PSYCHIATRIC HEALTH NURSING PREBOARDS

SITUATION #1: The ability to establish therapeutic relationships with clients is one of the most
important skills a nurse can develop. Although important in all nursing specialties, the therapeutic
relationship is especially crucial to the success of interventions with clients requiring psychiatric
care, because the therapeutic relationship and the communication within it serve as the
underpinning for treatment and success.

Nurse Paul is caring for a patient diagnosed with an anxiety disorder. In order to promote the
nurse–client relationship, Nurse Paul must apply what he learned in his psychiatric nursing
lectures.

1. Nurse Paul believes that he must clearly understand his own self first to promote his clients’
growth and to avoid limiting clients’ choices to those that he value. He believes he needs the
ability to use one’s personality consciously and in full awareness in an attempt to establish
relatedness and to structure nursing interventions. This process is called:
a. Milieu Therapy
b. Therapeutic Use of Self
c. Use of Sullivan’s Self System
d. Values Clarification
2. Nurse Paul remembers that the nurse–client relationship requires trust. To exhibit a
trusting behavior towards his patient, he must do all of the following, except:
a. “I have to leave now to go see other patients, but I will be back at 1 pm” and indeed
returns at 1 pm to see client.
b. Behavior is incongruent with nurse’s voice or body language
c. Providing schedules of activities
d. Treating the client as a human being
3. Which of the following behavior exhibited by Nurse Paul is therapeutic?
a. Eliminating “Haptic communication”
b. Maintaining a distance of 3 to 6 feet apart from client.
c. Probing and presenting reality
d. Using abstract messages rather than concrete messages
4. During rounds, the nurse supervisor happens to walk in on Nurse Paul who is currently
performing an interview on his client. Nurse Paul requires further teachings when the
supervisor observes that:
a. Continuous eye contact
b. He is sitting squarely, facing the client.
c. His arms and legs remain uncrossed.
d. Leans forward to client.
5. After Nurse Paul’s interview with the client, the supervisor asked him about his knowledge
on active listening. Nurse Paul is correct if he stated all of the following as barriers to active
listening:
a. 1, 2, 4,
b. 1, 2, 4, 6
c. 1 and 4 only
d. All except 3 and 5

(1) Absence of eye contact

(2) Closed posture
(3) Therapeutic distance between nurse and client
 (4) Making assumptions, biases and prejudices
(5) Paying attention to both verbal and nonverbal cues
(6) Interpret and respond to the message subjectively.
(7) Always focusing on what question to ask next

SITUATION #2: ADHD or Attention Deficit Hyperactivity Disorder is a mental disorder usually
diagnosed in childhood. Children with this disorder manifest a persistent pattern of inattention (at
least six [6] symptoms) and/or hyperactivity-impulsivity (at least [6] symptoms) that is more
frequent and severe than is typically observed in individuals. These children are highly distractible
and unable to contain stimuli.

6. A 9-year old child is hospitalized with a diagnosis of ADHD/Attention Deficit Hyperactivity

Disorder. As a knowledgeable nurse, Nurse Janina knows that all but one of the following
are true about the disorder:
a. ADHD is characterized by symptoms of “Inattention” such as fidgeting with hands or
squirming in seat, runs about or climbs excessively, talks excessively, has difficulty
playing quietly.
b. Methylphenidate (Ritalin), a CNS STIMULANT, is the drug of choice
c. The major neurotransmitters implicated in the pathophysiology of ADHD are
dopamine, norepinephrine, and serotonin.
d. There is clear evidence of clinically significant impairment in social, academic, or
occupational functioning
7. Nurse Janina is preparing to give Methylphenidate (Ritalin) to her 9-year old client with
ADHD. Nurse Janina understands that which of the following is a concern for children taking
stimulants for ADHD for several years?
a. Addiction
b. Growth suppression
c. Insomnia
d. Weight gain
8. The 9-year old client is constantly showing signs of accident-prone behavior, intrusive and
immature behavior, impulsivity, short attention span and low self-esteem. Nurse Janina
knows that the BEST/PRIORITY outcome for planning interventions for this type of client
would be:
a. The client has experienced no physical harm
b. The client has developed trusting relationship with nurse and interacts with peers
appropriately
c. The client demonstrates fewer demanding behaviors
d. The client completes tasks independently or with minimal assistance
9. Nurse Janina understands that medications do not automatically improve the child’s
academic performance or ensure that he or she makes friends. Taking into consideration
the long-term management needed to effectively treat ADHD, what therapy is the most
appropriate?
a. Behavior therapy
b. Cognitive therapy
c. Electroconvulsive Therapy (ECT)
d. Gestalt therapy
10. Nurse Janina reviews the different stages of development according to Erik Erikson’s
Psychosocial Theory. She knows that the 9-year old client’s major developmental task is to:
a. To achieve a sense of self-confidence by learning, competing, performing and
receiving recognition from significant others, peers and acquaintances
 b. To develop a basic trust in the mothering figure and learn to generalize it to others
c. To develop a sense of purpose and the ability to initiate and direct own activities
d. To gain some self-control and independence within the environment

