PSYCH DISORDER I SET A

Prepared by: Prof. Ryan D. Reyes

Situation: Personality disorders are pervasive and inflexible patterns of functioning that is stable overtime, and leads to distress or impairment.
1. A client in an outpatient clinic is inconsiderate and attention seeking. Which personality disorder should the nurse suspect?
a. Schizoid b. Histrionic c. Antisocial d. Dependent
2. A nurse notices that a client with dependent personality disorder is depressed. Which of the following factors is assessed as contributing to
depression?
a. Unmet needs b. Sense of smothering c. Messy, unkempt appearance d. Difficulty delaying gratification
3. Which of the following behaviors by a client with dependent personality disorder shows the client has made progress toward the goal of
increasing problem-solving skills?
a. The client is courteous b. The client asks questions c. The client stops acting out d. The client controls emotions
4. Which of the following nursing interventions has priority for a client with borderline personality disorder?
a. Maintain consistent and realistic limits
b. Give instructions to meet basic care needs
c. Enlarge in daytime activities to stimulate wakefulness
d. Have the client attend group therapy on a daily basis
5. Which of the following findings is consistent with a diagnosis of antisocial personality disorder?
a. Problematic work history c. Severe physical health conditions
b. Struggle with severe anxiety d. Being critical of positive feedback
Situation: A fourteen year old girl was admitted to the hospital with a diagnosis of personality disorder. She is impulsive, demanding and
manipulates the staff with threats as tamper tantrums. Her history indicates sever parental rejection and lack of parental controls.
6. A major problem for the nursing staff concerns dealing effectively with her verbal threats to run away from the hospital. Therefore, the
nursing staff:
a. Decided it would be best to ignore her threats
b. Lock her in her room when she threatens to leave
c. Point out to her that her behavior is immature
d. Firmly tell her she is expected to remain on the ward, and if she do not control herself, the staff will help her to control herself
7. When asked why this approach was most to be effective, the head nurse explained:
a. “This will help her to learn that adults have the right to expect obedience from a child.”
b. “Setting limits for her indicates to her that we are concerned about her.”
c. “She is fourteen years old and should know right from wrong.”
d. “I’m sure she knows that she might get into trouble if she runs away.”
8. When the teenager requested permission to go out on pass, the nurse denied the request, as her passes had been discontinued. After
shouting that she didn’t care what the nurse said, the teenager ran into the elevator. The nurses initially respond to the teenager’s behavior
by:
a. Taking her gently by the arm and pulling her out of the elevator
b. Calling two other nurses to help get her out of the elevator
c. Suggesting to her that she step out of the elevator and talk things over
d. Telling her that her behavior would have to be reported to the doctor
9. The most important therapeutic goal would be to encourage this teenager to:
a. Give up her boisterous behavior c. Gradually accept limits and controls
b. Become less rebellious and more dependent d. Restrict her verbal expressions hostility
10. On your unit, you have a fifteen year old mentally retarded younger with a mental age of four years. He is a poor eater, and after eating
very little, he gets up and runs around the room enjoying everyone at the table. In an effort to improve his eating habits, the nurse would:
a. Sit beside him and periodically tell him to eat his meal
b. Be consistent, set limits and tell him to stay seated
c. Take him to a less stimulating environment during mealtimes
d. Encourage the other patients to assist in controlling his behavior
Situation: Mrs. Gina Hasa is admitted with a severe anxiety disorder. She is crying, wringing her hands, and pacing.
