MOOD DISORDERS

1. The nurse is preparing to care for a client with major depression. The priority nursing intervention is to assess
the client’s:
A. Response to medication administration
B. Appetite and weight
C. Current mood and activity level
D. Risk of suicide

1. While assessing a depressed client in the emergency room after an attempted suicide, the priority question
the nurse should ask the client is:
a.What is happening in your life that would cause you to attempt to kill yourself?
b.How are you feeling since you have awakened after your overdose?
c.Where is the pill bottle of the medications that you had taken?
d.What can be done to make your life better?

2. The family of a client diagnosed with major depression and who attempted suicide ask the nurse what the
difference is between major depression and a bipolar disorder. The most appropriate response by the nurse
is:
a.“Major depression and bipolar disorder are two different mood disorders, but the treatment is the same.”
b.“Bipolar disorder is an upswing of mood while major depression is a downward mood swing. They require
very similar treatment modalities”
c.“Major depression is a downward swing of mood with treatment, including mood stabilizers, whereas
bipolar depression is an upward swing of mood with antidepressants given to bring the mood down.”
d.“Major depression is a depressed mood state that requires antidepressant medication, while a bipolar
disorder is an upward swing of mood that requires mood stabilizers for treatment.”

3. The nurse evaluates which of the following lab results as within the normal range for a client who is
receiving lithium carbonate (Eskalith)?
a.1.5 to 2.0 mEq/L
b.1.8 to 2.5 mEq/L
c.0.1 to 0.5 mEq/L
d.0.6 to 1.2 mEq/L

4. Josefa, a 38 year old married woman, was admitted to the hospital with complains of severe depression,
insomnia, motor retardation and preoccupation of feeling of guilt.In addition to insomnia and motor
retardation, Josefa is likely to exhibit which of the following symptoms?
a.Hyperventilation
b.Tachycardia
c.Loss of sex drive
d.Pressured speech

5. The depressive patient is becoming increasingly dependent and unable to do personal hygiene and
grooming. Which of the following approaches would be BEST?
a.Be kind yet firm to say that you will assist her with the things she cannot do but the rest will be expected
to do herself
b.Tell her you understand and you will take care of everything
c.Be patient and let her try again next day
d.Reassure her that she will feel better soon

6. The patient was referred for occupational therapy. What would be the primary objective of this treatment
modality?
a.Express anger externally through motor activity
b.Learn a new skill for a job when she get discharged
c.An opportunity for her to be creative
d.To divert her attention from getting more depressed

7. Mentally ill clients, particularly those who have been reported as depressed must be assessed for suicidal
risk. All are appropriate questions except?

A. Do you intend to harm someone? If yes, who?

 B. Do you have a plan? If yes, what are the details of the plan?
C. Have you ever tried to harm or kill yourself?
D. Has a significant episode made you feel this way

8. Mrs. Diego has been depressed for quite sometime. She has walked around the unit with her hair
uncombed and looking unkempt. One morning, she put on an attractive dress and combed her hair before
going to breakfast. Which responses to her change in behaviors would be most appropriate by the nurse?

A. “Oh Mrs. Diego, you look beautiful. I like your new dress.”
B. “Good morning Mrs. Diego, I see that you have changed your dress and combed your hair before coming
to breakfast.”
C. “Are you feeling better today”
D. “You look better today than yesterday”

9. Suicide is a preventable problem and best addressed by:

A.Education approach in schools and work places
B.Medical approach by psychiatrists
C.Community approach of people and institutions
D.Mental health approach by professionals in clinical settings

SUBSTANCE ABUSE

1. Elsa is being treated in a chemical dependency unit. She tells the nurse that she only uses drugs when under
stress and therefore does not have a substance problem. Which defense mechanism is the client using?
 A. Compensation
 B. Denial
 C. Suppression
 D. Undoing

2. Nurse Rob has observed a co-worker arriving to work drunk at least three times in the past month. Which
action by Nurse Rob would best ensure client safety and obtain necessary assistance for the co-worker?
 A. Ignore the co worker's behavior, and frequently assess the clients assigned to the co-worker.
 B. Make general statements about safety issues at the next staff meeting.
 C. Report the coworker's behavior to the appropriate supervisor.
 D. Warn the co-worker that this practice is unsafe.