SITUATION #3: Many substances can be used and abused; some can be obtained legally while
others are illegal. Alcohol is one of the substances that can be abused.
ALCOHOLISM is characterized by a prolonged period of frequent, heavy alcohol use. Alcohol is a
central nervous system (CNS) depressant affecting all body tissues and it results to both physical
dependence (biological need for alcohol to avoid physical withdrawal symptoms) and
psychological dependence (craving for the subjective effect of alcohol).

11. Arnold, a 34-year old man, likes to drink alcohol. At first, he uses alcohol to relieve the
everyday stress and tensions of life. Gradually, he starts to experience “blackouts.” What
phase of alcoholism is Arnold at?
a. Chronic Phase
b. Crucial Phase
c. Early Alcoholic Phase
d. Pre-alcoholic Phase
12. Aizik, a patient with a history of alcoholism is brought to the emergency room in an agitated
state. He is vomiting and diaphoretic. He says he had his last drink five hours ago. The nurse
would expect to administer which of the following medications?
a. Chlordiazepoxide hydrochloride (Librium)
b. Disulfiram (Antabuse)
c. Librium with glucose
d. Naloxone hydrochloride ( Narcan)
13. Aizik, a client with chronic alcohol abuse has been admitted to a rehabilitation unit. When
Nurse Anjo was asking the client on how he felt on stopping on drinking, the client stated “I
can stop drinking anytime I feel like it.” This statement shows an example of what defense
mechanism?
a. Codependency
b. Denial
c. Projection
d. Rationalization
14. When would the first signs of alcohol withdrawal symptoms be expected to occur?
a. Within 12 hours after the last drink
b. 12 to 24 hours after the last drink
c. 48 to 72 hours after the last drink
d. 2 to 4 days after the last drink
15. The best indicator that a patient with substance dependence will progress through
rehabilitation successfully is:
a. Active participation in rehabilitation program
b. Developing the willpower to stop substance dependence
c. Recognition of the existence of the problem
d. Verbalizing the desire to help self

SITUATION #4: John is a 28-year-old high-school science teacher whose Army Reserve unit was
called to fight in Iraq. John did not want to fight. He admits that he joined the reserves to help pay
off his college loans. In Iraq, he participated in combat and witnessed the wounding of several from
his unit, as well as the death of his best friend. He has been experiencing flashbacks, intrusive
recollections, and nightmares. His wife reports he is afraid to go to sleep, and his work is suffering.
Sometimes he just sits as though he is in a trance. John is diagnosed with PTSD.

16. John says to the nurse, “I can’t figure out why God took my buddy instead of me.” From this
statement, the nurse assesses which of the following in John?
a. Intrusive thoughts.
b. Repressed anger.
c. Spiritual distress.
d. Survivor’s guilt.
17. John experiences a nightmare during his first night in the hospital. He explains to the nurse
that he was dreaming about gunfire all around and people being killed. The nurse’s most
appropriate initial intervention is:
a. Administer alprazolam as ordered p.r.n. for anxiety.
b. Call the physician and report the incident.
c. Have John listen to a tape of relaxation exercises.
d. Stay with John and reassure him of his safety.
18. Which of the following therapy regimens would most appropriately be ordered for John?
a. Alprazolam and behavior therapy
b. Carbamazepine and cognitive therapy
c. Diazepam and implosion therapy
d. Paroxetine (Paxil) and group therapy
19. Which of the following may be influential in the predisposition to PTSD?
a. Distorted, negative cognitions.
b. Excess of the neurotransmitter serotonin.
c. Severity of the stressor and availability of support systems.
d. Unsatisfactory parent–child relationship.
20. The nurse observes a client who is becoming increasingly upset. He is rapidly pacing (can’s
sit still), hyperventilating, clenching his jaw, wringing his hands, and trembling. His speech
is high pitched and random; he seems preoccupied with his thoughts (with hallucinations).
He is pounding his fist into his other hand. The nurse identifies his anxiety level as:
a. Mild
b. Moderate
c. Severe
d. None of the above

SITUATION # 5: American Psychiatric Association defines personality traits as “enduring patterns

of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a
wide range of social and personal contexts.” Nurses must have a basic knowledge of human
personality development to understand maladaptive behavioral responses commonly seen in
psychiatric clients.