11. The first nursing intervention should be to:
a. Ask her what is bothering her c. Stay physically close to her
b. Tell her to sit down and try to relax d Get her involved in a non-threatening activity
12. Physiologically, the nurse would expect Mrs. Hasa's anxiety to be manifested by:
a. Dilated pupils, dilated bronchioles, increased pulse rate, hyperglycemia and peripheral vasoconstriction
b. Constricted pupils, constricted bronchioles, decreased pulse rate, hypoglycemia and peripheral vasodilation
c. Dilated pupils, constricted bronchioles, decreased pulse rate, hypoglycemia and peripheral vasoconstriction
d. Constricted pupils, dilated bronchioles, increased pulse rate, hypoglycemia and peripheral vasodilation
13. What is the priority need of the patient at this time?
a. nutrition b. safety c. coping skills d. love
14. Upon interview Mrs. Hasa had this disorder after the death of her husband and children in a car accident. Anxiety disorders associated
with such an event are known as which of the following
a. obsessive-compulsive disorder c. post-traumatic stress disorder
c. panic disorder d. phobic disorder

Page 1 of 4
Psychiatric Nursing: Disorder 1 by: Prof. R.Reyes
In light of the rapid turnover of technology in the medical sciences, the compilation of information, and the possibility of human error, ONE QUEST, and any other parties involved in said
compilation of information contained herein, disclaims all responsibility for and accepts no liability for any inaccuracies, errors, omissions or liabilities incurred as a consequence, directly or indirectly, of
the use and application of its contents. Any similarities with other materials are only a result of such compilation.
15. Mrs. Hasa takes her medication regularly. Which of the following nursing responsibility is the least appropriate for this client?
a. check the client's pulse rate regularly
b. position the client gradually to prevent increase in BP
c. give the medication before meals
d. monitor for possible dependency to the drug
Situation: Ms. D age 30, is admitted to the hospitals with blisters in her hands due to scrubbing several times a day. She claims her hands
were always dirty.
16. Obsessive-compulsive disorder is characterized by which one of the following?
a. Persistent thoughts and behavior
b. Controllable impulses to perform on act or ritual repeatedly
c. Pathological persistence of unwilled thoughts, feelings or impulses
d. Recurring unwanted and distracting thoughts alternating with behavior
17. Initially, the nurse identifies this nursing diagnosis:
a. Potential for trauma c. Impaired skin integrity
b. Impaired tissue integrity d. Potential for impaired skin integrity
18. The best approach to prevent increased anxiety regarding her compulsive scrubbing of her hand is:
a. Allow agreeable limits to the ritual
b. Encourage her to join scheduled activities
c. Explain to her the disadvantages of ritual
d. Prevent her from carrying out her ritual of scrubbing her hands
19. Persons with obsessive-compulsive disorder usually manifest one of the following behaviors:
a. Anger b. Fear c. Suspiciousness d. Anxiety
20. It is postulated that obsessive-compulsive disorder results from failure to achieve properly this developmental task
a. Identity vs. Inferiority c. Autonomy vs. Shame or doubt
b. Trust vs. Mistrust d. Initiate vs. guilt
Situation: Mr. Sanchez 42-year-old businessman and father of three was admitted to the psychiatric unit with a diagnosis of depression.
During the intake interview, he exhibited symptoms of suicidal ideation when he made statements like “I am worthless. My family will better off
without me.” At home he was observed to have lost weight and diminished interest in practically all his daily activities.
21. The psychodynamic theory of depression manifested by Mr. Sanchez is categorized as :
a. negative views of himself, the world and future
b. problematic childhood
c. significant loss associated with anger and aggression
d. ambivalent family relationship
22. The nursing diagnosis for Mr. Sanchez is risk for violence, self-directed. The initial desired outcome would be: the client will
a. be safe from self-harm and harm to others c. extinguish suicidal ideation
b. verbalize higher quality of life d. participate in ward activities
23.In dealing with a client with suicidal ideation, the nurse’s attitude must indicate:
a. trying to make him feel guilty for thinking about ending his life
b. belief that he is a hopeless case
c. ability to stop him from any suicidal act
d. unconditional positive regard for the person
24. Cognitive-behavior therapy is a recommended type of psychotherapeutic approach to Mr. Sanchez includes
a. identifying and challenging clients negative views of himself
b. eliminating his suicidal tendencies
c. correcting his irrational beliefs
d. ventilation of feelings
25. Mr. Sanchez’s insomnia is related to his state of depressed condition which may be described as:
a. excessive amount of sleep
b. patient cannot sleep when they wish to sleep
c. long episodes of talking during sleep
d. difficulty in initiating or maintaining sleep
Situation: Manny P. Quiao, 26, was admitted to the psychiatric nursing unit, accompanied by wife. Claimed people are out to kill him and
being suspicious of his wife. He refused to take his medications and some food being offered. Diagnosis: Schizophrenia, Paranoid.
