PSYCH LAB

FINALS
(NCM 117)
Some of her ward mates were also Complaining about her extreme agitation. Which nursing intervention
should be implemented using a biological approach?
Select one:
a Administer PRN medications to decreased agitation and anxiety.
b. Discuss with the client factors that might trigger anger outbreaks
c. Encourage the client to use ROM exercises when dealing with increased agitation.
d, Develop a plan to decrease tension during family therapy.

Which of the following would be the most appropriate direct question for the nurse to use during an initial
interview with a client who has just experienced a panic attack?
Select one:
a. Tell me about what causes you to feel this way."
b. "Have you ever felt this way before?
C. "Does anyone else in your family have these feelings?"
d. "Tell me what you are feeling now?

In attempting to control a patient who is suffering panic, the priority is:

Select one:
a Hold the patient
b. Demonstrate ADLs frequently
c. Provide safety
d. Describe crisis in detail

In attempting to control a patient who is suffering panic, the priority is:

Select one:
a Demonstrate ADLs frequently
b. Hold the patient
C. DesChibe Crisis in detail
d. Provide safety

Which of the following is an example of a physiologic response to a panic Level of anxiety?

Select one:
a Loss of consciousness
b. Dilated pupils
C. Possible psychosis
d. Inability to focus

During a clinic visit, an expectant woman exhibits extreme anxiety during a discussion about school Life.
This is what type of crisis?
Select one:
a Maturational crisis
b. Crisis of anticipated life transition
C. Adventitious crisis
d. Situational crisis

After an argument with his father a boy 9oes to his room and kicked his door, is an example of which
defense mechanism?
Select one:
a Projection
b. Sublimation
C. Introjection
d Displacement
Which of the following instructions should the nurse include when teaching the family of a client with major
depression?
Select one:
a Explain that depression is an illness and can be treated
b. Describe how depression masks a person's true feelings
c. Teach how depression causes frequent disorganized thinking
d. Address that depression is a Lifelong illness

The fight or flight response is an automatic physiological reaction to an event that is perceived as stressful
or frightening. Which biological responses are associated to this syndrome?
Select one:
a Gonadotropins cause a decrease in secretion of sex hormone and Produce impotence
b. Bronchioles in the lung5 dilate, and respiration hate increases.
C. Thyrotropic hormone stimulates the thyroid gland to increase metabolic rate.
d. Vasopressin increases fluid retention and increases blood Pressure.

Which nursing intervention would take priority to patient who was admitted to a medical unit due to
complains of headaches, palpitations, and inability to concentrate?
Select one:
a Encourage the client to express feelings
b. Sit with the client and use a Colm but directive apPproach,
C. Discuss alternative copin9 strategies with the client.
d. Use a distraction, such Os having the client attend group.

Which of the follouing statement indicates that Learning took place during discussion about Crisis?
1. A Crisis is associated with psychopathology.
2. A Crisis is caused by specific discernible events.
3. A Crisis is chronic in nature and needs multiple interuentions over time.
4. A Crisis is unique to an individual and the cause may differ
5. A Crisis contains the potential for psychological grouth and deterioration.
Select one:
a 3, 4, 5
b. 1, 3, 5
c1.2
d. 2, 4, 5

You are developing a plan for a patient who is cuhrently manifestin9 a Crisis situation. Which of the
follouirg is the cortect order of this plan?
1. Assess for Suicidal and homicidol ideation
2. Discuss coping skills used in the past, and noteif they were effective
3. Establish a working relationship by active listening
4. Develop a plan of action fo dealing with future stressors
5. Evaluate the developed plantIBk-s effectiueness
Select one:
a 1, 3, 2, 4, 5
b. 2, 1, 5, 3, 4
c.1. 3, 4, 2, 5
d. 2. 5. 1, 4, 3

A person who habitually expresses anxiety through physical symptoms is using:

Select one:
a Regression
b. Projection
c. Hypochondriasis
d. Conversion
A client, who was raped and violently attacked by unknown person, tells the nurse about the incident with
no emotions related to the event. Which defense mechanism is the client using?
Select one:
a Isolation.
b. Regression.
C. Displacement.
d. Compensation.

During completion of a nursing risk assessment of client experiencing agitation, which cognitive symptom
would the nurse document?
Select one:
A. Flushed face
b. History of throwing objects on the unit
C. Past history of violence
d. Disturbed thought process

Projection is best pOrtrayed in which of the folLouing situation?

