University of Bohol

College of Nursing
City of Tagbilaran

PRELIM EXAM IN NCM 108 – HEALTH CARE ETHICS

Name: _________________________________________ Section: ____________________

INSTRUCTIONS: Read the situation and the questions carefully and write only the letter of the
correct answer on the separate answer sheet provided.

Statement: Nurses are responsible to provide their patients with high-quality care. Yet, they are
undoubtedly and ever-increasingly confronted with complex concerns in their professional
practice. They must be familiar with the essentials of health care ethics and ethical decision
making. Questions 1 to 7 refer to this statement.

1. Ethics is defined as a set of rules or principles that govern right conduct and is designed
to protect the rights of a human being. The following statements describe the term ethics
EXCEPT:

a. defined as the system or code of conduct and morals

b. system of understanding determinations and motivations
c. provides the professional standards
d. set of personal or social standards for good or bad behavior

2. The ICN adopted the code of ethics and implemented a rule that all nurses must follow
this code. The nurse knows that ICN stands for:

a. International Conference for Nurses

b. International Council for Nurses
c. Integrated Council for Nurses
d. Integrated Conference for Nurses

3. The fundamental responsibility of a nurse according to ICN are the following APART
FROM:

a. Promotion of health and well-being

b. Prevention of illnesses and complications
c. Restoration of health
d. Aggravation of suffering

4. Which of the following statements BEST defines Bioethics?

a. It proceeds from the deliberate free will of man
b. It is a quality of human acts where the acts could either be good or right, evil
or wrong.
c. It refers to the conditions in which the act is done affecting its morality
d. It deals with the ethical and moral implications of new biological discoveries
and biomedical advances

5. Which of the following DOES NOT describe the purpose and scope of BIOETHICS?
a. To reveal the hidden bioethical issues
b. To distinguish right or wrong based on given bioethical issue.
c. To measure the safety limits of any bioethical issue.
d. To create a new ethical law based on the bioethical issues.
 6. The following statements describe ethical dilemma EXCEPT:

a. Discusses an ethical issue to bring out solutions and check the pros and cons
b. Arises when a decision needs to be taken in a situation
c. Each alternative action is justified according to the view of ethical practice
d. Always enacted by public authority

7. Which of the following statements is TRUE about ethical dilemma?

a. It automatically ceases to bind with death or removal from office of the legislating
authority
b. There will be two morally acceptable solutions for the same issue, and it is difficult to
find a ‘right’ solution that can be justified
c. It is employed to regulate human conduct in the practice of health care so that good
may be done and evil may be avoided
d. It regulates human conduct in the light of moral principles in relation to human life in
all its aspects

Statement: The code of ethics states the kind of conduct expected from the members of a
profession and the responsibilities of its members towards those whom they serve, their co-
workers, the profession and the society as a whole. Questions 8 and 13 refer to this statement.

8. The ICN Code of Ethics gives a general description on HOW NURSING SERVICE
SHOULD BE GIVEN. This refers to:

a. Irrespective to age, sex, race, status, religion and politics

b. Carried out with honesty and integrity
c. Continued nursing care until adequate relief is attained
d. Giving of conscientious service

9. The ICN Code of Ethics gives a general description on TO WHOM SERVICE IS GIVEN.
This refers to:
a. Nurses and other members of the health care team
b. Individual, family and community
c. Local and international society
d. Individuals and families

10. A nurse tries to give treatment to a dying patient because he/she respects the patient’s
rights and believes that he/she is doing good to the patient. However, the patient believes
that he/she is going to die, asks for euthanasia or mercy killing, and refuses to take the
treatment. In this case, the dilemma involves conflicting ideas between the care provider
and the recipient. What type of ethical dilemma is present?

a. Internal dilemma
b. External dilemma
c. Median dilemma
d. None of the above

11. Nurse Ella is being asked by a student nurse on what specific area in the hospital wherein
ethical issues are more frequently met?

a. Emergency room
b. Out-patient department
c. Critical care units
d. All of the above
 12. The ethical issues in the care of abortion deals with the rights of the unborn child, who is
being killed mercilessly. When presented using the iceberg model, the hidden part of the
iceberg signifies what?