26. Among paranoid schizophrenics, the most common defense mechanism is:
a. suppression b. regression c. projection d. reaction formation
27. Which nursing action should the nurse take first to prevent medication non-compliance in a client with Schizophrenia?
a. teach benefits of medication compliance c. give medication in an alternate route
b. build rapport with client d. convince him that the drug is safe to take
28. Manny approached the nurse and reiterated his concern for his safety, since people are out to kill him. Which of the following actions by
the nurse would be most therapeutic at this time?
a. explaining that the fear is not reasonable c. acknowledging the patient’s fear
b. helping him to identify the alleged killers d. medicating him right away.
29. Which of Manny’s behaviors would help a nurse establish a nursing diagnosis of potential for violence for a patient who has a paranoid
schizophrenia?
a. avoidance to socialization c. verbal threats to other clients
b. insulting self d. moving to and fro
30. While receiving pharmacological treatment, Manny exhibits restlessness and sits-down for only a few minutes at a time. The nurse would
recognize that this behavior:
Page 2 of 4
Psychiatric Nursing: Disorder 1 by: Prof. R.Reyes
In light of the rapid turnover of technology in the medical sciences, the compilation of information, and the possibility of human error, ONE QUEST, and any other parties involved in said
compilation of information contained herein, disclaims all responsibility for and accepts no liability for any inaccuracies, errors, omissions or liabilities incurred as a consequence, directly or indirectly, of
the use and application of its contents. Any similarities with other materials are only a result of such compilation.
 a. needs to be further assessed to rule out medications side effect
b. is common in psychiatric patients
c. results from internal conflicts the patient is experiencing
d. will subside as the patient improves
Situation: Mhenoo Do, an 18 years old nursing student was attending a seminar in the auditorium when she began to perspire profusely,
tremble, increased respiration and felt nauseated and was not able to finish the seminar. She avoided crowds, going to a movie house and
eventually refused to go out from home. Interview revealed that when she was 5 years old, she got lost in a mall and was found by her
parents before closing time in the evening.
31. Freud would describe phobia as:
a. denial of reality by underdeveloped ego
b. inability of the ego to intervene between the id and superego
c. lack of internalization of parental attitude
d. a stressful stimulus produces an unconditional response
32. Therapeutic intervention for Mhenoo may include the following , the least needed of which is:
a. desensitization b. cognitive therap c. implosive therapy d. active socialization
33. The nursing diagnosis for Mhenoo’s problem is fear related to:
a. being in a situation from which escape might be difficult
b. traumatic childhood experience
c. inadequate support system
d. situational crisis
34. Initial intervention for Mhenoo should be:
a. accept Mhenoo and her fears without criticizing
b. help her decide with alternative coping strategies
c. explore underlying feelings that contribute to her irrational fears
d. slow unconditional positive regard
35. Desired patient outcome for this problem would be:
a. Mhenoo does not experience disabling fear when exposed to feared situation
b. Mhenoo verbalizes feelings about the situation
c. Mhenoo demonstrates willingness to socialize with others
d. Mhenoo voluntarily attends group therapy
Situation: Mr. Chris To Per, 62 years old retired teacher is admitted for complaints of epigastric pain and gas belching at night. He frequently
consults doctor for the same complaints but diagnostic test revealed negative results. Medical diagnosis: Somatoform disorder
36. Which of following defense mechanism is being utilized by Mr. Chris To Per?
a. Denial b. Displacement c. Repression d. Suppression
37. Which of the following theoretical framework for somatoform disorders explains the client’s persistent fear of disapproval from others?