21. Lexus was arrested for breaking into a jewelry store and stealing thousands of dollars’
worth of diamonds. At his arraignment, the judge ordered a psychological evaluation. He
has just been admitted by court order to the locked unit. Based on a long history of
maladaptive behavior, he has been given the diagnosis of antisocial personality disorder. In
evaluating Jack’s progress, which of the following behaviors would be considered the most
significant indication of positive change?
a. Jack got angry only once in group this week.
b. Jack was able to wait a whole hour for a cigarette without verbally abusing the staff.
c. Jack sent a note of apology to a man he had injured in a recent fight.
 d. Jack stated that he would no longer start any more fights.
22. In identifying clients with histrionic personality disorder, which of the following assessment
questions should be asked? Select all that does not apply:
a. All except 1, 3 and 5
b. All except 2
c. All except 3 and 5
d. All except 4 and 6
(1) “Do you think that compared to other people, you are a very special
person?”
(2) “If a friend hurts you, do you sometimes feel like hurting yourself, perhaps
by cutting or burning yourself?”
(3) “Do people of the opposite sex frequently find you attractive?”
(4) “Do you find that most people aren’t quite up to your standards?”
(5) “Do you think that you would make a good actor or actress?”
(6) “Do you frequently feel let down by people?”
23. In caring for clients with personality disorders, which statement by the nurse would
enhance a therapeutic relationship?
a. “After you attend the morning community meeting, you may work on your
homework.”
b. “We will have you get comfortable on the unit first before we have you work on any
homework.”
c. “What would you like to do first today?”
d. “You remind of a friend of mine.”
24. In caring for a client with a Paranoid personality disorder, which is the most appropriate?
a. Assess self-harm risk; provide factual feedback; promote self-esteem; increase
involvement in activities
b. Matter-of-fact approach; gain cooperation with needed treatment; teach client any
needed self-care skills
c. Promote safety; help client to cope and control emotions; cognitive restructuring
techniques; structure time; teach social skills
d. Serious, straightforward approach; teach client to validate ideas before taking
action; involve client in treatment planning
25. You are caring for a client with a borderline personality disorder. While doing your rounds,
you notice your client exhibiting a rigid posture, clenching of fists and jaw, hyperactivity,
pacing, breathlessness, and has threatening stances. What is the MOST APPROPRIATE
nursing diagnosis at this time?
a. Risk for Self-Directed Violence; Risk for Suicide
b. Risk for Other-Directed Violence
c. Anxiety (severe to panic)
d. Impaired Social Interaction

SITUATION #6: Health care personnel must attempt to provide treatment in a manner that least
restricts the freedom of clients. In psychiatry, the term restraints generally refers to a set of leather
straps that are used to restrain the extremities of an individual whose behavior is out of control and
who poses an inherent risk to the physical safety and psychological well-being of the individual and
staff.

26. The nurse calls security and has physical restraints applied when a client who was admitted
voluntarily becomes both physically and verbally abusive while demanding to be
 discharged from the hospital. Which represents the possible legal ramifications for the
nurse associated with these interventions? Select all that does not apply.
a. 1, 2, 4
b. 1, 4
c. 1, 3
d. 2, 4, 5
(1) Libel
(2) Battery
(3) Assault
(4) Slander
(5) False imprisonment
27. Justin, an agitated patient throws a chair across the dayroom on the psychiatry floor and
threatens the other patients with physical harm. To avoid injury and anticipated violence,
the nurse placed Justin in restraints. Which of the following is the BEST intervention?
a. Assessment for circulation, respiration, nutrition, hydration and elimination every
shift
b. In-person or one-on-one evaluation every 4 hours
c. Re-issuance of order for restraints every 24 – 48 hours
d. All of the above
28. In restraining Justin, which of the following nurse did the least appropriate action?
a. Regina, who asked nurse Anjo’s help in restraining client
b. Janina, who remained aware of Justin’s feelings
c. Katrina, who bore in mind that there are possible legal implications
d. Paulina, who talked with the other patients after the situation is resolved
29. Which of the following would indicate a duty to warn a third party?
a. A client states, “If I can’t have my girlfriend back, then no one can have her.”
b. A client with delusions states, “I’m going to get them before they get me.”
c. A client says he plans to blow up the federal government.
d. A hostile client says, “I hate all police.”
30. The client who is involuntarily committed to an inpatient psychiatric unit loses which of the
following rights?
a. Right to freedom
b. Right to refuse treatment
c. Right to sign legal documents
d. The client loses no rights.

