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PRE-BOARD EXAMINATION
NURSE PRACTICE 5

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1. A client involved in a motor vehicle accident presents with a BP 120/62, pulse100, respirations 28-32 and labored, and temperature
98.4F orally. Examination of the anterior chest reveals obvious rib fractures, and breath sounds are absent in this area. The client’s
trachea is deviated to the left side of the neck. The nurse concludes that the client is probably experiencing which of the following?
a Spontaneous pneumothorax
b Tension pneumothorax
c Iatrogenic pneumothorax
d Open pneumothorax

2. A client presents after a near-drowning incident in which the client was submerged for an undetermined amount of time. The client
has since regained consciousness and is alert and oriented, but anxious. Vital signs are BP 120/72, pulse 92, respirations 26,
temperature 98F orally. Pulse oximetry indicates an SaO2 of 93% on 4 L/min of oxygen via nasal cannula. The nurse concludes that
the client is at greatest risk to develop which of the following?
a. Cardiogenic shock
b. Spontaneous pneumothorax
c. Renal failure
d. Acute respiratory distress syndrome (ARDS)

3. A client was brought to the Emergency Department following a motorcycle accident. The client is alert and oriented with intermittent
periods of confusion and reports moderate to severe thirst and left thigh pain. Vital signs are BP 100/60, pulse 112, respirations 28,
and temperature 98.4F orally. Capillary refill is 3 seconds and urinary output is 30 ml/hour. On examination there is an obvious pelvic
deformity and the left thigh is distended. A diagnosis of hypovolemic shock is established. The nurse interprets by these findings that
the client is in which phase of shock?
a. Initial phase
b. Compensatory phase
c. Progressive phase
d. Irreversible phase

4. A client reports difficulty breathing and generalized weakness after experiencing chest pain approximately 1 hour the previous night.
On exam, the client’s skin is pale and diaphoretic, breath sounds are equal with crackles noted throughout all lung fields, capillary
beds are dusky, and jugular venous distention is present. Vital signs are BP 98/50, pulse 118 and thready to palpations, respirations 26
and labored temperature 98.6F orally. The nurse will take action for which of the following suspected conditions?
a. Obstructive shock
b. Neurogenic shock
c. Hypovolemic shock
d. Cardiogenic shock

5. A client who has ingested the third dose of an antibiotic prescribed for a urinary tract infection arrives at the urgent care clinic. The
client is weak, diaphoretic, reports difficulty breathing and itching, and appears flushed. The nurse ensures that epinephrine is at
hand considering that the client is likely experiencing which form of shock?
a. Septic
b. Anaphylactic
c. Hypovolemic
d. Neurogenic

6. A client arrives in the Emergency Department after a fall from approximately 10 feet. The initial body point of contact was the upper-
middle back, and the client reports sharp pain in this area with movement. The nurse suspects which type of injury?
a. Head injury
b. Spleen injury
c. Cervical spine injury
d. Liver injury

7. A client reports chest pain, rapid heartbeat, and difficulty breathing. On examination, heart sounds are muffled. Which of the
following assessment findings by the nurse would support a diagnosis of cardiac tamponade? Select all that apply.
1. Deviated trachea
2. Weak peripheral pulses.
3. Absent breathe sounds to the lower lobes.
4. Diminished or absent carotid or femoral pulses during inspiration.
5. Blood pressure 94/72 during inspiration, 10 mmHg lower systolic than the blood pressure on expiration.

a. 1, 3, 5
b. 2, 4, 5
c. 3, 4, 5
d. 1, 2, 3

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8. A client who sustained a penetrating bowel injury has several concerns to be addressed regarding future care that require prioritizing.
Which of the following conditions would receive priority by the nurse in developing the client’s plan of nursing care?
a. Constipation
b. Peritonitis
c. Paralytic ileus
d. Intestinal adhesions

9. A client seeks treatment for a laceration to the forehead sustained in a fight. Te client reports no loss of consciousness but is confused
and has a strong alcohol odor on the breath. The Emergency Department nurse prepares the client for which of the following priority
diagnostic assessments?
a. Skull x-ray and urine alcohol.
b. MRI of the brain and blood alcohol
c. Blood alcohol and glucose
d. Electroencephalography (EEG) and blood alcohol