a. Psychosexual theory b. Interpersonal c. Medico-biological theory d. Psychosocial theory
38. Somatization disorder is most recognizable in that the symptoms:
a. are only in the client’s imagination c. are misinterpreted by the patient
b. have no demonstrable organic cause d. result in loss of physical function
39. The conscious counterpart of conversion disorder is:
a. Malingering b. Phobia c. Dissociation d. Body dysmorphic disorder
40. A delayed reaction of the person who has been involved or exposed to a traumatic events is known as:
a. War shock b. Panic disorder c. Posttraumatic stress disorder d. Dissociative amnesia
Situation : Michaela is a 16 year-old female who displayed symptoms of anorexia nervosa for a year, but now displays symptoms of bulimia.
She has a 14 year-old sister. Her parents are in their 40’s and are both full-time professors. Michaela achieves well in school and is neat and
meticulous in her appearance.
41. During the initial interview with the nurse in the outpatient clinic, Michaela stated that there was nothing wrong with her. Which of the
following information would indicate to the nurse that Michaela displays symptoms of anorexia nervosa?
a. She has episodes of overeating and excessive weight gain
b. She expresses a positive self-concept
c. She has had severe weight loss
d. She feels lethargic
42. The nurse is also interested in information that might indicate that Michaela has symptoms of bulimia. Which of the following information
would indicate to the nurse that Michaela has symptoms of bulimia?
a. Binge eating and self-induced vomiting c. Hypertension and hypoglycemia
b. Severe weight loss due to metabolic dysfunction d. Excessive sweating and vasodilation
43. The nurse continues to interview Michaela about her health status. Additional characteristics of patients with anorexia nervosa and/or
bulimia include:
a. Below average intelligence c. Increased libido
b. Aversion to laxatives of diuretics d. Preoccupation with thinness
44. Michaela denies that she never feels nervous. However, the nurse observed that her fingernails have been bitten very short. One
component of Michaela’s nursing care would be for the nurse to:
a. Administer major tranquilizer drugs c. Set goals for immediate relief of all symptoms
b. Assess Michaela’s method of coping with anxiety d. Encourage Michaela to weight herself frequently
45. After several weeks of nursing care, Michaela stated that she feels better and has resolved most of her problems. Which of the following
behavior would indicate that Michaela had progressed?
a. Her conversations focus on foods c. Maintains secretiveness about her eating behavior
b. Identifies healthy ways of coping with anxiety d. Family contact at meal times is minimal
Page 3 of 4
Psychiatric Nursing: Disorder 1 by: Prof. R.Reyes
In light of the rapid turnover of technology in the medical sciences, the compilation of information, and the possibility of human error, ONE QUEST, and any other parties involved in said
compilation of information contained herein, disclaims all responsibility for and accepts no liability for any inaccuracies, errors, omissions or liabilities incurred as a consequence, directly or indirectly, of
the use and application of its contents. Any similarities with other materials are only a result of such compilation.
Situation: Rolly, 18 year-old has serious problems with substance abuse for the previous year. He has also difficulties with school work. He
has 6 siblings and his father is an alcoholic. His mother is passive and avoids responsibility. He has come to the mental health clinic for
treatment.
46. The nurse observed that Rolly seemed to be restless and pacing. Substance abused like Rolly have other characteristics that the nurse
should pay special attention including:
a. Characteristics of his feces c. His level of consciousness
b. His hemoglobin level d. The color of his nailbeds
47. Rolly admitted that 1 month previously, he was brought to the emergency room with an overdose of ampethamines. What nursing action
in the emergency room would be of priority in treating a patient who had overdosed?
a. Coordinating the monitoring of vital signs, urine output, mental alertness
b. Including him to vomit
c. Contacting local law officers
d. Obtaining a psychiatric concentration
48. The nurse continues to interview Rolly at the mental health clinic. To determine his pattern of drug use, the most important data for the
nurse to obtain relates to:
a. How he pays for the drug (s) being used
b. His current height and weight
c. His family’s response to his drug use
d. The types, quantity, and frequency of the drug (s) being used
49. Rolly decided that he did not want treatment. However, 1 week later he was admitted to the substance abuse unit for detoxification.