SITUATION #7: Emotion is any relatively brief conscious experience characterized by intense
mental activity and a high degree of pleasure or displeasure. Emotion is
often intertwined with mood, temperament, personality, disposition, and motivation. Two strong
emotions include ANGER and GRIEF.

31. A client is pacing in the hallway with clenched fists and a flushed face. He is yelling and
swearing. Which phase of the aggression cycle is he in?
a. Anger
b. Crisis
c. Escalation
d. Triggering
32. The nurse observes a client muttering to himself and pounding his fist in his other hand
while pacing in the hallway. Which of the following students said the correct statement
which would guide the nurse’s action?
 a. Princess who stated, “Only one nurse should approach an upset client to avoid
threatening the client.”
b. Pacita who stated, “Clients who can verbalize angry feelings are less likely to
become physically aggressive.”
c. Mary Grace who stated, “Talking to a client with delusions will not be helpful,
because the client has no ability to reason.”
d. Bodict who said that, “Verbally aggressive clients often calm down on their own if
staff don’t bother them.”
33. Which of the following is an example of assertive communication?
a. “Sana, huwag mo akong galitin.”
b. “Nasasaktan ako tuwing umaalis ka habang nagsasalita pa ako.”
c. “Hindi ka nakikinig kapag nagsasalita ako.”
d. “Sinasaktan mo ako kapag iniistorbo mo ko sa pagsasalita.”
34. Nurse Mary Grace reviews her notes on the stages of grief. She correctly identifies one of the
stages in the grieving process if she stated that:
a. Preoccupation with the lost object/person happens in Engel’s “resolution of the
loss” stage
b. The actual work of grieving happens in Bowlby’s “Disequilibrium stage
c. The individual fervently seeks alternatives to improve current situation in Kubler-
Ross’ “anger” stage.
d. The bereaved person experiences a reinvestment in new relationships and new
goals in Worden’s “Task I: accepting the reality of the loss” stage
35. Which of the following is most likely to initiate a normal grief response in an individual?
a. 1, 5, 7
b. Only 5
c. All except 2 and 7
d. All of the above
(1) Rowvie, who lost her pet dog
(2) Rose, whose imaginary friend died
(3) Ranz, who lost his secret mistress in a car accident
(4) Reine, who lost his father (a wanted criminal who has killed lot of people)
(5) Regina, who lost her father
(6) Rainer, who lost his illegitimate father
(7) Roshiela, who was told by her doctor that she begun menopause

SITUATION #8: Children and adolescents experience some of the same mental health problems as
adults, such as mood and anxiety disorders, and are diagnosed with these disorders using the same
criteria as for adults.

36. Which of the following is normal adolescent behavior?

a. Frederico, who is critical of self and others
b. Milagroso, who has defiant, negative, and depressed behavior
c. Ambrocio, who has frequent hypochondriacal complaints
d. Fulgoso, who has unwillingness to assume greater autonomy
37. Tic Disorders (such as Tourette’s disorder) involves multiple motor tics and vocal tics. Vocal
tics may include repeating certain words or phrases out of context such repeating what
others say. This vocal tic is called:
a. Coprolalia
b. Echolalia
c. Palilalia
 d. Either B or C
38. An effective nursing intervention for the impulsive and aggressive behaviors that
accompany conduct disorder is
a. Assertiveness training
b. Consistent limit setting
c. Negotiation of rules
d. Open expression of feelings
39. The nurse recognizes which of the following as a common behavioral sign of autism?
a. Clinging behavior toward parents
b. Creative, imaginative play with peers
c. Early language development
d. Indifference to being hugged or held
40. In an effort to help the mild-to-moderately mentally retarded child develop satisfying
relationships with others, which of the following nursing interventions is most appropriate?
a. Allow the child to behave spontaneously, for he or she has no concept of right or
wrong.
b. Interpret the child’s behavior for others.
c. Set limits on behavior that is socially inappropriate.
d. This child is not capable of forming social relationships.

SITUATION #9: Crisis is a temporary state of severe emotional disorganization caused by failure of
coping mechanisms and lack of support. Crises occur when an individual experiences a stressor
and perceives coping strategies to be ineffective.

