isolated and even detached with their own selves and identity.
G. 26. A 75 year old client is admitted to the hospital with the diagnosis of dementia of the Alzheimers type
and depression. The symptom that is unrelated to depression would be?
A. Apathetic response to the environment
C. Show of labile effect
B. I dont know answer to questions
D. Neglect of personal hygiene
E. 27. In the early stages of Alzheimers disease, the nurse would anticipate that a client will retain the ability to:
A. cope with stressful experiences
C. remember a daily schedule
B. solve simple mathematical problems
D. recall the events of the distant past

A. diazepam
E.(valium)
28. Anas
elderly
needed
client with Alzheimers disease hasC.
begun
chlorpromazine
to strike out at
(thorazine)
staff members
three when
times they
a daytry to
B. haloperidol (haldol)
assist the
at bedtime
client to bed at night. In addition, the staff
D. members
hydroxyzine
report
(vistaril)
that the
twice
client
daily
is awake and
E.
29. Which of restless
the following
most is
ofthe
thehighest
night. After
priority
further
in taking
assessment,
care of the
thepatient
nurse decides
with dementia?
to contact the physician for a
F. a. protecting medication
the client from
order.
injury
The nurse anticipates that the physician
H. c. reminding
will mostthe
likely
client
order:
of the things that
G. b. orienting the client for the time of the day
happened for the day
I. d. involve the client in story- telling
J.
30. Which of the following is true in patients with Dementia?
K.
a. Dementia includes illusion and
M.
c. Dementia always occurs in adults
hallucination
N.
d. Dementia is reversible.
L.
b. The progression of Dementia is slow
O.
P. Situation: Substance abuse is rampant in our country in spite of previous health promotions and
prevention of illness strategies were already conducted. Thus, nurses must be ready and equipped
enough to address the special needs of these clients.
Q. 31. The nurse approaches the triage window to see a client who is well known to the emergency room staff
as being a frequent visitor who demonstrates drug seeking behavior. When asked what the problem is, the
client states, I want to see the doctor. I am having chest pains. What is the most appropriate action for the
nurse to take?
A. bring the client to a treatment room and obtain a STAT electrocardiogram
B. take the clients pulse and blood pressure at the triage window
C. instruct the client to wait in the waiting room until it is his turn to be seen
D. ask the client an open ended question to elict information about his manifestations
R. 32. Which will the nurse expect to be ordered to manage a clients withdrawal from alcohol?
A. promethazine (Phenergan)
C. Haloperidol (haldol)
B. Chlordiazepoxide (Librium)
D. disulfiram (antabuse)
E. 33. Mr. Rolixn who is a drug addict is being cared by Nurse Benjie. Nurse Benjie knows that the nursing
diagnosis common for drug abusers and alcoholics is which of the following?
F.
a. ineffective individual coping
H.
c. impaired physical mobility
G.
b. altered nutrition: less than body
I.
d. altered thought process
requirements
J. 34. 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
C. Confabulation
B. Associative looseness
D. Concretism
E. 35. A homeless client with a history of alcohol abuse comes to the drop in shelter wherethe nurse volunteers.
The client arrives apparently intoxicated with the smell of alcoholon the breath and admits to have been
drinking to the nurse. Once admitted for the night,the client begins to shout obscenities at the other clients and
staff and becomes belligerent and threatening. The nurse advises the staff and other volunteers to:
A. evict the client from the shelter until sober
C. restrain the client to prevent self harm
B. have the client transported to the hospital
D. allow the client to blow off steam until tired
E.
F. Situation: Therapeutic Communication is indispensable in the field of nursing. It assists both the nurse
and the patients to achieve their set collaborative goal.
36. Nurse Andrea can minimize agitation in a disturbed client by?
A. Increasing stimulation
C. increasing appropriate sensory perception
B. limiting unnecessary interaction
D. ensuring constant client and staff contact
E. 37. A client on the psychiatric unit is unresponsive or mumbles incoherently whenever the nurse asks the client
questions. The nurse will best deal with the clients communication problems b:
A. encouraging the client to ask direct questions
B. continuing to speak with the client using short, clear statements or open ended questions
C. filling in silent periods by talking about topics interesting to the nurse
D. sitting quietly with the client during his/her scheduled times until the client indicates a willingness to talk
F. 38. Nurse Cherry 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. Youre 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
G.
H. 39. Which behavior would best indicate that the antisocial client is making the most progress in treatment?
A. serving as a judge for the units talent show
C. requesting a weekend pass to go home
B. volunteering to chair the client government meeting
D. assisting a depressed roommate to fill out a menu
E. 40. What would the nurse most expect to observe in a client with impulsive behavior?
A. ability to delay gratification
C. good problem solving skills
B. low tolerance for frustration
D. commitment to long term goals
E.
F. Situation: The incidence of suicide is known to be increasing these days. Along with this is the adjustment
that nurses must make in delivering a safe and quality care to the victims and enhancing their selfawareness so that they could be able to deliver the appropriate care effectively without being judgmental.
G. 41.
Nurse Michelle is caring for a female client who has suicidal tendency. When accompanying the
client to the restroom, Nurse Michelle should
A. Give her privacy
C. Open the window and allow her to get some
B. Allow her to urinate
fresh air
D. Observe her
E. 42. To further assess a clients suicidal potential. Nurse Katrina should be especially alert to the client expression
of:

A. Frustration & fear of death

C. Anxiety & loneliness
B. Anger & resentment
D. Helplessness & hopelessness
E. 43. A client is admitted to the psychiatric unit on a temporary detention order. The nurseobserves that the client is
staring out the 4th floor window and replying to voices that the nurse is unable to see. The initial
therapeutic statement that the nurse makes to the clientis:
A. tell me what the voices are saying to you
C. are you thinking about jumping out the window?
B. who are you talking to?
D. why are you looking outside?
E.
44. Te patient with suicidal ideations is gaining positive effects from her antidepressant therapy. What is the priority
nursing intervention of the nurse at this time?
F.
a. increase frequency in observing the client
H. c. let the client to maintain privacy as much as
G. b. prepare the client for discharge
possible
I.
d. decrease the frequency of observing the client
J.
45. Which of the following is the least helpful for the nurse to do keeping the safety of client with suicidal tendency?
K. a. removing sharps and ropes from the clients room
L. b. visiting the client in his room in a random manner
M. c. placing the client in the 5th floor of the building
N. d. have a consistent careful observation of the whereabouts of the client
O.
P. Situation: All of us are undergoing crisis at one or more times on our lives that disrupts our
equilibrium and makes our previous defenses ineffective. Anxiety is as well inevitable. Nurses are
one of the most appropriate persons that can give an effective care in persons undergoing crisis.
Q. 46. A nurse working with a client with agoraphobia recognizes that the most effective technique for
treatment of agoraphobia is:
a. gradual desensitization by controlled exposure to the situation the client fears
b. teaching relaxation techniques
c. repeated exposure to the situations the client fears
d. distraction each time the client brings up the problem
R. .47 A client is experiencing anxiety attack. The most appropriate nursing intervention should include?
a. Turning on the television
c. Staying with the client and speaking in short
b. Leaving the client alone
sentences
d. Ask the client to play with other clients
e. 48. 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
c. Feelings of guilt and inadequacy
b. Problems with anger and remorse
d. Feeling of unworthiness and hopelessness
e. 49. To establish open and trusting relationship with a female client who has been hospitalized with severe
anxiety, the nurse in charge should?
a. Encourage the staff to have frequent interaction
c. Give client feedback about behavior
with the client
d. Respect clients need for personal space
b. Share an activity with the client
e. 50. 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
c.
The client identifies anxiety producing situations
b.
The client ignores feelings of anxiety
d.
The client maintains contact with a crisis counsellor
e. 51. The nurse is working with an adolescent client with social anxiety disorder who will beattending college in 6
months. The parent tells the nurse that this anticipated change isalready causing increased anxiety for the
client. Which action reported by the client does the nurse evaluate as indicating the greatest amount of
progress? The client:
a. arranges an overnight visit at a college with a current student
b. sends an electronic application to a college close to home
c. attends open houses at colleges of interest with the parent
d. decides to go to a community college and commute from home
f. 52. Nurse Tanya would expect a child with a diagnosis of reactive attachment disorder to:
a. Have more positive relation with the father than the mother
b. Cling to mother & cry on separation
c. Be able to develop only superficial relation with the others
d. Have been physically abuse
g. 53. When working with a male client suffering phobia about black cats, the nurse should anticipate that a
problem for this client would be?
a. Anxiety when discussing phobia
c. Denying that the phobia exist
b. Anger toward the feared object
d. Distortion of reality when completing daily routines
e.
54. In dealing with clients during crisis, what is the best role of the nurse?
f. a. active and directive
h. c. optimistic and flexible
g. b. uphold the autonomy of the client for
i. d. allow the client to use previous defense
decision- making
mechanisms
j.
55. Which of the following is not true about crisis?
k. a. it is self- limiting
l. b. the previous coping mechanism of the client is not anymore useful