a. Rights of the mother

b. Rights of the parents
c. Legality of abortion
d. Rights of the unborn child

13. To address the dilemma, how would the nurse reveal the hidden part of the iceberg?

a. Seek counsel from persons in authority

b. Be constantly aware of the ethical issue
c. Be brave in adhering to the objective norm
d. In-depth understanding of the bioethical principles
Situation: Steve is in his early thirties and a very keen cyclist. A few years ago, he was run down
and very badly injured. One leg had to be amputated and there are no concerns that the other
may have to be amputated also. Steve also suffered irreversible brain damage. Since the
accident, he has been in a coma and is on life support. Yesterday, his partner Jane showed Nurse
Linda an advance directive that Steve had signed several years previously. That will made it clear
that if he suffered serious irreversible brain damage, he did not want any life-saving treatments
and certainly would not want to be kept alive if he could not carry on cycling. Questions 14 to 17
refer to the situation.
14. Using her prior knowledge on patient autonomy, Nurse Linda’s initial response to the
advance directive of her patient is to:

a. Honor and obey the patient’s wishes

b. Reject the patient’s wishes and proceed to treatment
c. Ask the ward supervisor
d. Report to attending physician

15. Despite the need, the medical team haven’t applied any life-saving treatments to patient
Steve as stated on his advance directives. Do you agree with his actions?

a. Yes, because you have respected patient’s right to make decisions for himself
b. No, it would be better if the medical team has to give life-saving treatment in
response to patient’s right to life
c. Not sure with this because the statements written in his advance directives are
insufficient

16. The nurse could say that she is currently facing an ethical dilemma. What ethical dilemma
is involved in the given situation?

a. Right to Refuse Treatment

b. Refusal to Treat
c. Refusal to Cure
d. Right to Refuse Cure

17. It was stated in Patient Steve’s advance directives that life-sustaining treatments or
medications must not be given onto him. The nurse anticipates that the doctor would write
what order on the physician’s progress notes?

a. Do Not Resuscitate
b. Allow Natural Death
c. On Watchful Waiting
d. Discontinue medications
Situation: A staff nurse working in a private hospital is told by the medical director who is a
gynecologist to assist him in the tubal ligation of a post D.R. case for purposes of preventing
further conception as per request of the patient on ground of having many children already.
Questions 18 to 20 refer to this situation.
18. With prior knowledge on health care ethics, the said nurse knows it is immoral. Yet, she
still assists the physician out of fear of losing her job if ever she refuses. She currently
encounters what ethical dilemma?

a. Right to Refuse Treatment

b. Refusal to Treat
c. Refusal to Cure
d. Right to Refuse Cure

19. She must obtain an important legal document prior to the procedure. This document is
known as:

a. Informed consent
b. Advance Directive
c. Living Will
d. Special Power of Attorney

20. While securing this document, the nurse knows that this nursing action is given of highest
priority:
a. Thorough explanation on indications, risks, benefits and alternatives of the procedure
b. Detailed explanation on the estimated expenses
c. Background about the procedure and the surgeon
d. Discussion on the indications of the procedure
Situation: A certain doctor-scientist exerts all his efforts to invent an absolute cure for a dreaded
disease. He invents one and applies it to chimpanzees infected with the advanced stage of such
a disease. The said drug is proven so effective among the other newly found cure for the disease
but that one. Upon knowing it, several patients with the disease rush to the doctor-scientist and
ask for the cure. The said drug has never been tested among human beings. Questions 21 and
22 refer to this situation.
21. As a nurse researcher working with the doctor-scientist, the primary role of the nurse is
to:

a. Do no harm to participants
b. Provide awareness about the research
c. Help them utilize their right to receive treatment
d. Conform with the principles of privacy and confidentiality

22. What ethical dilemmas are involved in the said experiment?

1. Trial and error experiment

2. Safety, Confidentiality and Privacy
3. Participation in Research
4. Protection of Respondents
a. 1 only
b. 1 and 2 only
c. 1 and 3 only
d. All of the above
Situation: Patient Manuel who is still conscious, yet, whose irreversible death because of terminal
prostatic cancer is fast approaching, verbally signifies his wish. The patient verbalizes to the
attending physician, “I want to donate some of my vital organs to the organ bank for life-
sustenance of other. You can have my kidneys, corneas, heart, lungs and liver removed for future
transplantation”. The patient’s significant others have also agreed. Questions 23 and 24 refer to
this situation.