10. A client has a suspected femoral fracture from an injury sustained 3 hours ago. There is gross swelling to the left thigh, and the skin is
tight and bruised. The client complains of numbness and tingling in the toes. What other assessments would the nurse expect to
make if compartment syndrome exists? Select all that apply.
1. Toes cool and dusky.
2. Bounding pulses distal to the fracture.
3. Pain in the leg unrelieved by narcotics.
4. Inability to move the ankle and toes in the affected leg.
5. Changes in level of consciousness.

a. 1, 2, 3
b. 1, 3, 4
c. 1, 2, 5
d. 1, 3, 5

11. A client is admitted to the Emergency Department with 50% burns to the chest and arms. The skin is white, dry, and there is no pain.
The nurse assesses the type of burn the client has as which of the following?
a. Superficial thickness
b. Superficial partial thickness
c. Deep partial thickness
d. Full thickness

12. A young boy is brought to the trauma unit with a chemical burn to the face. The nurse’s priority assessment would be which of the
following?
a. Skin integrity of the face
b. Blood pressure and pulse
c. Adequacy of respirations
d. Amount of pain

13. The nurse is most concerned about a wasp sting for a client who?
a. Has never been stung before.
b. Has a history of fever or chills when bitten.
c. Had hives and shortness of breath with the last sting.
d. Had a rise in blood pressure to 140/90 when stung.

14. A man sustained burns to the arms and chest when a fire got out of control in a campground. A fellow nurse camper immediately
removes jewelry from the affected burn site to accomplish which priority objective?
a. Be able to assess the fingers more accurately.
b. Prevent a tourniquet effect at the site.
c. Prevent infection.
d. Avoid interference with first aid treatment of the burn.

15. The nurse working at a summer camp on a hot, humid day notes that a group of 9- and 10-year-old children playing a baseball game.
The nurse determines that the children are at immediate risk for dehydration and which of the following conditions?
a. Skin cancer
b. Formation of nevi
c. Full thickness skin burns
d. Superficial thickness skin burns

16. A client presents to the Emergency Department with acute respiratory distress and the following arterial blood gases (ABGs): pH 7.35,
PCO2 40, mmHg, PO2 63 mmHg, HCO3 23 mEq/L, and oxygen saturation (SaO2) 93%. The nurse concludes that which of the following
represents the best analysis of the etiology of these ABGs?
a. Tuberculosis
b. Pneumonia
c. Pleural effusion
d. Hypoxia
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17. A client who is unable to cope with the sudden loss of a job and who is feeling confused and unable to make decisions is said to be
experiencing which of the following?
a. Adventitious crisis
b. Maturational crisis
c. Situational crisis
d. Social crisis

18. In assessing a client in crisis, it is important for the nurse to first assist the client to identify?
a. The client’s feelings.
b. The realistic nature of the event.
c. Others who might be affected by the event.
d. An immediate action plan.

19. A client was admitted to the hospital with suicidal ideations and a plan to harm himself. His wife recently died after a very brief
illness, and he sees no reason to go on living. He says that his wife was his best friend, and they did everything together. He feels
alone in the world and yet allows no one into his life. Which of the following nursing diagnoses best categorizes this problem?
a. Helplessness related to the death of his wife.
b. Ineffective individual coping related to loneliness.
c. Post-trauma response related to suicidal plan.
d. Social isolation related to the loss of his wife and failure to establish meaningful relationships.

20. A client came into the crisis center for assistance after he was involved in clean-up efforts following a shooting at a local high school.
The client says he has been feeling very anxious since his involvement in these efforts. The nurse working with the client chooses
which of the following to help him cope with the experience?
a. Arrange for his priest to visit with him.
b. Advise him to avoid going near the school for at least 90 days.
c. Send him to the Emergency Department for further evaluation because he is experiencing a crisis situation, which is an
emergency.
d. Create an opportunity for him to talk about his experience, ask him about how he has coped thus far, and explore enhanced
coping skills.