3. Ryan who is a chronic alcohol abuser is being assessed by Nurse Gina. Which problems are related to
thiamine deficiency?
 A. Cardiovascular symptoms, such as decreased hemoglobin and hematocrit levels.
 B. CNS symptoms, such as ataxia and peripheral neuropathy.
 C. Gastrointestinal symptoms, such as nausea and vomiting.
 D. Respiratory symptoms, such as cough and sore throat.

4. Which medication is commonly used in treatment programs for heroin abusers to produce a non-euphoric
state and to replace heroin use?
 A. Diazepam
 B. Carbamazepine
 C. Clonidine
 D. Methadone

5. Nurse Christine is teaching an adolescent health class about the dangers of inhalant abuse; the nurse warns
about the possibility of:
 A. Contracting an infectious disease, such as hepatitis or AIDS.
 B. Recurrent flashback events.
 C. Psychological dependence after initial use.
 D. Sudden death from cardiac or respiratory depression

6. The newly hired nurse at Nurseslabs Medical Center is assessing a client who abuses barbiturates and
benzodiazepine. The nurse would observe for evidence of which withdrawal symptoms?
A. Respiratory depression, stupor, and bradycardia
 B. Anxiety, tremors, and tachycardia
 C. Muscle aches, cramps, and lacrimation
 D. Paranoia, depression, and agitation

7. Johnette is reviewing her lessons in Pharmacology. She is aware that the general classification of drugs
belonging to the opioid category is analgesic and:
 A. Tranquilizing
 B. Hallucinogenic
 C. Stimulant
 D. Depressant

8. Kendall, the sister of a client with a substance-related disorder, tells the nurse she calls out sick for her sister
Kylie occasionally when the latter has too much to drink and cannot work. This behavior can be described as:
 A. Caretaking
 B. Codependent
 C. Helpful
 D. Supportive

9. The nurse is monitoring a client who abuses alcohol for signs of alcohol withdrawal. Which of the following
would alert the nurse to the potential for delirium tremens?
 A. Hypertension, changes in LOC, hallucinations
 B. Hypotension, ataxia, hunger
 C. Stupor, agitation, muscular rigidity
 D. Hypotension, coarse hand tremors, agitation

PERSONALITY DISORDER
1. When assessing a client with narcissistic personality disorder, Doods would expect the client to demonstrate
which of the following?

A.Genuine concern for others

B.Mistrust of others
C.Grandiose and superior self-concept
D.Dependence on others for decision making

2. A nursing student is elected leader of a group project because she always stays up half the night making sure
every detail of an assignment is perfect. However, the student is never fully satisfied with her work and is
making changes up until the deadline. The nursing student may be showing signs of which personality disorder?

A.Paranoid
B.Borderline
C.Narcissistic
D.Obsessive-compulsive

3. In response to a client's manipulative behavior, Baste should provide:

A.Consistent limits
B.Feedback about behavior
C.Reasonable punishment
D.Relaxation exercises

4. Which of the following interventions should Baste include in his plan of care for a client with histrionic
personality disorder?
A.Accept the client's behavior
B.Assist the client to eliminate passive behavior
C.Set limits on attention-seeking behavior
D.Try to meet the client's needs for attention

5. When planning the care of a client who is paranoid, the nurse should include which of the following
interventions to increase the sense of trust?
a.Give the client the nurse’s home phone number for support
b.Spend more time with this client than with other clients
c.Solicit the client’s participation in the development of the treatment plan
d. Fulfill all of the client’s requests to provide assurance of active listening

6. When working with the nurse during the orientation phase of the relationship, a client with a borderline
personality disorder would probably have the most difficulty in:
A. Controlling anxiety.
B. Terminating the session on time.
C. Accepting the psychiatric diagnosis.
D. Setting mutual goals for the relationship.