23. On the other hand, the doctor writes “DNR” order on the patient’s chart. The nurse must:
a. Obey and do no measures to prolong the life of the patient during arrest
b. Clarify the doctor’s order. It might be a mistake
c. Review the patient’s condition if it necessitates for it
d. Discuss with your nurse supervisor regarding the doctor’s order.
24. As a nurse assigned to Patient Manuel, you anticipate that the attending physician’s
response would be:
a. “Okay, but it’s better for you and your relatives to sign a document consenting to the
donation of your vital organs.”
b. “Okay, we can have the procedure as soon as possible. We appreciate your
generosity.”
c. “Sorry, I won’t allow you to have organ donation because you have an irreversible
illness. Only those people who died from an accident are allowed to donate vital
organs.”
d. “I’m not sure if it is morally good to donate organs. God won’t allow that.”

25. Nurse Jessica is assigned in the intensive care unit at a certain private hospital. One of
her patients verbally request assistance to remove all life-sustaining devices from her.
The BEST way that she must do is to:

a. Notify the attending physician

b. Notify the nurse supervisor
c. Obey patient’s request
d. Let the patient sign consent

26. Ethics act as an important guide to ensure right and proper conduct in the daily practice
of the law. What is the BEST practice for a nurse to avoid law suites?

a. Practice within the scope of your expertise

b. Always put the patient’s rights and welfare first
c. Observe proper documentation
d. All of the above

27. DNR is also known as “allow natural death” indicating that a person does not want to
receive cardiopulmonary resuscitation if that person’s heart stops beating. The nurse
knows that DNR stands for?

a. Do Not Repeat (procedure)

b. Do Not Resuscitate
c. Did Night Recall
d. Doctor Noticed Recurrence
28. Ms. Marjorie is a nurse for 25 years and has been diagnosed with stage 4 breast Cancer
which has metastasized to other parts of the body. Although prognosis is poor she sees
life as the highest value with death as defeat. She is hopeful and somewhat overly
influenced by available technology and biological idolatry thus she wants to do everything
to prolong life beyond one’s time. This refers to:

a. Euthanasia
b. Dysthanasia
c. Orthonasia
d. Suicide

29. During times when pain is quite unbearable, she cannot endure such feeling and cannot
bear to see her family’s suffering, then one resorts to “advanced” death. This is termed:

a. Euthanasia
b. Dysthanasia
c. Orthonasia
d. All of the above

30. In countries where assisted suicide is legal, this act is popular may be due to the
following concept EXCEPT:

a. Economic constraint
b. Quality of life is poor
c. An attempt of the patient to gain control
d. None of the above

31. Autonomy as a reason for Euthanasia would mean:

a. High cost of health care for the elderly

b. Quality of life is poor
c. It is practicing the “right to die”
d. Patients see themselves as burdensome

32. In the Philippines, any form of euthanasia is never allowed. For the reason that:

a. It is intrinsically evil to kill another human being

b. There’s economic constraint from the escalating health care cost of the elderly
c. It is an attempt to regain control of her own life
d. Patients develop a misplaced “duty” to die

33. As a Filipino, we strongly believed in the following EXCEPT:

a. Human life is a gift from God.

b. One cannot bear to see suffering and it is respectful to resort to euthanasia
c. Disabled newborn is good luck and caring for a loved one is a privilege
d. In brotherhood and solidarity, we cannot end life of another person even if she
wishes to.

34. Allowing death at its natural time is acceptable to us Filipinos. There are also people
around the world with such belief. These may be due to religious influences. The reason
for this brave decision may be:

a. Life is not the highest value because death is everyone’s natural end.
b. Technology can prolong life no matter how little the quality might be.
c. It is the patient’s right to decide for her life to end in advance through the
assistance of the physician
d. None of the above
35. The nurse who is caring for the dying should make sure that her patient has dignity. And
this would mean:

a. Cared for by stranger

b. Amidst unfamiliar surroundings
c. With pain management
d. With minimal control over his destiny

