1. Mental health is defined as:
Case finding and surveillance in the
A. The ability to distinguish what is real from
what is not.
B. A state of well-being where a person can
realize his own abilities can cope with normal
stresses of life and work productively.
C. Is the promotion of mental health, prevention
of mental disorders, nursing care of patients
during illness and rehabilitation
D. Absence of mental illness
2. Which of the following describes the role of
a technician?
A. Administers medications to a schizophrenic
patient.
B. The nurse feeds and bathes a catatonic client
C. Coordinates diverse aspects of care rendered
to the patient
D. Disseminates information about alcohol and
its effects.
3. Letty says, “Give me ten (10) minutes to
recall the name of our college professor who
failed many students in our anatomy class.”
She is operating on her:
A. Subconscious
B. Conscious
C. Unconscious
D. Ego
4. The superego is that part of the psyche
that:
A. Uses defensive function for protection.
B. Is impulsive and without morals.
C. Determines the circumstances before making
decisions.
D. The censoring portion of the mind.
5. Primary level of prevention is exemplified
by:
A. Helping the client resume self-care.
B. Ensuring the safety of a suicidal client in the
institution.
C. Teaching the client stress management
techniques
D.
community
6. Situation: In a home visit done by the
nurse, she suspects that the wife and her
child are victims of abuse. Which of the
following is the most appropriate for the
nurse to ask?
A. “Are you being threatened or hurt by your
partner?
B. “Are you frightened of you partner.”
C. “Is something bothering you?”
D. “What happens when you and your partner
argue?”
7. The wife admits that she is a victim of
abuse and opens up about her persistent
distaste for sex. This sexual disorder is:
A. Sexual desire disorder
B. Sexual arousal disorder
C. Orgasm disorder
D. Sexual Pain Disorder
8. What would be the best approach for a wife
who is still living with her abusive husband?
A. “Here’s the number of a crisis center that you
can call for help .”
B. “It’s best to leave your husband.”
C. “Did you discuss this with your family?”
D. “ Why do you allow yourself to be treated this
way.”
9. Which comment about a 3-year-old child if
made by the parent may indicate child
abuse?
A. “Once my child is toilet trained, I can still
expect her to have some.”
B. “When I tell my child to do something once, I
don’t expect to have to tell.”
C. “My child is expected to try to do things such
as dress and feed.”
D. “My three (3)-year-old loves to say NO.”
10. The primary nursing intervention for a
victim of child abuse is:
A. Assess the scope of the problem
B. Analyze the family dynamics
C. Ensure the safety of the victim
D. Teach the victim coping skills
11. Situation: A 30-year-old male employee
frequently complains of low back pain that
leads to frequent absences from work.
Consultation and tests reveal negative
results. The client has which somatoform
disorder?
A. Somatization Disorder
B. Hypochondriasis
C. Conversion Disorder
D. Somatoform Pain Disorder
12. Freud explains anxiety as:
A. Strives to gratify the needs for satisfaction and
security
B. Conflict between id and superego
C. A hypothalamic-pituitary-adrenal reaction
to stress
D. A conditioned response to stressors
13. The following are the appropriate nursing
diagnosis for the client EXCEPT:
A. Ineffective individual coping
B. Alteration in comfort, pain
C. Altered role performance
D. Impaired social interaction
14. The following statements describe
somatoform disorders:
A. Physical symptoms are explained by organic
causes
B. It is a voluntary expression of psychological
conflicts
C. Expression of conflicts through bodily
symptoms
D. Management entails a specific medical
treatment
15. What would be the best response to the
client’s repeated complaints of pain:
A. “I know the feeling is real tests revealed
negative results.”
B. “I think you’re exaggerating things a little bit.”
C. “Try to forget this feeling and have activities to
take it off your mind.”