Select one:
a A Promiscuous wife alleges her husband of having an affain
b. A wife who failed to get Pregnant, works hard at becoming9 employee of the year
C A mon who was sexually assaulted as a child remembers nothirg of the event
d. A husband baught an expensiue bracelet to his wife but hauing an outside affair

A young physician begins to smoke a pipe, started to Look like Sigmund Freud and displayed insecurities
after he failed the licensure examination. You know that the client is exhibiting what defense mechanism?
Select one:
a Repression
b. Reaction formation
C. Identification
d. Regression

A student nurse is envious of her classmate for earning the award she herself expected. During their meet-
up, the student nurse was 1 hour Late, apologizing and begging forgiveness. The student is displaying
which behavior?
Select one:
a Self-assertion
b. Passive-aggressiveness
c.Omnipotence
d. Splitting

Which of the following client would require an immediate nursing intervention?

Select one:
a A client isolating herself and not joining any milieu therapy.
b. A client verbalizing homicidal thoughts towards his cousin.
C. A client verbalizing inability to sleeping for the last 2 nights
d. A client experiencing apd, pressured speech and poor personal boundaries

Which of the following situations is an example of displacement?

Select one:
a A nursing student is unable to report for duty because of severe headache
b. A man does not recall hitting his son when he was a young child
C. A married woman is attracted to one of her husband's male friends and treats him rudely
d. The patient shouts at the nurse after her family fails to visit her
Lately, Freeda has been very sarcastic and does not join any group therapy. Which short term outcome is
appropriate for her?
Select one:
a The client will take accountability about her own feelings.
b. The client will join during an outpatient group therapy sessions within 2 weeks upon discharge.
C. The client will not inflict harm towards herself or others.
d. The client will voice feelings of anger and hostility during group therapy by end of shift.

Among which of the following nursing interventions is needed by a client who is experiencing tension and
needs direction to solve a problem, using a behavioral approach?
Select one:
a Ask the client to think of a time in the past when anxiety was marageable.
b. Assess the client+IBk°s famiLy history for anxiety disorders.
C. Encourage jounal writing9 t express feelings.
d. Encourage the client to use deep breathing techniques.

A client is scheduled for a radical mastectomy. As the nurse enters the client's hospital room, the client
says, it would be easier if I just didn’t wake up from the surgery", The best response for the nurse to make
at this time is
Select one
a "You are just afraid now everything will look different tomorrow
b. Why do you think it would be easier to die than to wake up after Surgery?
c. "You feel, it would be easier die than to face the Loss of you breast?
d. "Some people feel the same way you do but this does not mean that the end of your Life

A client who is experiencing a panic attack, Your priority action is to:

Select one:
a Administer a dose of diazepam
b, Stay with the client and eassure of safety.
C, Leaue the client alone ina quiet toom so that she can calm doun
d. Encourage the client to talk about what triggered the attack.

Reaction formation is best demonstrated in which of the follauirg situation

Select one:
a A client beirg a Leader of ALcoholic Anonymous while still drinkirg 8 bottles of beer a day
b. A raped client at very young age, and later joining lau enforcement.
C. An unhappy cLient being a fathen although he has been seen pampering his son publicly.
d. A client is angy when his call bel was not ansuwered but decides to make unne cessary calls
to the huse,

Jasper has been terminated from work because of dounscaling9. Obviously upset when explaining to his
friend, he stated that, +IBu-Imagine what I can do with this extra time.+IB0- He is exhibiting which
defense mechanism?
Select one:
a Rationalization.
b. Intellectualization.
c. Denial.
d. Suppression.

During a group therapy, Jose became increasingly restless and iritable ond shouts at the coordinaton
Which of the follouing nursing diagnasis is you priority?
Select one:
a Ineffective coping
b. Risk for injury towards others
c. Social isolation
d. Anxiety
Futhermore, Narcissa has been displaying patterns of terminating relationships and poo selfresteem Usirg
Sullivant 1Bk-s interpersonal theory, uhat major developmental state is this client trying to lean?
Select one:
a Early adolescence.
b. Preadolescence
c. Juenile.
d. Late adolesocence

Which of the followir9 is an example of a behauioral response to a mild Level of anxiety!