m. c. the victim needs someone to direct him what to do and to let him focus
n. d. the perception of crisis is the same for all people
o. Situation: Schizophrenia is caused by many factors such as genetics, biological influences and
environmental factors. The nurse must be fully equipped in dealing with the clients with schizophrenia.
p. 56. 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
E. 57. A client who is taking chlorpromazine hydrochloride (Thorazine) is experiencingextrapyramidal side effects
(EPS). The nurse understands that EPS is:
A. dysfunction of the cardiovascular system
C. similar to a seizure disorder
B. involuntary muscle movements
D. a toxic reaction of the liver
E. 58. A client with paranoid delusions believes the hospital food is being poisoned by the staff.
The nurse knows the meal presentation that is the most effective method of encouraging
nutritional intake is to serve:
A.
the clients favorite foods in an attractive arrangement
B.
only warm foods that arrive from the kitchen with lids in place
C.
individual items that are pre-packaged and sealed
F. 59. In planning the initial care for a client with an acute schizophrenic illness, the nurse will
appropriately emphasize:
A. establishing a daily routine to promote orientation to the unit
B. encouraging the client to enter into simple group activities
C. providing a variety of activities to keep the client focused on reality based topics
D. assign the same staff members of the nursing staff to work with the client each day.
G. 60. A 23 year old client has been admitted with a diagnosis of schizophrenia says to the
nurse Yes, its march, March is little woman. Thats literal you know. These statement
illustrate:
A. Neologisms
C. Flight of ideas
B. Echolalia
D. Loosenes of association
E. 61. The nurse understands that the best explanation for involuntary admission for psychiatric treatment is that:
A. a psychiatrist has determined the clients behavior is irrational
B. the client exhibits behavior that is a threat to either the client or to society
C. The client is unable to manage the affairs necessary for daily life
D. the client has broken a law
F. 62. 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
C. Feeling of self worth
B. Better self control
D. Faith in his wife
E. 63. 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
F. 64. Nurse Nina is assigned to care for a client diagnosed with Catatonic Stupor. When Nurse Nina enters the
clients 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
G.
65. Which of the following EPS for the clients taking antipsychotic drug is known to occur years after and is
irreversible?
H. a. dystonia
J. c. neuroleptic malignant syndrome
I. b. tardive dyskinesia
K. d. resting tremors
L.
M.
N. Situation: Nurses must be well- versed in dealing with clients with personality disorders and helping them
manage this so as to attain optimal level of well- being.
O. 66. A client diagnosed with borderline personality disorder purposely cuts his arm with a piece of broken glass when
his favourite nurse calls in sick. When the clients favourite nurse returns to the unit, they meet to discuss the
cutting incident. How can the nurse best prevent future incidents of self mutilating behaviour in this client?
A. ask the client to make a promise to discuss any self destructive feelings that theclient may have with a staff
member
B. emphasize that self destructive behavior is unacceptable and obtain a writtencontract from the client stating, I will
not harm myself.
C. tell the client that he is making increasingly unrealistic demands on the nurseand other staff members
D. assign a staff member to supervise the clients whereabouts at all times
P. 67. 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
D. Inability to make choices and decision without
B. Avoiding relationship
advise
C. Showing interest in solitary activities
E. 68.
A male client is diagnosed with schizotypal personality disorder. Which signs would this client exhibit during
social situation?
A. Paranoid thoughts
C. Independence need
B. Emotional affect
D. Aggressive behaviour
E. 69. Christine 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 clients statement with her
C. Request an immediate extension for the client
D. Ignore the clients statement because its a sign of manipulation
F.
70. A woman was seen on the streets wearing flamboyant clothes, heavy make-ups and is trying to catch the
attention of all people passing her way is a manifestation of clients who are:

G. a. narcissistic
I. c. schizotypal
H. b. histrionic
J. d. schizoid
K.
L. Situation: Defense mechanisms are utilized by the person to save the ego from an uncomfortable and
anxiety- producing situations. The nurse must be knowledgeable enough to determine these different
defense mechanisms to deal effectively with the patients.
M. 71. A nurse is aware that pedophiles are using defense mechanisms because of their low self- esteem. Which of
the following qualifies a person as a pedophile?
N. a. the victim is less than 13 years old while the pedophile is 6 years older
O. b. the victim is less than 18 years old while the pedophile is 6 years older
P. c. the victim is less than 10 years old while the pedophile is 10 years older
Q. d. the victim is less than 13 years old while the pedophile is 15 years older
R.
S. 72. While initiating response to the client in the psyche ward, the nurse started to become uncomfortable when the
patients started to become verbally abusive because it reminds her oh her abusive mother. This indicates:
T. a. transference
V. c. denial
U. b. counter- transference
W. d. reaction formation
X. 73. During the orientation phase of nurse- patient relationship, the client became agitated upon seeing the nurse
and shouted at him to go away because he is afraid that the nurse might hurt him as the nurse was seen by the
patient to be her boyfriend who constantly hurts her. This clearly indicates:
Y. a. transference
AA. c. denial
Z. b. counter- transeference
AB. d. reaction formation
AC. 74. After a very traumatic event of car accident, Lila cannot anymore recall the happenings while being interviewed
in the ER. This indicates:
AD. a. repression
AF. c. reaction formation
AE. b. suppression
AG.
d. denial
AH. 75. After failing to be the class valedictorian, Lisa preferred not to talk about it. This is an example of what defense
mechanism?
AI. a. repression
AK. c. reaction formation
AJ. b. suppression
AL.
d. denial
AM.
AN. Situation. Psychological disorders in children is one of the most challenging tasks not only for the nurses
to tackle but to the parents as well. We nurses must possess certain skill to help the child and parents
cope with this.
AO. 76. Nurse Perry is aware that language development in autistic child resembles:
A. Scanning speech
C. Shuttering
B. Speech lag
D. Echolalia
E. 77. 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
F.
78. Which of the following pervasive childhood disorder is characterized by lack of social skills and eye contact, yet
has a certain field of interest wherein they can excel very well?
G. a. tourettes syndrome
I. c. ADHD
H. b. aspergers
J. d. oppositional defiant disorder
K.
79. The following are the characteristics of the children with autism except:
L. a. lack of eye contact
M. b. does not respond to touch and affection
N. c. attention can be fully caught by rotating fan blades and spinning tops
O. d. they can effectively use the pronoun I, me to refer to themselves
P.
80. The following are the object of comfort of autistic children. Which of this is the least?
Q. a. pillows
S. c. huggable toys
R. b. blanket
T. d. pingpong racket
U.
V. Situation: Violence is manifests itself in any setting, no matter of age, economic status and gender. Nurses
are of the best position in assisting the victims of violence find means of finding again their self- worth and
dignity as a person.
W. 81 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
X. 82. The nurse is talking to a resident of a long term care facility who has returned from an overnight stay with his
son and sons wife. Which statement by the resident would warrant further investigation by the nurse for elder
abuse?
A. The food wasnt very good. My daughter in law was never a very good cook
B. we had a nice visit. My grandchildren are a little unruly, but I enjoy that in small doses
C. they needed a new TV, so I gave them money so they could buy one
D. Those bruises arent anything. I got clumsy at my sons house
Y. 83. In caring for abused children, the nurse understands that sexual abuse of children is:
A. often repeated from generation to generation
B. significantly less common than physical abuse and neglect
C. more prevalent in economically depressed segments of society
D. usually perpetrated by strangers

Z. 84. The nurse would judge that a client might be developing Wernicke-Korsakoff syndrome when the client exhibits:
A. mood swings and suicidal ideation
C. short term memory loss and disorientation
B. suspicion and fearfulness
D. aggression and impulsiveness
E. 85. The client is admitted to the hospital with injuries sustained in an automobile accident. The
client, who has a history of previous arrests for driving under the influence (DUI) has an admission
blood alcohol level of 0.25. When the nurse asks the client how much alcohol the client consumes
daily, the nurse knows the most likely response by the client is:
A. I can drink more than anyone I know
C. I am not sure, I dont keep track
B. not much, I dont even get drunk
D. How much do you think I drink?
E. 86. The community health nurse notes several suspicious bruises and old burns on an infant. Which is the
nurses priority action?
A. call the child protection hotline and report possible abuse
B. discuss the family with the physician and social worker at the next team meeting
C. carefully record the visit for follow-up
D. tell the parent that child protection will be notified if injuries are noted at the next visit.
F.
G.