D. “So tell me more about the pain.”
16. Situation: A nurse may encounter children
with mental disorders. Her knowledge of
these various disorders is vital. When
planning school interventions for a child with
a diagnosis of attention deficit hyperactivity
disorder, a guide to remember is to:
A. Provide as much structure as possible for the
child
B. Ignore the child’s overactivity.
C. Encourage the child to engage in any play
activity to dissipate energy
D. Remove the child from the classroom when
disruptive behavior occurs
17. The child with conduct disorder will likely
demonstrate:
A. Easy distractibility to external stimuli.
B. Ritualistic behaviors
C. Preference for inanimate objects.
D. Serious violations of age related norms.
18. Ritalin is the drug of choice for children
with ADHD. The side effects of the following
may be noted:
A. Increased attention span and concentration
B. Increase in appetite
C. Sleepiness and lethargy
D. Bradycardia and diarrhea
19. School phobia is usually treated by:
A. Returning the child to the school immediately
with family support.
B. Calmly explaining why attendance in school is
necessary
C. Allowing the child to enter the school before
the other children
D. Allowing the parent to accompany the child in
the classroom
20. A 10 year old child has very limited
vocabulary and interaction skills. She has an
I.Q. of 45. She is diagnosed to have Mental
retardation of this classification:
A. Profound
B. Mild
C. Moderate
D. Severe
21. The nurse teaches the parents of a
mentally retarded child regarding her care.
The following guidelines may be taught
except:
A. Overprotection of the child
B. Patience, routine, and repetition
C. Assisting the parents set realistic goals
D. Giving reasonable compliments
22. The parents express apprehensions on
their ability to care for their maladaptive
child. The nurse identifies what nursing
diagnosis:
A. Hopelessness
B. Altered parenting role
C. Altered family process
D. Ineffective coping
23. A 5-year-old boy is diagnosed to have
autistic disorder. Which of the following
manifestations may be noted in a client with
autistic disorder?
A. Aargumentativeness, disobedience, angry
outburst
B. Intolerance to change, disturbed relatedness,
stereotypes
C. Distractibility, impulsiveness, and overactivity
D. Aggression, truancy, stealing, lying
24. The therapeutic approach in the care of
an autistic child includes the following
EXCEPT:
A. Engage in diversionary activities when acting
-out
B. Provide an atmosphere of acceptance
C. Provide safety measures
D. Rearrange the environment to activate the
child
25. According to Piaget, a 5-year-old is at what
stage of development:
A. Sensorimotor stage
B. Concrete operations
C. Pre-operational
D. Formal operation
26. Situation: The nurse assigned to the
detoxification unit attends to various
patients with substance-related disorders. A
45 years old male revealed that he
experienced a marked increase in his intake
of alcohol to achieve the desired effect This
indicates:
A. Withdrawal
B. Tolerance
C. Intoxication
D. Psychological dependence
27. The client admitted for alcohol
detoxification develops increased tremors,
irritability, hypertension, and fever. The
nurse should be alert for impending:
A. Delirium tremens
B. Korsakoff’s syndrome
C. Esophageal varices
D. Wernicke’s syndrome
28. The care for the client places priority on
which of the following:
A. Monitoring his vital signs every hour
B. Providing a quiet, dim room
C. Encouraging adequate fluids and nutritious
foods
D. Administering Librium as ordered
29. Another client is brought to the
emergency room by friends who state that he
took something an hour ago. He is actively
hallucinating, agitated, with an
irritated nasal septum.
A. Heroin
B. Cocaine
C. LSD
D. Marijuana
30. A client is admitted with needle tracks on
his arm, stuporous and with pin point pupil
will likely be managed with:
A. Naltrexone (Revia)
B. Narcan (Naloxone)
C. Disulfiram (Antabuse)
D. Methadone (Dolophine)
31. Situation: An old woman was brought for
evaluation due to the hospital for evaluation
due to increasing forgetfulness and
limitations in daily function. The daughter
revealed that the client used her toothbrush
to comb her hair. She is manifesting:
A. Apraxia
B. Aphasia
C. Agnosia
D. Amnesia
32. She tearfully tells the nurse “I can’t take it
when she accuses me of stealing her things.”