21. When working with the client in crisis, which of the following is most important?
a. Obtaining a complete assessment of the client’s past history.
b. Remaining focused on the immediate problem.
c. Determining whether the client may have had a part in the emergence of the crisis.
d. Assisting the client to identify what is similar about this crisis to other crises in the client’s life.

22. A 35-year-old client with a diagnosis of bipolar disorder, mixed and borderline personality disorder was brought to the Emergency
Depart after taking a handful of pills and calling 911. The nurse overheard a staff member saying of the client, “Oh, here she comes
again. If she was serious about committing suicide, she’d have done it by now.” The nurse considers which of the following when
preparing to see the client?
a. Clients with personality disorders rarely kill themselves.
b. People who talk about suicide or have a history of suicidal behavior are at serious risk of self-harm and each event must be taken
seriously.
c. Then nurse should not reinforce manipulative behaviors, therefore the nursing assessment must be brief and exploration of
suicidal ideations must be kept to a minimum.
d. The nurse should anticipate that the client will be admitted directly to the inpatient unit.

23. The client is transferred to the psychiatric inpatient unit of a general hospital from the surgical ICU after being treated for a self-
inflicted gunshot wound. The nurse schedules time to meet with the client on a one-to-one basis with which of the following goals in
mind?
a. The client will explore current life events that led to the suicide attempt.
b. The client will initiate contact with the nurse spontaneously.
c. The client will identify past suicidal ideations and behavior.
d. The client will begin group therapy as soon as he is able to ambulate and remain seated for 50 minutes.

24. A client admitted to the psychiatric inpatient following expressed suicidal ideations tells the nurse the next day that she feels fine, is
at peace, and wants to go home now. The nurse understands that the client?
a. Has resolved her feelings and is no longer at risk for self-harm.
b. Is probably ready to be discharged to home since the suicidal intent has been resolved.
c. Remains at risk, may have sufficient psychic energy to act out on the suicidal ideation, and requires further assessment.
d. Has reached a realistic self-appraisal of the serious nature of her suicidal intentions.

25. The priority nursing diagnosis for a client with suicidal ideations and intent is?
a. Risk for violence, self-directed.
b. Ineffective individual coping.
c. Hopelessness.
d. Defensive coping.
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26. A female client has placed on one-to-one observation, and as the nurse follows her into the bathroom, she objects strongly, yelling,
“I’m sick of being followed around and watched like a small child who can’t be trusted.” The best response for the nurse would be?
a. “I understand you are angry, but I must be able to see you at all time to make sure you are safe.”
b. “Stop yelling at me! I can’t change the rules for clients who talk about suicide as you have done.”
c. “Well, you are better. I’ll wait outside the bathroom and you can close the door until you are finished.”
d. “You should stop being angry and uncooperative and focus on happy things.”

27. The client is scheduled for electroconvulsive therapy (ECT). You will inform the client that after the procedure there may be?
a. An immediate increase in the client’s ability to recall recent events.
b. Some memory deficit of the period before ECT was begun.
c. Slowing of the client’s physical abilities for the remainder of the day of treatment.
d. No recall of long-term events.

28. The client has been diagnosed with bipolar I disorder. Lithium carbonate (Lithium) 300 mg q.i.d has been prescribed. After 3 days of
lithium therapy, the client says, “My hands are shaking.” Your best response to the client is?
a. “These fine motor tremors can be an early effect of the lithium. The tremors should subside after the first few weeks of taking
the lithium.”
b. “You do not have to worry about that yet. If it is still happening next week, then we will worry about your hands shaking.”
c. “The tremors are an early warning sign of lithium toxicity, but you need to continue to take the medication. We will continue to
monitor your blood to be sure you are taking enough lithium to treat your bipolar I disorder.”
d. “You can expect hand tremors when you begin to take lithium. They will go away soon. Why are you so concerned about such a
small tremor?”

29. The client is being admitted to the inpatient psychiatric unit. You determine that which of the following must be present in order to
be diagnosed with major depression?
a. Suicidal thoughts or plans of suicide reported over at least last 2 weeks.
b. History of one depressive episode within the last 2 years.
c. Loss of appetite for more than 3 days.
d. Loss of interest in previously enjoyed activities.