41. Cynthia, age 56, is the mother of five children. Her youngest child, who had been living at
home and attending the local college, recently graduated and accepted a job in another
state. Marie has never worked outside the home and has devoted her life to satisfying the
needs of her husband and children. Since the departure of her last child from home, Marie
has become more and more despondent. Her husband has become very concerned, and
takes her to the local mental health center. This type of crisis is called:
a. Adventitious
b. Maturational
c. Situational
d. Psychiatric Emergency
42. The most appropriate nursing intervention with Cynthia would be to:
a. Begin grief work immediately and assist her to recognize areas of self-worth
separate and apart from her children.
b. Identify convenient support systems for times when she is feeling particularly
despondent.
c. Refer her to her family physician for a complete physical examination.
d. Suggest she seek outside employment now that her children have left home.
43. The desired outcome of working with Shara, who has witnessed a traumatic event and is
now experiencing panic anxiety is:
a. The individual will experience no anxiety.
b. The individual will demonstrate hope for the future.
c. The individual will maintain anxiety at a manageable level.
d. The individual will verbalize acceptance of self as worthy.
44. Another example of crisis is Rape. Nurse Mariel is caring for a Maria, a victim of rape. Nurse
Mariel understands that all of the following predisposing factors may be true about Maria’s
situation, except?
 a. Maria asked for trouble when she dressed provocatively
b. Maria is healthy 16 year old woman
c. Rape occurred in Maria’s neighborhood, near her home
d. The rape is premeditated
45. Nurse Mariel is working with Maria during a flashback says, “I know you’re scared, but
you’re in a safe place. Do you see the bed in your room? Do you feel the chair you’re sitting
on?” Nurse Mariel is using which of the following techniques?
a. Distraction
b. Presenting reality
c. Relaxation technique
d. Grounding

SITUATION #10: Everyone occasionally feels sad, low, and tired with the desire to stay in bed and
shut out the world. These episodes often are accompanied by anergia (lack of energy), exhaustion,
agitation, noise intolerance, and slowed thinking processes, all of which make decisions difficult.
Depression is the most treatable disease in the mental health setting.

46. Your client Ella with Borderline Personality disorder said “You are the best nurse I’ve ever
met. I want you to remember me.” What is your best response as a nurse?
a. “Are you thinking of suicide?”
b. “I suspect you want something from me. What is it?”
c. “Thank you very much.”
d. “You probably say that to all your nurses.”
47. Ella says to the nurse, “When I get out of here, I’m going to try this again, and next time I’ll
choose a no-fail method.” Which is the best response by the nurse?
a. “You are safe here. We will make sure nothing happens to you.”
b. “You’re just lucky your roommate came home when she did.”
c. “What exactly do you plan to do?”
d. “I don’t understand. You have so much to live for.”
48. The nurse observes that Keizha, a client diagnosed with depression sat at the table with two
other clients during lunch. The best feedback the nurse could give the client is:
a. “Do you feel better after talking with others during lunch?”
b. “I’m so happy to see you interacting with other clients.”
c. “I see you were sitting with others at lunch today.”
d. “You must feel much better than you were a few days ago.”
49. In determining degree of suicidal risk with Keizha, the nurse assesses the following
behavioral manifestations: severely depressed, withdrawn, statements of worthlessness,
difficulty accomplishing activities of daily living, no close support systems. The nurse
identifies risk for suicide as:
a. Low
b. Moderate
c. High
d. Unable to determine
50. All of the following may be performed by your client Keizha inside the hospital to commit
suicide successfully, except?
 a. Hanging by rope, knotting it at the side, instead of the back
b. Shooting her head by using a 33-caliber gun
c. Using a tiny broken ampule
d. Using the nurse’s ID lace

SITUATION #11: When caring for a client who is taking psychiatric medication, it is the most
appropriate to have knowledge on its indication and uses. It is also an utmost importance to
monitor for the medication’s adverse effects.

51. Which of the following manifestations would you assess on a client with lithium level of 2.9
mEq/L?
a. Anuria and the need for dialysis
b. Large output of dilute urine
c. Generalized seizures
d. Nausea, vomiting and diarrhea
52. Which of the following antidepressant drugs is a preferred drug for clients at high risk of
suicide?
a. Tranylcypromine (Parnate)
b. Sertraline (Zoloft)
c. Imipramine (Tofranil)
d. Phenelzine (Nardil)
53. Which of the following disorders are extrapyramidal symptoms that may be caused by
antipsychotic drugs? Select all that apply.
a. 1, 2, 4
b. 1, 4, 5, 6
c. 1, 2, 3, 4
d. 1 and 4 only
(1) Akathisia
(2) Pseudoparkinsonism
(3) Neuroleptic malignant syndrome
(4) Dystonia
(5) Anticholinergic effects
(6) Breast tenderness in men and women
54. Which of the following increases the risk for neuroleptic malignant syndrome (NMS)?
a. Dehydration
b. Intake of vitamins
c. Overhydration
d. Vegetarian diet
55. When teaching a client about restrictions for tranylcypromine (Parnate), the nurse will tell
the client to avoid which of the following foods?
a. Broad beans
b. Citrus fruit
c. Egg products
d. Fried foods
SITUATION #12: Sexual dysfunctions are disturbances in the processes of sexual response cycle
consisting of desire, excitement, orgasm and resolution. Paraphilias, on the other hand, are
recurrent intense sexual arousal to non-human objects, children, etc.