36. When caring for the dying, the primary person to decide for his health management is:

a. Health practitioner
b. Nurse
c. Patient
d. Significant others

37. When the patient is not competent to make decisions for his care, the reasons could be
the following EXCEPT:

a. Age of the patient

b. Cognitive status of the patient
c. Conscious state of the patient
d. Part of the health care team

38. The nurse checks if the patient has made a living will in case he becomes incompetent.
This means:

a. Ensuring that all his properties will be distributed evenly

b. He has directives to withhold or discontinue certain treatments if unable to make
decisions
c. Ensuring that the nurse will be able to witness the making of the will
d. He has directives to his family to be fair and respect his decision

39. A durable power of attorney for healthcare was made by the patient. You expect:

a. A spokesperson is selected to represent the patient

b. A means to physician assisted suicide
c. A directive instructing the physician to discontinue certain treatment
d. All of the above

40. Palliative care is given for irreversible fatal, terminal conditions and recognizes that time
is no longer feasible. The approach for this kind of care is:

a. To seek technology to prolong the life of the patient to its maximum time
possible.
b. To seek the patient’s best interest holistically in compassionate manner.
c. To care for the patient with family alongside in every procedure.
d. To refuse treatment

41. Physician’s role in the care of the dying patient may include the following EXCEPT:

a. Physician should endure and medicalized rich patient as they are ones who can
afford
b. Physician should have appropriate skills to encourage the patient to undergo
newly discovered procedures
c. Physician should allow his patient to die peacefully as desired
d. Physicians make sure that patient dies alone and isolated from her family
42. Some physicians could sometimes forget the personhood but instead might focus on the
biological aspect of the patient. The prudent use of technology should be measured well.
A disproportionate measure could happen when

a. A patient has no reasonable hope of success

b. He has a good chance of success in health
c. Priority must be given to desires rather than needs
d. We do not deny the existence of death.

43. Nurse Claudine with the members of the health team were in a conference with the mother
of an 8-year-old patient with terminal disease. The family has decided to withhold the
treatment doing extra-ordinary life support measures. Knowing that this can actually lead
to the death of the patient, nurse Claudine is hesitant to take part in the processes as she
thinks she is killing the patient. Which statement may assure the nurse’s role?

a. Refusal is the right of the patient / family members.

b. Allowing one to die is morally acceptable as a natural conclusion of life.
c. Technology is reasonable hope of success of life or health
d. The denial of death keeps the patient hanging on to technology

44. Most of the patients are afraid to feel pain. Doctors then should:

a. Assure patient that pain can be controlled within the boundaries that they can
cope.
b. Give care limited to the body.
c. Give the family enlightenment and support.
d. Assure openness and truth should prevail.

45. The goal of nursing includes the conservation of life, alleviation of suffering and
promotion of health. Ethical knowing focuses on:

a. The art of nursing and is expressed by the individual nurse through creativity
b. Focuses on matters of obligation or what ought to be done
c. Promoting wholeness and integrity in the personal encounter
d. A range of knowing from factual and observable phenomenon.

46. An action or omission which of itself or by intention causes death, in order that all
suffering may be eliminated is:

a. Euthanasia
b. Health economics
c. Health management
d. Dysthanasia

47. A reason why assisted suicide is popular in other countries is Hedonism. This means:

a. The patient has the right to decide for his care and management.
b. The patient attempts to regain control over the management of his care.
c. The patient is concern with his economic constraint
d. The patient follows the concept that when the quality of life is poor

48. Abortion is probably the most disputed and emotional medical ethics there is. Abortion is
defined as:
a. The expulsion of a fetus
b. The expulsion of a nonviable fetus
c. The removal of a nonviable fetus
d. The removal of any fetus where death is the intended outcome.
Situation: A pregnant patient is admitted with excessive accumulation of amniotic fluid in her
uterine cavity. The physician told the patient that the fetus is still non-viable and if they drain the
excess fluid, the fetus will die. Questions 49 and 50 refer to this situation.
49. As a nurse assigned to this patient, is it morally justifiable for the health care practitioners
to get rid of the excessive accumulation of amniotic fluid resulting to the fetus’ death?

a. Yes, it is morally permissible because abortion is foreseen but unintended loss of

the fetus following a procedure necessary to preserve the life or health of the
mother
b. No, it is not morally justifiable because any form of abortion (ending the fetus’ life)
is conspicuously condemned by the Sacred Scriptures at all costs.
c. No, it is not morally permissible because innocent life is taken which is grievously
against the natural law
d. Yes, it is morally permissible because health care practitioners are morally allowed
to do procedures only when they are sure that the fetus is dead.