30. A client has bipolar disorder and is in a state of mania. He is in an inpatient setting and tells the nurse that he is here because he said
he would stay but now has decided to leave the unit later today. The nurse will first?
a. Notify the police about the client’s intention.
b. Develop a plan with the client’s wife.
c. Develop a contract for safety with the client.
d. Notify the supervisor on the nursing unit.

31. While teaching about sertraline (Zoloft), you explain to the client that in order for the medication to be effective it should be taken?
a. Twice daily.
b. Only with food.
c. Before meals.
d. As prescribed.

32. A client had coronary bypass surgery 3 days ago. He says he is feeling very sad and does not have much of an appetite. He is also
complaining of difficulty falling asleep but, once asleep, he usually can sleep at least 6 hours. You conclude the client may have?
a. A mild depression.
b. Too much time to think.
c. Severe depression.
d. A normal reaction to recent surgery.

33. In order to help the client understand dysthymia, you explain that the sign and symptoms of depression must be present for?
a. At least 2 weeks.
b. At least 1 month.
c. At least 2 years.
d. More than a year.

34. The nurse would assist the client to set which of the following as an appropriate goal while being hospitalized in the acute stage of
mania?
a. Participate in unlimited television privileges daily to keep busy.
b. Participate in the drama group daily.
c. Be able to express all feelings as they arise.
d. Be able to maintain adequate distance when interacting with others.

35. The nurse should consider the irregularities in which of the following body systems before an accurate diagnosis of mood disorder can
be assigned?
a. Integumentary
b. Cardiovascular
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c. Respiratory
d. Endocrine

36. During a manic episode, a client talks about self-harm. The nurse must plan care so that the client?
a. Has a room that is observable from the nurse’s station.
b. Has constant supervision until the risk for the suicide is ruled out.
c. Receives all medications intramuscularly rather than orally until the threat of suicide has passed.
d. Will notify the family immediately of self-harm intent.

37. During an assessment of a client the nurse finds that the client is trembling and restless, the client’s blood pressure and pulse are
elevated and the client is complaining of dry mouth, shortness of breath, inability to relax, loss of appetite, and an upset stomach.
What is the client’s level of anxiety?
a Mild
b Moderate
c Severe
d Panic

38. During an assessment interview the client tells the nurse, “I can’t stop worrying about my makeup. I can’t go anywhere or do anything
unless my makeup is fresh and perfect. I wash my face and put on fresh makeup at least once and sometimes twice an hour.” This
behavior is most likely a sign of a(n):
a Acute stress disorder
b Generalized anxiety disorder
c Obsessive-compulsive disorder
d Panic disorder

39. When assessing an apparently anxious client, questions about anxiety should be:
a Abstract and nonthreatening
b Avoided until the anxiety disappears
c Avoided until the client brings up the subject
d Specific and direct

40. Which of the following nursing diagnoses has the highest priority for an anxious client?
a Defensive coping
b Ineffective denial
c Risk for loneliness
d Risk for self-directed violence

41. The best goal for a client learning relaxation technique is that the client will:
a Confront the source of the anxiety.
b Experience anxiety without feeling overwhelmed.
c Keep a journal as a self-monitoring technique.
d Suppress anxious feelings.

42. The long-term goal, “The client will learn new ways of coping with anxiety,” is most appropriate at which level of anxiety?
a Mild
b Moderate
c Severe
d Panic

43. Which of the following would be the best nursing action for a client who is having a panic attack?
a Remain with the client.
b Teach the client o recognize signs of a panic attack.
c Instruct the client to remain alone until the symptoms subside.
d Involve the client in a physical activity.