Select one:
a Heart palpitations
b. Limited attention span
c. Restlessress
d. Narrowing perception

Taking care of a patient with dependent personality disorder is a great challenge for the nurse. To foster
development of autonomy to the patient, the nurse should:
Select one:
a. Assist client to improve daily functioning
b. Teach client problem solving skills
C. Help client explore strergth and assets
d. ALL of the above

In terminating the therapeutic relationship with Paul prior to his discharge, Nurse Dolores should do one of
the following:
Select one:
a. Focus less on the expression of feelings as termination of relationship nears
b. Allow him to express his feelings about leaving the hospital
c. Discuss opportunities for future relationship
d. Discourage discussion of past relationship

Temperament is understood by the client if she stated which of the following statement?
Select one:
a. +IBw-I need to put effort in fixing my problem as this affects my development. +IBO
b. +IBw-Social and personal situations build my temperament, thus affecting how I perceive, relate to
others and think about myself. +IBO
c. +IBw-I am eccentric, and this affects my relationship with others.+IBO
d. +IBw-Infancy and childhood greatly affect the development of my temperament. +IBO

Denial is best demonstrated in which of the following situation?

Select one:
a. After a mother scolded her child, the child pulls the dog+16k-s tail.
b. After years of heavy alcohol drinking, the client fails to recognize a problem.
c The client expresses that there is higher chance of survival with his current condition.
d. When her twin sister excels in swimming, the client begins lessons in swimming pro league.

Narcissa, an 88-year-old client admitted in and in-patient psychiatric dementia unit states, +IBw-My
children refuses to visit me and I have this feeling of quitting+180 This client has a deficit in which of
Erikson+IBk-s stages of development?
Select one:
a Industry versus inferiority.
b. Integrity versus despair
c Identity versus role confusion.
d Initiative versus guilt
Sublimation is best presented in which of the following situation?
Select one:
a. A boy who decides to become a therapist after being hostile and anger to others.
b. A young girl who became a nurse after frequent hospitalizations due to asthma.
c. A child reminding a friend not to steal after being warned by parents that stealing is bad.
d. A man who became an athletic trainer after unable to play due to injury.

Ma+IBk-am Karen is teaching about defense mechanisms. Which of the following statements by the class
indicates learning took place?
1. +IBw-When ego is being tested and anxiety tends to increase, defense mechanism is being used.+IBO-
2. +IBw When defense mechanisms are used for stress adaptation, an individual may exhibit healthy egos.
3. +IBw-Unhealthy ego development may occur when defense mechanisms are overused or maladaptive.
4. +IBw-Defense mechanisms are used to assist with coping, thus only utilized by mentally ill patients.
+IBO-
5. +IBw-Defense. mechanisms are used to deal with mild to moderate anxiety.+IBO
Select one:
a. 1, 3, 5
b. 1, 2, 4, 5
c. 3,5
d. 3, 4, 5

In a nurse-patient interaction, Paul says, "I don't want to talk today." The nurse responds therapeutically
by saying one of the following:
Select one:
a. "I'll sit here with you for a while."
b. "What made you say that?"
c. "Are you not feeling well today?"
d. "Why are you reluctant to talk?"

Teacher Nina is discussing about prodromal syndrome. Which statement of the students indicates that
learning took place?
Select one:
. +IBw-Very few symptoms are associated with a prodromal syndrome.+IBO
b. +IBw-Prodromal syndrome occurs after a client+1Bk-s outburst.+180
c. +IBw-Staff cannot assist clients who are experiencing a prodromal syndrome to gain control.+IBO
d. +IBw-Behaviors associated with prodromal syndrome necessitate immediate action by the
nurse.+IBO

What should be included completing a nursing risk assessment?

1. Past history of violence.
2. Disturbed thought process.
3. Invasion of personal space.
4. Flushed face.
5. Self-mutilation.
Select one:
a. 1, 2, 3
b. 1, 3, 5
c. 1, 4, 5
d. 1, 3, 4

A young school teacher adopts his former mentor's teaching style when conducting class sessions is an
example of
Select one:
a Admonition
b Identification
c. Fantasy
d Idolization
The client is unwilling to go out of the house for fear of "doing something crazy in public." Because of this fear, the client
remains homebound, except when accompanied outside by the spouse. Based on this data, the client is experiencing:
Select one:
a. Agoraphobia
b. Claustrophobia
c. Hypochondriasis
d. Social phobia

When planning activities for a child with autism, nurse Amy must remember that autistic children respond best to:
Select one:
a. Loud, cheerful music
b. Large-group activity
c. Their own self-stimulating acts
d. Individuals in small groups

When the client has a distorted perception of the environment, the nurse will institute what BEST therapeutic modality?
Select one:
a. Milieu Therapy
b. Gestalt Therapy
c. Logo Therapy
d. Individual Therapy