50. What possible alternative solution would you suggest as a health care practitioner?

a. Request the attending physician to prescribe medications that decrease amniotic

fluid volume
b. None, there is no possible alternative for the patient’s condition
c. Collaborate with the patient’s significant others
d. Collaborate with a guidance counselor to address patient’s grief

51. Abortion issue has drawn religious groups into the public controversy. Which of the
following is not a basis for the religious groups’ objection to abortion?

a. Divine revelation
b. Church tradition
c. Court decision
d. Philosophical arguments

52. Two ways that a patient can be declared dead are:

a. Cardiopulmonary and brain death

b. Multiple organ failure and cardiopulmonary
c. End stage renal disease and brain death
d. Cardiopulmonary and liver dysfunction

53. Which of the following allows the minors to make their own decisions?

a. Absence of significant others

b. Marriage
c. Allowed by the physician
d. By virtue of the principle of justice

54. The philosophy of maximizing pleasure and minimizing pain:

a. Justice
b. Utilitarianism
c. Autonomy
d. All of the above
55. The __________ focuses on the consequences of an action rather than the intentions
behind it.

a. Consequentialist
b. Behaviorist
c. Psychologist
d. Principle of Utilitarianism

56. When deciding on a dilemma in health care, another consideration is that pleasure is the
greatest good. This refers to:

a. Autonomy
b. Hedonist
c. Utility
d. Truthfulness

57. When caring for a patient, the nurse recognizes that it is up to the patient to make her
own decision in the management of her status and this principle is:

a. Justice
b. Autonomy
c. Beneficence
d. Nonmaleficence

58. When faced with health care dilemma it is important that the health care provider avoid
either inflicting physical and emotional harm on a patient or increasing the risk of such
harm. This principle is called:

a. Justice
b. Autonomy
c. Beneficence
d. Nonmaleficence

59. The goal of nursing is to promote health, prevent further complications and basically care
for the good of the patient. When deciding for the kind of nursing management for the
patient it is vital in the nurse’s decision to prevent or remove harm and promote well-being.
Do good and avoid evil. This follows the principle of:

a. Justice
b. Autonomy
c. Beneficence
d. Nonmaleficence

60. Bioethics can be described/defined by the following:

a. The branch of ethical inquiry that examines the nature of biological discoveries
b. The branch of ethical inquiry that examines the technological discoveries
c. The responsible use of biomedical advances, with particular emphasis on their
moral implications for our individual and common humanity.
d. All of the above

61. The patient has autonomous choice when it has the following criteria EXCEPT:
a. The choice is guided by family members and health care team.
b. The choice is intentional.
c. The choice is free of undue outside influence
d. The choice is made with rational understanding.
Euthanasia is inherently wrong because it violates the nature and dignity of human beings.
62. Euthanasia is commonly known as:

a. Mercy kidding
b. Mercy killing
c. Sanctity of human life
d. Moment of conception

63. Euthanasia is derived from the Greek word “Eu” which means:

a. Bad
b. Good
c. Tender
d. Mercy

64. The word “thanatus” a Greek word which also means:

a. Birth
b. Love
c. Death
d. Alive

65. Some argue that directly intending a patient's death may be permissible because, to the
patient death:

a. May be a great harm

b. May be what the family wishes
c. May release physicians from responsibility
d. May not be a harm

66. Scientific research on policies permitting euthanasia or assisted suicide lead to

unjustified killing is:

a. Scant
b. Definitive
c. Sufficient
d. Abundant

67. Allowing someone to die by not doing something that would prolong life is called:

a. Voluntary euthanasia
b. Passive euthanasia
c. Non voluntary euthanasia
d. Active euthanasia

68. Proponents of active voluntary euthanasia believe that the right to die is:

a. Compel others to help someone die

b. Does not compel others
c. Justifies involuntary euthanasia
d. Applies only to the nonreligious
69. Which of following persons first used euthanasia in 1623?