7. The client with antisocial personality disorder:

A. Suffers from a great deal of anxiety.
B. Is generally unable to postpone gratification. - pleasure
C. Rapidly learns by experience and punishment.
D. Has a great sense of responsibility toward others.

8. A nurse is orienting a new client to the unit when another client rushes down the hallway and asks the nurse
to sit down and talk. The client requesting the nurse’s attention is extremely manipulative and uses socially
acting-out behaviors when demands are unmet. The nurse should:

A. Suggest that the client requesting attention speak with another staff member.
B. Leave the new client and talk with the other client to avoid precipitating acting out behavior.
C. Tell the interrupting client to sit down and be patient, stating, “I’ll be back as soon as possible.”
D. Introduce the two clients and suggest that the client join the new client and the nurse on the tour.

9. A client with a diagnosis of narcissistic personality disorder has been given a day pass from the psychiatric
hospital. The client is due to return at 6 pm. At 5 pm the client telephones the nurse in charge of the unit and
says “6 o’clock is too early. I feel like coming back at 7:30.” The nurse would be most therapeutic by telling the
client to:

A. Return immediately, to demonstrate control.

B. Return on time or restrictions will be imposed.
C. Come back at 6:45, as a compromise to set limits.
D. Come back as soon as possible or the police will be sent.

EATING DISORDERS

1. Kathleen is admitted to the psychiatric clinic for treatment of anorexia nervosa. To promote the client’s
physical health, the nurse should plan to:
A. Severely restrict the client's physical activities.
B. Weigh the client daily, after the evening meal.
C. Monitor vital signs, serum electrolyte levels, and acid-base balance.
D. Instruct the client to keep an accurate record of food and fluid intake.

2. Nurse Penny is aware that the following medical conditions are commonly found in clients with bulimia
nervosa?
 A. Allergies
 B. Cancer
 C. Diabetes mellitus
 D. Hepatitis A

3. Nurse Helen is assigned to care for a client with anorexia nervosa. Initially, which nursing intervention
is most appropriate for this client?
 A. Providing one-on-one supervision during meals and for one (1) hour afterward.
 B. Letting the client eat with other clients to create a normal mealtime atmosphere.
 C. Trying to persuade the client to eat and thus restore nutritional balance.
 D. Giving the client as much time to eat as desired.

4. A 14-year-old client was brought to the clinic by her mother. Her mother expresses concern about her
daughter’s weight loss and constant dieting. Nurse Kris conducts a health history interview. Which of the
following comments indicates that the client may be suffering from anorexia nervosa?
 A. “I like the way I look. I just need to keep my weight down because I’m a cheerleader.”
 B. “I don’t like the food my mother cooks. I eat plenty of fast food when I’m out with my friends.”
 C. “I just can’t seem to get down to the weight I want to be. I’m so fat compared to other girls.”
 D. “I do diet around my periods; otherwise, I just get so bloated.”

5. A female client with anorexia nervosa describes herself as “a whale.” However, the nurse’s assessment
reveals that the client is 5′ 8″ (1.7 m) tall and weighs only 90 lb (40.8 kg). Considering the client’s unrealistic
body image, which intervention should nurse Angel be included in the plan of care?

 A. Asking the client to compare her figure with magazine photographs of women her age.
 B. Assigning the client to group therapy in which participants provide realistic feedback about her weight.
 C. Confronting the client about her actual appearance during one-on-one sessions, scheduled during each shift.
 D. Telling the client of the nurse’s concern for her health and desire to help her make decisions to keep her
healthy.

6. Nurse Harry is developing a plan of care for a client with anorexia nervosa. Which action should the nurse
include in the plan?
 A. Restrict visits with the family until the client begins to eat.
 B. Provide privacy during meals.
 C. Set up a strict eating plan for the client.
 D. Encourage the client to exercise, which will reduce her anxiety.