During the acute phase of detoxification from drug abuse, which of the following would be priority nursing actions?
a. Monitoring Rolly for manipulative behavior
b. Monitoring Rolly’s vital signs and other physiological withdrawal symptoms
c. Encouraging Rolly to analyze his family dynamics
d. Arranging for vacational rehabilitation counseling for Rolly
50. Following successful detoxification, Rolly participated in the 4-week substance abuse treatment program.
Nursing intervention for him would be considered to be most effective if he could:
a. Identify positive ways to cope with stress
b. Identify ways to avoid peer contact
c. Meet basic dietary and hygienic needs
d. Identify ways to decrease but not discontinue drug use
Situation: Mr. Zamora, an alcoholic, is in the emergency unit of the hospital. He exhibits agitation, slurred speech and tremors.
51. The following are characteristic of the alcoholic personality, EXCEPT:
a. Orally-fixated c. High frustration tolerance
b. Underlying depression d. Denial
52. Mr. Zamora’s wife, Chona, says “My husband can still perform his duties even though he drinks.” This is a manifestation of:
a. Enmeshment b. Blackout c. Codependency d. Projection
53. Mr. Zamora develops Korsakoff’s psychosis which is manifested by:
a. Echolalia and echopraxia b. Delusions of grandeur c. Flat affect d. Confabulation and amnesia
54. Mr. Zamora, while taking Disulfiram (Antabuse) should avoid:
a. Shaving lotions b. Toothpaste c. Baking soda d. Pastries
55. While taking Disulfiram (Antabuse) for one month, Mr. Zamora ingested 2 bottles of beer. The nurse assesses:
a. No vital signs change b. Euphoric mood c. Nausea, vomiting, hypotension d. Craving for additional alcohol
56. The nurse is using the CAGE questionnaire as a screening tool for alcohol problems. What do these initials represent?
a. Cut down, annoyed, guilty, eye opener c. Cancer, alcoholic liver, gastric ulcer, erosive gastritis
b. Consumed, angry, gastritis, esophageal varices d. Cunning, anger, guilt, excess
Situation: Manny, 80 years old was brought to the hospital by his grandson. He was observed to be wandering characterized as
“purposeless.” He was also remarked as excessively “forgetful” the previous days. Initial diagnosis: Alzheimer’s disease.
57. The nurse places an object in the hand of Manny and asks him to identify the object. Which of the following terms represents the client’s
inability to name the object?
a. Agnosia b. Aphasia c. Apraxia d. Perseveration
58. For a client with dementia who lives in a long-term care facility, which outcome takes the highest nursing priority?
a. Maintaining the client’s optimal level of functioning
b. Identifying coping methods the client can use to handle stress
c. Facilitating client conversation with five people each day
d. Having the client use physical activity to work off aggressive energy
59. Which of the following nursing interventions is the most important aspect in caring for a client diagnosed with Manny?
a. Make sure the environment is safe to prevent injury
b. Make sure the client receives food she likes to prevent hunger
c. Make sure the client meets other clients to prevent social isolation
d. Make sure the client takes care of her daily physical care to prevent dependence.
60. Which of the following interventions would help a client diagnosed with Alzheimer’s disease perform activities of daily living?
a. Have the client perform all basic care without help
b. Tell the client morning care must be done by 9 a.m.
c. Give the client a written list of activities he’s expected to do
d. Encourage the client, and give ample time to complete basic tasks.

Page 4 of 4
Psychiatric Nursing: Disorder 1 by: Prof. R.Reyes
In light of the rapid turnover of technology in the medical sciences, the compilation of information, and the possibility of human error, ONE QUEST, and any other parties involved in said
compilation of information contained herein, disclaims all responsibility for and accepts no liability for any inaccuracies, errors, omissions or liabilities incurred as a consequence, directly or indirectly, of
the use and application of its contents. Any similarities with other materials are only a result of such compilation.