44. A client asks why a beta blocker has been prescribed for anxiety. When answering this question the nurse should explain that beta
blockers are effective for treatment of which symptoms associated with anxiety?
a Cognitive dissonance and confusion
b Depression and suicidal ideations
c Insomnia and nightmare
d Palpitations and rapid heart rate

45. A client who has refused to take the regular prescribed dose of clonazepam (Klonopin) complains of irritability, insomnia, tremors,
and sweating. It is likely the client is experiencing symptoms associated with:
a Addiction
b Manipulation
c Overdose
d Withdrawal
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46. Which of the following statements by a client with post-traumatic stress disorder would indicate the most improvement?
a “I am responsible for what happened to me.”
b “I enjoy being back to work with my friends.”
c “I have forgotten some of the things that happened to me.”
d “I stay alert all the time.”

47. A client in the ICU fell out of bed and fractured his hip. The side rails of the bed were not raised at bedtime, although this client has
been identified with risks of falling. Which lawsuit may be filed against the nurses?
a. Battery
b. Negligence
c. Homicide
d. Incompetence

48. The New Born Screening Act requires early detection of infant’s abnormalities. In which promulgation was it stipulated?
a. RA 9288
b. RA 7600
c. RA 6675
d. RA 9173

49. Antoinette is Mark’s friend and also a manager of another level in the same hospital. Antoinette spends 80% of her time making and
submitting schedules for nursing shifts for her subordinates. What particular level of management does she belong to?
a Top level
b Middle level
c Front line level
d Operational level

50. Antoinette’s clinical abilities, education and experience are the qualities considered as her:
a Legitimate power
b Charismatic power
c Connection power
d Expert power

51. A client with chronic low back pain receives cooking and cleaning help from her extended family. This is best described as:
a Primary gain.
b Secondary gain.
c Attention-seeking.
d Malingering

52. The spouse of a woman diagnosed with somatization disorders asks the nurse If his wife has so many health problems on purpose.
The best response is:
a “Have you tried asking her? I think she’d tell you the truth.”
b “Your wife is trying to gain your attention.”
c “She doesn’t have the problem on purpose; however, this is probably difficult for both of you.”
d “She has some significant emotional problems that she cannot admit.”

53. The nurse would know that the plan of care for a client with a pain disorder was successful if the client states:
a “I realize that my pain can be influenced by stress.”
b “I should avoid most physical activity.”
c “Relaxation techniques only help when I am anxious about my pain.”
d “I should keep myself pain-free by increasing my pain medications as I need.”

54. The most appropriate nursing diagnosis for a client with a conversion disorder manifested by a stocking anesthesia is:
a High risk for impaired tissue integrity
b Altered thought processes
c Sensory-perceptual alteration
d Ineffective individual coping

55. What would the nurse expect the client with a somatization disorder to reveal in the nursing history?
a Abrupt onset of physical symptoms at menopause.
b Exaggeration of the importance of a minor symptom.
c Ignoring physical symptoms until role performance was altered.
d Numerous physical symptoms in many organ systems.

56. A goal of care for a client with hypochondriasis is:

a The nurse will respond matter-of-factly to the client’s complaints.
b The client will seek second opinions about the symptom from health care providers.
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c The client will state the relationships between life events and physical symptoms.
d The spouse will encourage the client to talk more about the symptoms.

57. The nurse would anticipate that health assessment of a client with a conversion disorder is likely to reveal which of the following?
a Elevated serum calcium levels.
b Sensory loss along affected nerve tracks.
c No significant physical or laboratory findings.
d Motor loss to body parts along the nerve tracks.

58. The most appropriate nursing diagnosis for a client with a somatoform disorder is:
a Altered role performance.
b Knowledge deficit: medication.
c High risk for violence, self-directed.
d Acute trauma reaction.

59. A hospitalized client diagnosed as having a somatization disorder asks for her “PRN” for stomach pain. The nurse’s best response it to:
a Matter-of-factly assess the pain and administer PRN medication.
b Confront her with the negative gastroscopy findings.
c Ask her to take slow, deep breaths.
d Delay fulfilling her request to see if the pain subsides first.

60. A client treated for hypochondriasis would demonstrate understanding of his disorder by which statement?
a “I realize the tests and lab results cannot pick up on the seriousness of my illness.”
b “Once my family realizes how severely ill I am, they will be more understanding.”
c “I know that I don’t have a serious illness even though I still worry a little about the symptoms.”
d “I realize that exposure to toxins can cause significant organ damage.”