56. Which among the following is not true about sexuality?

a. By age 2 or 2 and a half years, children know what gender they are.
b. Children masturbates
c. Infants are capable of sexual arousal and orgasm
d. Sexuality relates exclusively to the sex organs or sexual behavior.
57. Which of the following sexual disorders is due to disruption in the desire phase of sexual
cycle?
a. Male erectile disorder
b. Premature ejaculation
c. Sexual aversion disorder
d. Dyspareunia
58. Janina realizes that she finds women to be sexually attractive. This is specifically called:
a. Pansexuality
b. Homosexuality
c. Transsexuality
d. Intersexuality
59. When counseling Janina, a lesbian, about sexual relationships, which is the priority?
a. To help patient attain identity synthesis
b. To understand where they are in terms of sexuality
c. To possess a non-judgmental attitude
d. To discuss possibility of acquiring HIV/AIDS

60. Paraphilias are diagnosed as recurrent, intensely sexually arousing fantasies, sexual urges,
or behaviors generally involving:
a. Non-human objects
b. Non-consenting Individuals only
c. Interpersonal difficulty or marked distress
d. All of the above

SITUATION #13: Eating is part of everyday life. It is necessary for survival, but it is also a social
activity and part of many happy occasions. The most common eating disorders in a clinical setting
includes anorexia nervosa and bulimia nervosa.

61. Which of the following is true about Anorexia Nervosa?

a. They are not preoccupied with thoughts of food
b. May perform binge-eating and purging
c. (+) Amenorrhea for 2 consecutive cycles
d. Weight is only 45 kg (when Ideal body weight is 50 kg)
 62. The nurse is working with a client with anorexia nervosa. Even though the client has been
eating all her meals and snacks, her weight has remained unchanged for 1 week. Which of
the following interventions is indicated?
a. Supervise the client closely for 2 hours after meals and snacks.
b. Increase the daily caloric intake from 1,500 to 2,000 calories.
c. Increase the client’s fluid intake.
d. Request an order from the physician for fluoxetine.
63. Treating clients with anorexia nervosa with a selective serotonin reuptake inhibitor
antidepressant such as fluoxetine (Prozac) may present which of the following problems?
a. Clients object to the side effect of weight gain.
b. Fluoxetine can cause appetite suppression and weight loss.
c. Fluoxetine can cause clients to become giddy and silly.
d. Clients with anorexia get no benefit from fluoxetine.
64. Which of the following is not false about the diagnosis of Bulimia nervosa?
a. Characterized by morning anorexia and evening hyperphagia
b. Recurrent episodes of binge-eating (at least 1x/week) with no regular use purging
c. Recurrent episodes of binge-eating (at least 1x/week) with compensatory purging
d. Recurrent episodes of binge-eating (at least 1x/week) with compulsive purging
65. They are often the first health care professionals to identify clients with Bulimia Nervosa?
a. Dentists
b. Dietitian
c. Psychiatrists
d. Registered nurses

SITUATION #14: Many theories attempt to explain human behavior, health, and mental illness.
Each theory suggests how normal development occurs based on the theorist’s beliefs, assumptions,
and view of the world. These theories suggest strategies that the clinician can use to work with
clients.

66. According to Erik Erikson’s Psychosocial theory, which is the virtue of the adolescent?

a. Competence
b. Love
c. Caring
d. Fidelity

67. In which stage of Sigmund Freud’s psychosexual theory is the superego formed?
a. Anal
b. Latency
c. Phallic
d. Oedipal

68. Macy is shy, fearful, reserved and very frugal. Her temperament is described as:
a. High novelty seeking, Low harm avoidance
b. High harm avoidance, Low novelty seeking
c. High novelty seeking, High harm avoidance
 d. Low harm avoidance, Low novelty seeking

69. According to Carper’s four patterns of knowing, the science of nursing is under:
a. Empirical knowing
b. Personal knowing
c. Ethical knowing
d. Aesthetic knowing

70. Existential theories’ very goal is to help the person’s authentic sense of self. Which
existential theory focuses on the here and now?
a. Rational emotive therapy
b. Logotherapy
c. Gestalt therapy
d. Reality therapy

SITUATION #15: Anxiety is a vague feeling of dread or apprehension; it is a response to external or

internal stimuli that can have behavioral, emotional, cognitive, and physical symptoms. Anxiety
disorders comprise a group of conditions that share a key feature of excessive anxiety with ensuing
behavioral, emotional, and physiologic responses.