What is your priority nursing diagnosis to client who is currently displaying rigid posture and uses profanity when using
phone?
Select one:
a. Ineffective coping
b. Risk for injury towards others
c. Disturbed thought process
d. Social isolation

The goal of treatment for a patient with DID is to connect or integrate the difference personalities into one functioning
individual. Which of the following would the nurse be NON-THERAPEUTIC?
Select one:
a. Play favourites among the alternate personalities and urge the patient to ignore or get rid of alternate personalities
b. Provide structure in the nurse-client relationship with emphasis on consistency and predictability
c. Provide clearly defined limits and consequences for inappropriate behaviour.
d. Encourage patient to talk about or write his feelings not to act them out

e. Make the whole person be responsible, all alter-identities should be held responsible for the behaviour of each of the
other alter-identities. Which one of the following factors will ensure the ability of an alcoholic to abstain alcohol?
Select one:
a. Expresses regrets about drinking too much alcohol
b. Family support system
c. Overcoming the denial that he has an alcohol problem
d. Can help himself
A day after his admission, the nurse noticed that the client is avoiding a patient with antisocial personality disorder.
During behavioral group therapy, the nurse should expect which comment from the other client regarding this patient?
Select one:
a. Constant need for attention
b. Lack of honesty
c. Belief in superstitions
d. Show of temper tantrum

A client's disruptive behavior on the ward has been increasingly annoying to the other patients. One approach by the
nurse might be to
Select one:
a. Ignore her behavior, realizing it is consistent with her illness
b. Set limits on her behavior and be consistent in approach
c. Make a rigid structured plan that she will have to follow
d. Tell her she is annoying others and confine her to her room

A client who is mad at her ex-husband+IBk-s charges of child abuse expresses her madness by shouting at her brother-
in-law. You understand that the client is exhibiting the use of which defense mechanism?
Select one:
a. Displacement
b. Denial
c. Rationalization
d. Projection

Vincenth, 30 year old client is diagnosed with Antisocial Personality Disorder. The nurse needs to teach Vincenth related
to interaction skills if he/she noticed which of the following behavior?
Select one:
a. Avoiding social activities
b. Failing to follow social norms
c. Frequently crying
d. Having panic disorders

To gain trust and rapport with a patient diagnosed with Paranoid Personality Disorder, the nurse should implement all of
the following nursing interventions, EXCEPT:
Select one:
a. Clarify everything that was discussed during interactions and do not leave any query of the patient unanswered
b. Inquire deeply into the client's life or history, exploring more possible causes and effects
c. Avoid making indirect statements to the patient
d. Talk with the patient in a formal, honest and direct manner

Some of her wardmates were also complaining about her extreme agitation. Which nursing intervention should be
implemented using a behavioral approach?
Select one:
a. Discuss with the client factors that might trigger anger outbreaks.
b. Develop a plan to deal with stressors during a family meeting.
c. Administer PRN medication to decrease anxiety and agitation.
d. Provide role-playing of stressful situations to assist in coping with agitation.
Trust may develop in the nurse-client relationship when the nurse:
Select one:
a. Avoids limit setting.
b. Tells the client how he or she should behave.
c. Encourages the client to use "testing" behaviors.
d. Uses consistency in approaching the client.

A client on an in-patient psychiatric unit is sarcastic to staff and avoids discussions in group therapy. Which long-term
outcome is appropriate for this client?
Select one:
a. The client will not inflict on himself or others.
b. The client will take accountability of his own feelings.
c. The client will join during in-patient group therapy 2 weeks after discharge.
d. The client will verbalize feelings of anger during group therapy by EOS.

Which of the following intervention strategy is most appropriate to use with a client with depression suspected as
suicidal?
Select one:
a. Arrange for the client to be placed on immediate suicidal precautions
b. Speak to family members to ascertain if the client is suicidal
c. Ask a direct question such as, Do you ever think about killing yourself?"
d. Talk to the client to determine if the client is an attention seeker

A client with schizophrenia is mute, can't perform activities of daily living, and stares out the window for hours. What is
the nurse's first priority?
Select one:
a. Reassure the client about safety
b. Encourage socialization with peers
c. Assist the client with feeding
d. Assist the client with showering

With implosive therapy, a client with phobic anxiety would be: Select one:
a. Presented with massive exposure to a variety of stimuli associated with the phobic object/situation
b. b. Subjected to graded intensities of the fear
c. Instructed to stop the therapeutic session as soon as anxiety is experienced
d. Taught relaxation exercises

A client was rushed to the emergency room after an accident but does not recall about the incident. The client is using
which defense mechanism? Select one:
a. Repression.
b. Rationalization.
c. Suppression.
d. Undoing.