61. Before formulating a research problem, Maki must consider the contribution of her research study to the body of knowledge that is
deemed important to the foundation of nursing practice. What criterion for choice of research problem is this?
a. Researchability of the problem
b. Feasibility of the problem
c. Significance of the problem
d. Motivation of the researcher

62. Maki must also assess how much money she needs, the availability of her subjects, ethical consideration, her experience as a
psychiatric nursing and the existence of pertinent research for her reference. These are the factors that might be considered give her
an idea pertaining to the possibility or plausibility otherwise known as:
a. Researchability of the problem
b. Feasibility of the problem
c. Significance of the problem
d. Motivation of the researcher

63. She must also have the genuine interest to answer her research problems. This eagerness is otherwise known as what criterion of
choice?
a. Researchability of the problem
b. Feasibility of the problem
c. Significance of the problem
d. Motivation of the researcher

64. Maki must consider problems that can be investigated scientifically with empirical data gathering and an orderly and systematic
process of providing solutions with factual basis and not merely by opinion. This is the:
a. Researchability of the problem
b. Feasibility of the problem
c. Significance of the problem
d. Motivation of the researcher

65. Research has been helpful to mankind. It aids in the continuous development of mankind by providing a systematic tool to answer
certain problems. Which among the following is not a characteristic of research?
a. It generates generalized statements after due investigation of phenomenon
b. It uses empirical data gathering
c. It uses systematic and orderly steps in answering a researchable problem
d. It permits the interference of constraints to enhance the purity of results

66. The client, although oriented to person, place, and tie, cannot remember being extracted from his burning automobile the day
before. His inability to remember events surrounding the accident is best described as:
a Denial
b Localized amnesia
c Confabulation
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d Continuous amnesia

67. The most appropriate nursing diagnosis for a client experiencing a fugue state is:
a Anxiety
b Self-esteem disturbance
c Altered family processes
d Relocation stress syndrome

68. The nurse who assesses the client in a fugue state is most likely to note:
a A history of childhood trauma.
b Coexisting depression.
c Exposure to a major stressor.
d Selective amnesia.

69. A priority goal for a client who is unable to recollect events surrounding the tornado that demolished his farm is:
a The client will report decrease depression by day 2.
b The client will express anger about his loss by day 2.
c The client will apply for a job retraining by day 2.
d The client will attend a support group for disaster survivors by day 2.

70. A nursing assistant asks for advice about talking with a client recently diagnosed with dissociative identity disorder: “Should I talk
about her childhood abuse?” The nurse’s best answer is:
a “If she brings up the abuse, listen to her and be supportive.”
b “You will need to really push her to get it all out.”
c “Ask her to discuss this only with her therapist.”
d “Remind her that sometimes adults exaggerate about their childhood experiences.”

71. The nurse realizes a dissociative client may best be able to recover memories through which of the following types of therapy?
a Electroconvulsive therapy
b Hypnosis
c Relaxation techniques
d Antianxiety agents

72. The nurse would determine that client education to manage dissociative episodes is effective if the client states, “Once I start to
dissociate, I should:
a Immediately take my antianxiety medication.”
b Focus on what I can see and hear externally.”
c Begin my relaxation technique.”
d Focus on my internal feelings.”

73. A client with dissociative identity disorder, who is now 20 minutes late for group, is adamant that she was never told to go to the
cognitive therapy group. The nurse’s best response is:
a “You can’t get out of group that easily.”
b “People with dissociative identity disorder forget quite a bit.”
c “Have you thought about just why you might be resisting treatment?”
d “It is possible that you were not aware of group time.”

74. The wife of a client who has returned to his pre-fugue state asks if her husband will be able to remember what happened during the
time of the fugue. The nurse’s best response is:
a “He will have no memory for events during the fugue.”
b “He will be able to tell you – if you can gently encourage him to talk.”
c “Only his therapist should have him talk.”
d “Avoid mentioning it, or he may start alternating old and new identities.”