7. Nurse Mary is caring for a client with bulimia. Strict management of dietary intake is necessary. Which
intervention is also important?
 A. Fill out the client’s menu and make sure she eats at least half of what is on her tray.
 B. Let the client eat her meals in private. Then engage her in social activities for at least 2 hours after each
meal.
 C. Let the client choose her own food. If she eats everything she orders, then stay with her for 1 hour after
each meal.
 D. Let the client eat food brought in by the family if she chooses, but she should keep a strict calorie count.

8. For a female client with anorexia nervosa, Nurse Jimmy is aware that which goal takes the highest priority?
 A. The client will establish adequate daily nutritional intake.
 B. The client will make a contract with the nurse that sets a target weight.
 C. The client will identify self-perceptions about body size as unrealistic.
 D. The client will verbalize the possible physiological consequences of self-starvation.

9. During postprandial monitoring, a female client with bulimia nervosa tells the nurse, “You can sit with me, but
you’re just wasting your time. After you had sat with me yesterday, I was still able to purge. Today, my goal is
to do it twice.” What is the nurse’s best response?
 A. “I trust you not to purge.”
 B. “How are you purging and when do you do it?”
 C. “Don’t worry. I won’t allow you to purge today.”
 D. “I know it’s important for you to feel in control, but I’ll monitor you for 90 minutes after you eat.”

10. A client whose husband just left her has a recurrence of anorexia nervosa. Nurse Vic caring for her realizes
that this exacerbation of anorexia nervosa results from the client’s effort to:

 A. Manipulate her husband.

 B. Gain control of one part of her life.
 C. Commit suicide.
 D. Live up to her mother’s expectations.

DEVELOPMENTAL AND SEXUAL DISORDERS

1. Nikka can distinguish delirium from dementia by

2. knowing which of the following?
A.Delirium has an acute onset and is progressive in course.
B.Delirium has a gradual onset and can be resolved.
C.Dementia has a gradual onset and is progressive in course.
D.Dementia has an acute onset and can be resolved

3. A patient with dementia is starting pharmacotherapy to slow the progression of cognitive decline. The patient
has a history of moderate but steady alcohol use over the past 45 years. Which of the following medications
should Nikka question as least suitable for this patient?
A.Tacrine (Cognex)- Becaues it is the most hepatotoxic drug among the 3 drug
B.Memantine (Namenda)- ANTIGLUTAMATE
C.Donepezil (Aricept)
D.Rivastigmine (Exelon)

4. Nikka is caring for an elderly woman with dementia. She asked the woman’s children to bring old photo
albums when they visit. Which of the following best describes the usefulness of viewing photos when caring for
the dementia patient?
A.Viewing photos will help stimulate remote memory
B.Sharing photos will encourage interaction with other patients
C.Creating a scrapbook with photos will provide for a recreational activity
D.Talking about the photos will encourage the patient to live in the past

reminiscing therapy- remote memory-magaling ang may dementia

5. When planning care for a client newly diagnosed with Alzheimer's disease, Nikka should focus on:
A.Providing a safe, structured environment
B.Helping the client recognize physical limitations
C.Helping to reverse the disease
D.Preventing loss of cognitive functions

agnosia- impairement in recognition objects, person, sounds ect.

6. A patient with dementia gets angry and begins to yell at Nikka during mealtime. Nikka leaves the patient’s
side for 5-10 minutes and then returns. Which of the following best explains Nikka’s behavior?

A.The nurse was unsure of how to calm the patient

B.The nurse was frustrated and needed to take a “time out
C.The nurse gave the patient a chance to calm down before resuming the meal
D.The nurse stepped away to verify the safety of other patients

time out- when you are so full of your patient and you want to leave the room to calm down and let pther nurse
to look after your pt. for awhile
countertransference- nurse to pt.