a. Francis Port
b. Francis Hope
c. Francis Berk
d. Francis Bacon

70. Withholding or withdrawing life-sustaining measures without the consent of the patient is
known as:

a. Active non voluntary euthanasia

b. Active voluntary euthanasia
c. Physician-assisted euthanasia
d. Passive non voluntary euthanasia

71. A patient taking his or her own life with the aid of a physician is known as:

a. Suicide
b. Passive suicide
c. Physician-assisted suicide
d. Active euthanasia

72. The view of death that says an individual should be considered dead when the higher
brain operations responsible for consciousness permanently shutdown is called:

a. Chemical death
b. Traditional standard of death
c. Higher brain death
d. Whole brain death

73. Opinion polls show that on the issue of physician-assisted euthanasia:

a. Almost everyone favors it

b. Almost everyone opposes it
c. A large majority oppose it
d. People are divided

74. Which of the following is a positive argument that Euthanasia aims?

a. Cowardliness in the face of pain

b. To preserve human dignity until death
c. Cowardliness in the face of suffering
d. To suppress life

75. Which of the following describes suicidal euthanasia?

a. Seeks to eliminate lives, devoid of vital value

b. To liberate a person from a terrible disease
c. Subject himself to lethal means to interrupt or suppress his life
d. Passive death
 76. When a person request to be killed this is under what classification of euthanasia?

a. Euthanasia by omission
b. Euthanasia by action
c. Voluntary euthanasia
d. Direct euthanasia

77. Which of the following choices describes Euthanasia for piety?

a. Perform to liberate a person from a terrible disease

b. Subject himself to lethal means to suppress his life
c. Passive death
d. Seeks to eliminate life without medical interventions

78. Which of the following is an example of non- active euthanasia?

a. Life support systems shall be withdrawn from the patient

b. Avoid intake of common treatments
c. Person consents himself to be killed painlessly
d. Lethal means to suppress his life

79. A terminally ill patient vehemently refuses to take food and drinks in an intention to
hasten his death. The type of euthanasia being described in this situation is:

a. Euthanasia by Commission
b. Euthanasia by Omission
c. Euthanasia by Audition
d. Euthanasia by Illusion

Suicide is a blatant negation to accept the facts of life in the name of courage, obligation,
respect, love and gratitude to God and the members of human society. If life is God-given then it
is God alone who has the absolute right to curtail it. Therefore suicide is condemned with so much
spite of distaste as gravely illegal and the most gravely immoral.

80. The term suicide is derived from the Latin word suicidium which means:

a. To love oneself
b. To kill oneself
c. To inflict oneself
d. To ignore oneself

81. According to the data provided by the WHO how many people die of suicide every year?

a. 2 million
b. 3 million
c. 500 thousand
d. 1 million

82. The following are common causes of suicide EXCEPT:

a. Physical pain, illness

b. Anxiety, emotional pressure
c. Depression, desperation
d. Sense of awe and wonder
83. Experts qualify the following as a common methods of committing suicides EXCEPT:

a. Asphyxiation, caused by hanging oneself

b. Toxification or poisoning
c. Blunt force trauma , jumping from a building
d. Starvation

84. Geographic comparison, records show that Asians have earned a higher suicide marks in
the following country EXCEPT:

a. China
b. India
c. Japan
d. America

85. “No one has absolute power over life and death but God. We are stewards of the gift of
life granted by God”. This statement is according to:

a. Catechism for Filipino Catholics 1038

b. Catechism for Filipino Catholics 2281
c. Catechism for Filipino Catholics 2080
d. Any of the choices

86. According to study which of the following choices is CORRECT data for men and women
who commit suicide?

a. More men die of suicide than women

b. More women die of suicide than men
c. There is an equal number of men and women who commit suicide
d. Any of the choices

87. A patient with a diagnosis of major depression who has attempted suicide says to the
nurse, "I should have died. I've always been a failure. Which response demonstrates
therapeutic communication?

a. "You have everything to live for"

b. "Why do you see yourself as a failure?"
c. "Feeling like this is all part of being depressed."
d. "You've been feeling like a failure for a while?