71. When assessing a client with anxiety, the nurse’s questions should be
a. Avoided until the anxiety is gone
b. Open-ended
c. Postponed until the client volunteers information
d. Specific and direct
72. Which of the following would be the best intervention for a client having a panic attack?
a. Involve the client in a physical activity.
b. Offer a distraction such as music.
c. Remain with the client.
d. Teach the client a relaxation technique.
73. A client with generalized anxiety disorder states “I have learned that the best thing I can do
is to forget my worries.” How would the nurse evaluate this statement?
a. The client is developing insight.
b. The client’s coping skills have improved.
c. The client needs encouragement to verbalize feelings.
d. The client’s treatment has been successful
74. Which of the following treatment for anxiety disorders is not included in the client’s
cognitive-behavioral therapy?
a. Assertiveness training
b. Decatastrophizing
c. Positive reframing
d. Use of anti-depressants and Anxiolytics
75. When performing flooding to a client with anxiety disorder, which of the following would
you exclude?
a. Obtaining informed consent
b. Done for 1 or 2 sessions only
c. Only done by a trained psychotherapist
d. None of the above
SITUATION #16: John Nichol is admitted with diagnosis of Schizophrenia. In caring for this client,
you must know the nursing interventions related to this disorder.

76. Which of the following is your most important responsibility?

a. Establishing therapeutic relationship by establishing trust
b. Promoting safety of client and others
c. Teach client positive thinking
d. Teach client to ignore delusional beliefs
77. The family of John Nichol, with schizophrenia, asks the nurse about the difference between
conventional and atypical antipsychotic medications. The nurse’s answer is based on which
of the following?
a. Atypical antipsychotics are newer medications but act in the same ways as
conventional antipsychotics.
b. Conventional antipsychotics are dopamine antagonists; atypical antipsychotics
inhibit the reuptake of serotonin.
c. Conventional antipsychotics have serious side effects; atypical antipsychotics have
virtually no side effects.
d. Atypical antipsychotics are dopamine and serotonin antagonists; conventional
antipsychotics are only dopamine antagonists.
78. The client who hesitates 30 seconds before responding to any question is described as
having:
a. Blunted affect
b. Latency of response
c. Paranoid delusions
d. Poverty of speech

79. The overall goal of psychiatric rehabilitation is for the client to gain
a. Control of symptoms
b. Freedom from hospitalization
c. Management of anxiety
d. Recovery from the illness
80. What is the most common hallucination?
a. Auditory
b. Visual
c. Olfactory
d. Gustatory

SITUATION #17: Cognition is the brain’s ability to process, retain, and use information. A cognitive
disorder is a disruption or impairment in these higher-level functions of the brain. Cognitive
disorders can have devastating effects on the ability to function in daily life.

81. The nurse is talking with a woman who is worried that her mother has Alzheimer’s disease.
The nurse knows that the first sign of dementia is
a. Disorientation to person, place, or time
 b. Memory loss that is more than ordinary forgetfulness
c. Inability to perform self-care tasks without assistance
d. Varies with different people
82. The nurse has been teaching a caregiver about donepezil (Aricept). The nurse knows that
teaching has been effective by which of the following statements?
a. “Let’s hope this medication will stop the Alzheimer’s disease from progressing any
further.”
b. “It is important to take this medication on an empty stomach.”
c. “I’ll be eager to see if this medication makes any improvement in concentration.”
d. “This medication will slow the progress of Alzheimer’s disease temporarily.”
83. When teaching a client about tacrine (Cognex), the nurse will include which of the
following?
a. Taking tacrine can increase the risk for elevated liver enzymes.
b. Tacrine causes agranulocytosis in some clients.
c. The most common side effect is skin rash.
d. Tacrine has no known serious side effects
84. Which of the following statements by the caregiver of a client newly diagnosed with
dementia requires further intervention by the nurse?
a. “I will remind Mother of things she has forgotten.”
b. “I will keep Mother busy with favorite activities as long as she can participate.”
c. “I will try to find new and different things to do every day.”
d. “I will encourage Mother to talk about her friends and family.
85. Creutzfeldt-Jakob disease is a central nervous system disorder that typically develops in
adults 40 to 60 years of age. Which of the following is true about the disease?
a. The cause of the encephalopathy is an infectious particle resistant to boiling, some
disinfectants (e.g., formalin, alcohol), and ultraviolet radiation.
b. Degenerative brain disease that particularly affects the frontal and temporal lobes
and results in a clinical picture similar to that of Alzheimer’s.
c. Has symptoms similar to those of Alzheimer’s, but onset is typically abrupt followed
by rapid changes in functioning, a plateau or leveling-off period, more abrupt
changes, another leveling-off period, and so on.
d. There are choreiform movements that are continuous during waking hours and
involve facial contortions, twisting, turning, and tongue movements.