7. What is the most appropriate action for the nurse to take when a patient with dementia wanders in the rooms
of the other clients?
A.Lock the door to her room - illegal
B.Take her by the hand and guide her back to her room
C.Tell her to stay in her room except for meals
D.Tell her that she will be restrained if she continues to wander- illegal

wandering- sundowning syndrome- sa paglubog ng araw mas nagiging balisa sila

8. The daughter of a patient with Alzheimers begins to cry and shares her concerns with the nurse about the
patient not being able to recognize her as a daughter. Which statement by the nurse would demonstrate an
empathetic response?
A.“It must be difficult for you to visit your mother when she is confused about who you are”
B.“If you are going to cry when you come to visit, maybe you should not visit”
C.“It is not unusual for people in your mother’s condition to forget who other people are”
D.“If these visits upset you, maybe you should telephone your mother instead of visiting”

family therapy is important in here

9. A student nurse was asked which of the following best describes dementia. Which of the following best
describes the condition?

 A. Memory loss occurring as part of the natural consequence of aging.

 B. Difficulty coping with physical and psychological change.
 C. Severe cognitive impairment that occurs rapidly.
 D. Loss of cognitive abilities, impairing ability to perform activities of daily living.

10. Which of the following will Nurse Dory use when communicating with a client who has cognitive impairment
due to Alzheimers?
 A. Complete explanations with multiple details.
 B. Pictures or gestures instead of words.
 C. Stimulating words and phrases to capture the client's attention.
 D. Short words and simple sentences.

11. Mrs. Jordan is an elderly client diagnosed with Alzheimer’s disease. She becomes agitated and combative
when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation
would be to:
 A. Tell the client firmly that it is time to get dressed.
 B. Obtain assistance to restrain the client for safety.
 C. Remain calm and talk quietly to the client.
 D. Call the doctor and request an order for sedation

12. Which class of drugs is NOT used to treat ADHD in children or adults?

A.Psychostimulant medications- ritalin- metamphetamine

B.Antidepressant medications
C.Antipsychotic medications - in adhd there is no hallucinations so there is no need to give this
D.B and C

attention deficit hypereativity disorder

13. Which of these is a behavioural disorder that is characterized by inattention and impulsivity, as well as other
symptoms?
A.ADHD
B.autism-ASD autism spectrum disorder- may mental retardation
C.Down syndrome
D. Mental retardation

Savant- very inteligent in one field

Aspergers- fixation in only one thing

14. Which is a symptom of inattentiveness?

A.lacking focus
B.being easily distracted
C.Messiness
D.All of the above

15. In the diagnosis of a possible pervasive developmental autistic disorder. The nurse would find it most
unusual for a 3-year-old child to demonstrate:
 A. An interest in music.
 B. An attachment to odd objects.
 C. Ritualistic behavior.
 D. Responsiveness to the parents.

PDD- Another spectrum of autism or asd

ASD- usually diagnosed at the age of 3
adhd - best diagnosed at the age of 7

Autism can do head banging- helmet is required due to uncontrollable tantrums

16. Which condition is also on the spectrum of autism disorders?
A.Obsessive-compulsive disorder
B.Epilepsy
C.Panic disorder
D.Asperger syndrome- too much fixation on a certain objec

17. The community nurse visits the home of George. a child recently diagnosed with autism. The parents
express feelings of shame and guilt about having somehow caused this problem. Which statement by the nurse
would best help alleviate parental guilt
A. “Autism is a rare disorder. Your other children shouldn’t be affected.”
B. “The specific cause of autism is unknown. However. it is known to be associated with problems in the
structure of and chemicals in the brain.”
C. “Sometimes a lack of prenatal care can be cause of autism.”
D. “Although autism is genetically inherited if you didn’t have testing you could not have known this would
happen.”