75. The nurse may note switching from one alter to another by observing for which of the following in a client?
a Orthostatic hypotension.
b Blinking or rolling of the eyes.
c Dystonic reactions.
d None of these; there are no discernable features of switching.

76. The nurse would assess for which of the following characteristics in the behavior of any client diagnosed with a personality disorder?
a. Ability to charm and manipulate people.
b. Desire for interpersonal relationships.
c. Diminished need for approval.
d. Disruption in some aspect of his/her life.

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77. A 27-year-old woman has been diagnosed with borderline personality disorder. She displays a labile affect, impulsivity, frequent
anger outbursts, and difficulty tolerating her anger feelings without self-injury. A priority nursing diagnosis for this client is?
a. Anxiety
b. Risk for self-mutilation
c. Risk for violence towards others.
d. Ineffective individual coping.

78. The nurse assesses for the presence of which of the following etiologic factors that may explain the dichotomous thinking observed in
an individual diagnosed with borderline personality disorder?
a. Gender stereotyping.
b. Family enmeshment.
c. Perfectionistic standards.
d. Physiological under-arousal.

79. A client recently released from prison for embezzlement has a history of blaming others for his problems and becoming defensive and
angry when criticized. He expressed no remorse for his actions or any response to his conviction. He claims his actions were justified
since his employer did not treat him fairly. He is displaying characteristics of which personality disorder?
a. Narcissistic
b. Histrionic
c. Antisocial
d. Borderline

80. A 35-yaer-old client is being interviewed by the nurse. The client’s history indicates that she has few friends, fear criticism and
rejection from others, and withholds information about her thoughts and feelings because she anticipates a negative reaction. Based
on the data, the nurse suspects that the client may have which of the following personality disorders?
a. Schizotypal
b. Paranoid
c. Avoidant
d. Schizoid

81. Which nursing diagnosis may be a priority of care at the time of admission for a client diagnosed with antisocial personality disorder?
a. Personal identity disturbance.
b. Fear
c. Risk for violence directed at others.
d. Social isolation.

82. The nurse anticipates that which of the following intervention would be appropriately ordered for a client admitted with an axis I
diagnosis of major depression and an axis II diagnosis of schizoid personality disorder?
a. Group psychotherapy
b. Individual psychotherapy
c. Family therapy
d. Participation in a support group

83. The nurse would look for signs of which of the following as a prominent behavioral characteristic of an individual diagnosed with
narcissistic personality disorder?
a. Splitting
b. Hypersensitivity
c. Suspicious
d. Entitlement

84. An intervention strategy routinely included in the nursing care plan for a client diagnosed with antisocial personality disorder is?
a. Establishing clear and enforceable limits.
b. Varying unit rules based on client demands.
c. Varying unit rules based on staff needs.
d. Letting the client have a voice in when unit rules should apply.

85. Which of the following interventions would be appropriate for the nurse to implement when caring for the client with obsessive-
compulsive personality disorder?
a. Assertiveness training
b. Decision-making skills
c. Anxiety management
d. Values clarification

86. A client with a diagnosis of schizophrenia, paranoid type, is admitted to an acute-care psychiatric hospital unit. In anticipation of the
client’s needs, what nursing diagnosis would be given the highest priority?
a. Altered thought processes
b. Social isolation
c. Impaired verbal communication
d. Risk for violence directed to self or at others.
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87. While working with a client who is having delusions, what nursing intervention would be the most helpful?
a. Avoid challenging the content of the client’s delusion.
b. Promise the client that antipsychotic medications will improve thought processes.
c. Challenge the content of the client’s delusion.
d. Seclude the client in his room to decrease stimulation.

88. A male client diagnosed with schizophrenia is having negative symptoms associated with his illness. Which of the following is
classified as a negative symptom?
a. Abnormal thoughts.
b. Ideas of reference.
c. Blunted affect.
d. Hallucinations.

89. A female home health client in your care was recently started a typical antipsychotic medication. While assessing the client, you
notice that the client’s hands are trembling and she complains of muscle stiffness. Her vital signs indicate hyperthermia and
tachycardia. Based on this information, what should you do next?
a. Administer the PRN acetaminophen (Tylenol) ordered for the client.
b. Tell the client to rest today and increase her fluid intake.
c. Transport client to the hospital ER for further evaluation.
d. Schedule an appointment with the client’s physician for further evaluation.