SITUATION #18: Violent behavior has been identified as a national health concern and a priority
for intervention. Victims of abuse are found across the life span. They can be a spouse or partner, a
child, or an elderly parent.

86. Your client always beat his wife after arriving home from a stressful day at work. When you
asked why he always beat his wife, he stated “I only beat her because she nags too much.”
What defense mechanism is being portrayed?
a. Displacement
b. Projection
c. Sublimation
 d. Rationalization

87. What is R.A. 8353?

a. The Anti-Rape Law of 1997
b. Anti-Violence against Women and Their Children Act of 2004.
c. Child Abuse Law.
d. Anti-Bullying Act of 2013
88. Which of the following is the best action for the nurse to take when assessing a child who
might be abused?
a. Confront the parents with the facts and ask them what happened.
b. Consult with a professional member of the health team about making a report.
c. Ask the child which of his parents caused this injury.
d. Say or do nothing; the nurse has only suspicions, not evidence.
89. Which of the following is true about touching a client who is experiencing a flashback?
a. The nurse should stand in front of the client before touching.
b. The nurse should never touch a client who is having a flashback.
c. The nurse should touch the client only after receiving permission to do so.
d. The nurse should touch the client to increase feelings of security
90. Which type of child abuse can be most difficult to treat effectively?
a. Emotional
b. Neglect
c. Physical
d. Sexual

SITUATION #19: The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) is the 2013
update to the American Psychiatric Association's (APA) classification and diagnostic tool. As nurses,
we should be familiar to the changes made from DSM-IV to DSM V.

91. This is described as the persistent difficulty in the social use of verbal and nonverbal
communication:
a. Learning disorder
b. Phonologic disorder
c. Hoarding disorder
d. Pragmatic communication disorder
92. This is a disorder for individuals with high anxiety about health, but without somatic
symptoms:
a. Hypochondriasis
b. Illness anxiety disorder
c. Somatic symptom disorder
d. Somatization disorder
93. Trichotillomania, a new disorder, is included under Obsessive-Compulsive related disorders
which is described as:
a. Skin-picking
b. Nail-pulling
c. Hair-pulling
d. Nail-biting
94. This disorder is characterized by difficulty discarding or parting with possesions:
 a. Separation anxiety disorder
b. Hoarding disorder
c. Excoriation disorder
d. Cataplexy
95. Which of the following is not included in the diseases/disorders under DSM V?
a. Hypochondriasis
b. Pain disorder
c. Somatization disorder
d. All of the above

SITUATION #20: Touch is a powerful communication tool. It can elicit both negative and positive
reactions, depending on the people involved and the circumstances of the interaction. In this
premise, touch can be categorized according to the message communicated.

96. Nurse Paul is a newly hired as a staff nurse. In meeting the chief nurse for the first time,
both of them engaged in a handshake. What type of touch is this?
a. Friendship-warmth
b. Functional-professional
c. Love-intimacy
d. Social-polite
97. When Nurse Paul touches the patient’s abdomen for physical examination, what kind of
touch is elicited?
a. Love-intimacy
b. Friendship-warmth
c. Functional-professional
d. Social-polite
98. Which of the five categories of touch must NEVER be done in any premise or situation?
a. Friendship-warmth
b. Love-intimacy
c. Sexual-arousal
d. Social-polite
99. Which touch indicates a strong liking for the other person, such as engaging in a mutual
embrace among your best buddies?
a. Friendship-warmth
b. Love-intimacy
c. Sexual-arousal
d. Social-polite
100. Nurse Paul sighted a child hugging ang kissing his parents. You know that this touch
is at which level?
a. Friendship-warmth
b. Functional-professional
c. Love-intimacy
d. Social-polite