18. Intellectual disabilities are divided into a number of degrees of severity, depending primarily on the range of
IQ score provided by the sufferer. One of these is Mild Mental Retardation, corresponding to an IQ score
between:
A.60-65 to 80
B.40-55 to 60
C.50-55 to 70- mild disorder-educable
D.70-75 to 90

grade 6- highest educatioanal level a mentality retarded pt. can achieve which 12 y/o- IQ of mild mental
retardation

19. Intellectual disabilities are divided into a number of degrees of severity, depending primarily on the range of
IQ score provided by the sufferer. One of these is Moderate Mental Retardation, represented by an IQ score
between:
A.60-65- to 70-75
B.35-40 to 50-55- moderate- can achieve until grade2
(trainable)
C.80-85 to 90-95
D.20-25 to 30-35- severe mental retardation,can be independent in some activities

below 20 IQ- need Is totally dependent care- also called imbecile

20. Autism:
A.results in visual and hearing impairment
B.is the same as mental retardation- they are not the same
C.affects verbal and nonverbal communication and manifests itself before the age of 3.
D.affects height and stature before the age of

21. Mental retardation:

A.is usually associated with emotional disturbances.
B.can be reversed by and intensive program of early childhood education.
C.occurs more in boys than it does in girls.
D.manifests itself before the age of 18.

22. The aim of Orgasmic Reorientation treatment for paraphilias is to:

A.Pair inappropriate or distressing sexual activities with an aversive stimulus
B.Suppress inappropriate or distressing sexual activities through drug
C.Suppress inappropriate or distressing sexual activities through castration
D.Suppress inappropriate or distressing sexual activities and replace them with acceptable sexual practices

criteria: disorder atleast percevere for 6 months- continues

3 sexual disorders:
>paraphilias- orgasm just by handling an anderwear, naninilip
orgasm in non genital things or non living objects
>sexual disfunction- excitement, orgasm, plateau, resolution= any problem in sex cycle
> gender disphoria- not confortable with own sex identity

23. A diagnosis of fetishism involves which of the following?

A.Intense sexually arousing fantasies that occur while observing an unsuspecting person who is naked, in the
process of undressing, or engaging in a sexual activity- voyeurism
B.Sexual arousal and satisfaction from the psychological or physical suffering of others- sadomasochism
C.Intense, recurrent sexual urges to touch and rub up against non-consenting people- frotteurism
D.Intense sexually arousing fantasies and urges involving non-animate objects, and this causes them personal
distress or affects social and occupational functioning

24. The condition of experiencing sexual arousal in response to the extreme pain, suffering or humiliation of
others is termed as?
A. Sexual sadism
B. Sexual fetishism
C. Sadomasochism
D. Voyeurism

25. Self-reported sexual arousal from spying on others or the observation of others who are engaged in sexual
interaction is?
A. Fetishism
B. Voyeurism
C. Exhibitionism- sexual orgasm by exposing the genitals in front of stranger
D. Sadism

26. Sexual satisfaction being derived from rubbing upon another non-consenting individual is called?
A. Voyeurism
B. Frotteurism
C. Fetishism
D. Transvestism- transdressing, using clothes of oppoite sex

27. Non pharmacological management of Sexual disorders include?

A. CBT-
B. Aversion
C. Reconditioning
D. All the above

28. Sexual preference for prepubescent children is termed as?

A. Paedophilia- sex with child
B. Necrophilia- sex with the dead peson
C. Masochism- painful sex
D. None of the above

29. According to DSM V, a confirmatory diagnosis of Paraphilia’s can be made only if the behaviour persists for
how many months?
A. 3
B. 2
C. 6
D. 9

30. Which of the following is a paraphilia involving sexual fantasies about exposing the penis to a stranger,
which are usually strong and recurrent to the point where the individual feels a compulsion to expose himself?
A.Voyeurism
B.Expositionism
C.Exhibitionism
D.Frotteurism
31. Preference for sexual activity that involves bondage or the infliction of pain or being humiliated is called as?
A. Sexual sadism
B. Sadomasochism
C. Voyeurism
D. Fetishism