90. While meeting with a schizophrenic client’s family, you are asked the question, “What causes schizophrenia?” The best response to
this question is?
a. “Research indicates that schizophrenia is caused by a genetic predisposition.”
b. “The exact cause of schizophrenia is unclear at this time.”
c. “Poor parenting skills most likely caused schizophrenia to occur.”
d. “An early-age trauma most likely caused schizophrenia to occur.”

91. While working with a client who is withdrawn and disconnected which of the following is an appropriate short-term goal?
a. The client will attend one group meeting accompanied by a staff member within 1 week.
b. The client will voluntarily lead the unit community meeting by discharge from the hospital.
c. The client will be more connected to the unit in 3 days.
d. The client will attend many of the unit group meetings by discharge from the hospital.

92. A client presents in the intake assessment office of the mental health clinic with mutism and wax-like flexibility of the extremities.
What type of schizophrenia is characteristic of these findings?
a. Disorganized type
b. Undifferentiated type
c. Residual type
d. Catatonic type

93. A client with a diagnosis of schizophrenia is speaking in group by putting rhyming words that have no meaning together. This speech
pattern is known as?
a. Echopraxia
b. Echolalia
c. Clang associations
d. Neologisms

94. The nurse administering atypical antipsychotic medications is aware that they have been defined as having which of the following
characteristics?
a. High risk for tardive dyskinesia.
b. Minimal to no risk for extrapyramidal effects.
c. Effective in treating only positive symptoms of schizophrenia.
d. Effective in treating only negative symptoms of schizophrenia.

95. A male client with a diagnosis of schizophrenia tells you that his roommate is putting thoughts in his mind against his will. This is an
example of?
a. Thought broadcasting.
b. Thought blocking.
c. Thought insertion.
d. Thought control.

96. A nurse is teaching a new group of inpatients about addiction. The clients say they can stop drinking whenever they want. These
clients still lack the understanding that addiction is a disease in which individuals lose permanent ability to?
a. Regulate their addictive and impulsive behaviors.
b. Recognize that their addictive behavior is harmful to themselves and others.
c. Act sober even if they are not.
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d. Identify with a higher power.

97. The clients in a psycho-education class on addiction express the feeling that they cannot relate with other clients who do not have the
same kind of addictions as they do. The nurse teaches about the similarities and the differences between process and chemical
addictions. The nurse would evaluate that the clients understand the difference between process addiction and chemical addictions
when they say?
a. “Withdrawal is not associated with process addictions.”
b. “Intoxication is not associated with process addictions.”
c. “Tolerance is not associated with process addictions.”
d. “There is difference between process and chemical addictions.”

98. Upon orientation to the addiction treatment unit the nurse informs the client of the family program and suggests that the client invite
his son to the sessions. The client questions why his 13-year-old son needs to participate, as he has not seen his father drunk. The
nurse’s best response would be?
a. “There generally are no consequences from the addictive behavior because the parent is usually sober when they are with the
children.”
b. “There generally are no consequences from the addictive behavior because the parents are using responsibly when they are with
the children.”
c. “There are generally consequences from the addictive behavior because the child knows they are using even is they do not see
it.”
d. “There are generally consequences from the addictive behavior because parents are impaired whether they are actively using or
recovering from use.”

99. The nurse provides an in-service on impaired nursing practice. The nurse evaluates teaching as effective, when the staff is able to
identify that the most influential risk for impaired nursing practice is that?
a. “Most nurses are adult children of alcoholics or dysfunctional families and are at risk for developing addiction.”
b. “Most nurses have exposure to various substances and believe they are not at risk to develop the disease.”
c. “Most nurses have preconceived ideas about what kind of people get addictions.”
d. “Most nurses are codependent in their personal and professional relationships.”

100. A client comes to day treatment intoxicated but says he is not. The nurse’s evaluation of his symptomatology reveals?
a. Denial
b. Reaction formation
c. Transference
d. Counter transference

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