When upset, the patient curls into a fetal position in bed. The nurse judges the patient to be exhibiting: Select one:
a. Fixation
b. b. Regression
c. Symbolization
d. Substitution.

.
The nurse recognizes that an excellent indicator of improvement in a client with the diagnosis of generalized anxiety
disorder is when the client:
Select one:
a. Identifies when anxiety is developing.
b. Participates in activities
c. Learns to avoid anxiety.
d. Takes medication as prescribed.
This psychotherapy focuses on current issues and dilemma of the patient:
Select one:
a. CBT
b. Milieu
c. Rational Emotive
d. Gestalt

Compensation is best demonstrated in which of the following scenario?

Select one:
a. A woman who pursues fashion design as her career but feels unappealing.
b. An alcoholic woman who tells alcohol helps her overcome her diffidence.
c. A basketball player injured his ankle and curled into fetal position to deal with pain.
d. A minimally paid supervisor who yells at the negligible mistakes of his assistant.

In the ward, a client was seen isolating himself in his room and refuses to join group therapy. Which is an appropriate
short-term outcome for this client?
Select one:
a. The client will communicate with nurses by the end of the shirt.
b. The client will display socialization skills during milieu therapy.
c. The client will participate during one group session
d. The client will increase self-esteem after provision of opportunities upon discharge.

A 25-year old female whose fianc+AOk-e has recently broken their engagement was brough to the emergency
department after taking a bottle of lorazepam. Which is your nursing priority during this psychiatric crisis?
Select one:
a. Examine the client+IBk-s feelings about the broken engagement.
b. Observe vital signs and note any signs of CNS depression.
c. Let the client take time to rest because of the sedating effect of lorazepam.
d. Reduce fluids and place the client on close observation.

In-patient clients have been complaining regarding impulse control issues of Freeda. She was also seen irritable and
hostile towards other patients. Based on psychoanalytic theory, how do you describe this behavior?
Select one:
a. The behavior is influenced by id personality.
b. The behavior is influenced by ego personality.
c. The behavior is influenced by ego-ideal personality.
d. The behavior is influenced by super-ego personality.

When asked by the nurse about his childhood, Eyron replied, "I'd rather not talk about it right now, maybe next time."
This is an example of defense mechanism known as:
Select one:
a. Supression
b. Thought blocking
c. Denial
d. Repression
A defense mechanism used by patient with borderline personality disorder is reaction formation which is described in one
of the following statements:
Select one:
a. Blaming someone else for one's difficulties
b. Unconscious and involuntary forgetting of painful ideas, events and conflicts
c. A conscious behavior that is the exact opposite of an unconscious feeling.
d. Doing something to counteract or make up for a wrong doing

When teaching about child abuse, the nurse includes the fact that the defense mechanism most often used by the
physically abusive individual is:
Select one:
a. Reaction formation
b. Transference
c. Manipulation
d. Displacement

In severe, major depression, which of the following defense mechanisms is most prominent?
Select one:
a. Rationalization
b. Introjection
c. Sublimation
d. Projection

25. A nurse is assessing a client at risk for acting out behaviors. As a nurse, which of the following would you expect the
client to display?
Select one:
a Misinterpretation of stimuli.
b. Increased anxiety.
c Flushed face.
d. Invasion of personal space.

A client experiencing alcohol withdrawal is upset about going through detoxification. Which of the following goals is a
priority?
Select one:
a. The client will make a personal inventory of strengths
b. The client will drink plenty of fluids on a daily basis
c. The client will commit to a drug-free lifestyle
d. The client will work with the nurse to remain safe

A new nurse is coming to the psychiatric department for the first time. As a nurse manager, which client would you assign
to this nurse?
Select one:
a. A client admitted 2 days ago for alcohol detoxification with a history of seizures.
b. A client starting clozapine (Clozaril) therapy to treat auditory hallucinations,
c. A client newly admitted for suicidal ideations with a plan to jump off a bridge.
d. A client grimacing and pacing the halls with a grim defiant affect.

Which of the following is an example of a cognitive response to a mild level of anxiety? Select one:
a. Feelings of horror or dread
b. Increase concentration
C. Increased respirations
d. Pacing the hall

A client was rushed to the emergency department due to head and abdominal trauma sustained during a family
confrontation. Which nursing diagnosis would take priority? Select one:
a. Risk for other-directed violence
b. Anxiety
c. Poor self-esteem
d. Risk for injury