87. Which of the following assessment findings indicates that an elderly is a victim of neglect?
a. loss of large amount of money from her savings in the bank
b. always go on shopping and ballroom dancing with friends
c. slouch appearance, emaciated, wearing dirty clothing
d. always forgets appointments, and disoriented
L.
88. Nurse Isabel is assigned to a client with catatonic schizophrenia. Which intervention should the nurse include in
the client's plan of care?
M. a. Meeting all of the clients physical needs
N. b. Giving the client an opportunity to express concerns
O. c. Administering lithium carbonate (Lithonate) as prescribed
P. d. Providing a quiet environment where the client can be alone
Q.
89. Nurse Jeremiah formulates a nursing diagnosis of Impaired verbal communication for a client with schizotypal
personality disorder. Based on this nursing diagnosis, which nursing intervention is most appropriate?
R. a. Helping the client participate in social interactions
S. b. Establishing a one-on-one relationship with the client
T. c. Establishing alternative forms of communication
U. d. Allowing the client to decide when he wants to participate in verbal communication with the nurse
V.
90. Nurse Lea is providing care to a client with a catatonic type of schizophrenia who exhibits extreme negativism.
To help the client meet his basic needs, the nurse should:
W. a. ask the client which activity he would prefer to do first
X. b. negotiate a time when the client will perform activities
Y. c. tell the client specifically and concisely what needs to be done
Z. d. prepare the client ahead of time for the activity
AA.
91. Joe is admitted to a psychiatric facility with a diagnosis of chronic schizophrenia. The history indicates that the
client has been taking neuroleptic medication for many years. Assessment reveals unusual movements of the tongue, neck,
and arms. Which condition should the nurse suspect?
AB. a. Tardive dyskinesia
AD. c. Neuroleptic malignant syndrome
AC. b. Dystonia
AE. d. Akathisia
AF.
AG.
Situation: The following questions pertain to the general management and concepts of clients with
psychiatric disorders.
AH.
92. Nurse Irma is aware that the most antipsychotic medications exert which of following effects on the central
nervous system (CNS)?
AI. a. Stimulate the CNS by blocking postsynaptic dopamine, norepinephrine and serotonin receptors
AJ. b. Sedate the CNS by stimulating serotonin at the synaptic cleft
AK. c. Depress the CNS by blocking the postsynaptic transmission of dopamine, serotonin and norepinephrine
AL. d. Depress the CNS by stimulating the release of acetylcholine
AM.
93. During a group therapy session in the psychiatric unit, Joyce constantly interrupts with impulsive behavior and
exaggerated stories that cast her as a hero or princess. She also manipulates the group with attention-seeking behaviors,
such as sexual comments and angry outbursts. Nurse Joey realizes that these behaviors are typical of:
AN. a. paranoid personality disorder
AP. c. histrionic personality disorder
AO. b. avoidant personality disorder
AQ. d. borderline personality disorder
AR.
94. Catherine has received treatment for depression for 3 weeks. Which behavior suggests that the client is
recovering from depression?
AS. a. the client talks about the difficulties of returning to college after discharge
AT. b. the client spends most of the day sitting alone in the corner of the room
AU. c. the client wears a hospital gown instead of street clothes
AV. d. the client shows no emotion when visitors leave
AW.
95. Nurse Jason is teaching a psychiatric client about her prescribed drugs, chlorpromazine and benztropine. Why
is benztropine administered?
AX. a. To reduce psychotic symptoms
AZ. c. To control nausea and vomiting
AY. b. To reduce extrapyramidal symptoms
BA. d. To relieve anxiety
BB.
BC. Research is very important to uphold quality nursing care. Nurses must not only be a research
consumer but must also conduct their own research works. This will ensure that trends in nursing
care are continuously updated and are congruent to the advances of the society.
BD. 96. It is a type of research design which is used to solve practical problems and conflicts which affects
people in their everyday lives:
A.
Descriptive
C. Basic
B.
Exploratory
D Applied
BE. 97. An investigator wants to determine some of the problems that are experienced by hypertensive clients
H.
I.
J.
K.

in their medication compliance. The investigator went into the clinic where he personally knows that several
hypertensive clients are having problem with their medication compliance. The type of sampling done by
the investigator is called?
C.
Probability
C. Snow ball
D.
Purposive
D. Incidental
BF. 98. If the researcher implemented a new structured counseling program with a randomized group of subject and a
routine counseling program with another randomized group of subject, the research is utilizing which design?
BG.
a. Quasi-experimental
C. Comparative
BH.
b. Experimental
D. Methodological
BI. 99. One of the characteristics of a good and scientific research is objectivity. This term focuses more on the
research work which is:
BJ.
a. Order
C. Empiricism
BK.
b. Generality
D. Control and manipulation
BL.
100. Nurse Ana wanted to know the median age of the respondents which are the following:
BM.
23, 21, 35, 24, 32, 33:
BN. a. 28
BP. c. 24
BO. b. 32
BQ. d. 25

BR.

BT.

BS.