88. In planning care for a suicidal client, which correctly written outcome should be a nurse's
first priority?

a. The client will not physically harm his self.

b. The client will express hope for the future
c. The client will establish a trusting relationship with the nurse.
d. The client will remain safe during the hospital stay.
89. Nurse Anita is working with the family of Mary Ann, a client with personality disorder.
Which of the following should Nurse Anita encourage the family members to work on?

a. Avoiding direct expressions of problems with family

b. Changing Mary Ann’s problem behaviors
c. Improving self-functioning
d. Supporting Mary Ann’s defenses.

90. Nurse Dana is working with clients who have personality disorders. Which of the following
techniques would the nurse use to deal with her own feelings that interfere with therapeutic
performance:

a. Active listening techniques

b. Challenging the client’s assertions
c. Forming social relations
d. Seeking peer or supervisor direction

91. Angela has a history of conflict-filled relationships. Despite an expressed desire for friends,
she acts in ways that tend to alienate people. Which nursing intervention would be
important for Angela?

a. Establish a therapeutic relationship in which the nurse uses role-modeling and role-
playing for appropriate behaviors
b. Help the client to select friends who are kind and extra caring.
c. Point out that the client acts in ways that alienate others.
d. Recognize that this client is unlikely to change and therefore intervention is
inappropriate.

92. Kyle is a client with an anxious, fearful personality who has difficulty accomplishing work
assignments because of his fear of failure. Which nursing diagnosis would be most
appropriate?

a. Ineffective coping
b. Decisional conflict
c. Disturbed thought process
d. Risk for self-directed violence

93. Nurse Rica is teaching a client and her family about the causes of depression. Which of
the following causative factors should the nurse emphasize as the most significant?

a. Brain structure abnormalities

b. Chemical imbalance
c. Social environment
d. Recessive gene transmission

94. Clara is under evaluation for imminent suicide risk, which information given by her would
be most significant?

a. At least a 2-year history of feeling depressed

b. Divorced from spouse 6 months ago
c. Feeling loss of energy and appetite
d. Reference to suicide as best solution to identified problems
 95. Rendell your best friend suddenly tells you about his plans for suicide. Which of the
interventions will appropriate for your best friend?

a. Allow time alone for reflection.

b. Encourage to verbalize feelings.
c. Monitor Rendell for suicide precautions.
d. Stimulate Rendell for interest in activities.

96. Which of the following individuals is at highest risk for committing suicide?

a. 71 year old male, alcohol user, independent-minded

b. 16 year old female, diabetic, with 2 best friends
c. 47 year old male, schizophrenic, unemployed
d. 57 year old female, depression, active in church

97. A suicidal client says to a nurse, "There's nothing to live for anymore." Which is the most
appropriate nursing reply?

A. "Why don't you consider doing volunteer work in a homeless shelter."

B. "Let's discuss the negative aspects of your life."
C. "Things will look better in the morning."
D. "It sounds like you are feeling pretty hopeless."

98. 4 During a one-to-one session with a client, the client states, "Nothing will ever get
better," and "Nobody can help me." Which nursing diagnosis is most appropriate for a
nurse to assign to this client at this time?

A. Powerlessness R/T altered mood AEB client statements

B. Risk for injury R/T altered mood AEB client statements
C. Risk for suicide R/T altered mood AEB client statements
D. Hopelessness R/T altered mood AEB client statements

99. A nurse is caring for a client who has threatened to commit suicide by hanging. The
client states, "I'm going to use a knotted shower curtain when no one is around." Which
information would determine the nurse's plan of care for this client?

A. The more specific the plan is, the more likely the client will attempt suicide.
B. Clients who talk about suicide never actually commit it.
C. Clients who threaten suicide should be observed every 15 minutes.
D. After a brief assessment, the nurse should avoid the topic of suicide.

100. A nurse is caring for a client who has threatened to commit suicide by hanging.
The client states, "I'm going to use a knotted shower curtain when no one is around."
Which information would determine the nurse's plan of care for this client?

A. The more specific the plan is, the more likely the client will attempt suicide.
B. Clients who talk about suicide never actually commit it.
C. Clients who threaten suicide should be observed every 15 minutes.
D. After a brief assessment, the nurse should avoid the topic of suicide.

“Nursing encompasses an art, a humanistic orientation, a feeling for the value of the individual,
and an intuitive sense of ethics, and of the appropriateness of action taken.”

– Myrtle Aydelotte