Which response by the nurse will be most
therapeutic?
A. ”Don’t take it personally. Your mother does
not mean it.”
B. “Have you tried discussing this with your
mother?”
C. “This must be difficult for you and your
mother.”
D. “Next time ask your mother where her things
were last seen.”
33. The primary nursing intervention in
working with a client with moderate stage
dementia is ensuring that the client:
A. Receives adequate nutrition and hydration
B. Will reminisce to decrease isolation
C. Remains in a safe and secure environment
D. Independently performs self-care
34. She says to the nurse who offers her
breakfast, “Oh no, I will wait for my husband.
We will eat together” The therapeutic
response by the nurse is:
A. “Your husband is dead. Let me serve you your
breakfast.”
B. “I’ve told you several times that he is dead. It’s
time to eat.”
C. “You’re going to have to wait a long time.”
D. “What made you say that your husband is
alive?
35. Dementia, unlike delirium, is
characterized by:
A. Slurred speech
B. Insidious onset
C. Clouding of consciousness
D. Sensory perceptual change
36. Situation: A 17-year-old gymnast is
admitted to the hospital due to weight loss
and dehydration secondary to starvation.
Which of the following nursing diagnoses will
be given priority for the client?
A. Altered self-image
B. Fluid volume deficit
C. Altered nutrition less than body requirements
D. Altered family process
37. What is the best intervention to teach the
client when she feels the need to starve?
A. Allow her to starve to relieve her anxiety
B. Do a short term exercise until the urge passes
C. Approach the nurse and talk out her feelings
D. Call her mother on the phone and tell her how
she feels
38. The client with anorexia nervosa is
improving if:
A. She eats meals in the dining room.
B. Weight gain
C. She attends ward activities.
D. She has a more realistic self-concept.
39. The characteristic manifestation that will
differentiate bulimia nervosa from anorexia
nervosa is that bulimic individual
A. Have episodic binge eating and purging
B. Have repeated attempts to stabilize their
weight
C. Have peculiar food handling patterns
D. Have threatened self-esteem
40. A nursing diagnosis for bulimia nervosa
is powerlessness related to feeling not in
control of eating habits. The goal for this
problem is:
A. Patient will learn problem-solving skills
B. Patient will have decreased symptoms of
anxiety.
C. Patient will perform self-care activities daily.
D. Patient will verbalize how to set limits on
others.
41. In the management of bulimic patients,
the following nursing interventions will
promote a therapeutic relationship EXCEPT:
A. Establish an atmosphere of trust
B. Discuss their eating behavior.
C. Help patients identify feelings associated with
binge-purge behavior
D. Teach patient about bulimia nervosa
42. Situation: A 35-year-old male has an
intense fear of riding an elevator. He claims “
As if I will die inside.” This has affected his
studies The client is suffering from:
A. Agoraphobia
B. Social phobia
C. Claustrophobia
D. Xenophobia
43. Initial intervention for the client should
be to:
A. Encourage to verbalize his fears as much as he
wants.
B. Assist him to find meaning to his feelings in
relation to his past.
C. Establish trust through a consistent approach.
D. Accept her fears without criticizing.
44. The nurse develops a countertransference
reaction. This is evidenced by:
A. Revealing personal information to the client
B. Focusing on the feelings of the client.
C. Confronting the client about discrepancies in
verbal or non-verbal behavior
D. The client feels angry towards the nurse who
resembles his mother.
45. Which is the desired outcome in
conducting desensitization:
A. The client verbalize his fears about the
situation
B. The client will voluntarily attend group therapy
in the social hall.
C. The client will socialize with others willingly
D. The client will be able to overcome his
disabling fear.
46. Which of the following should be included
in the health teachings among clients
receiving Valium:
A. Avoid taking CNS depressant like alcohol.
B. There are no restrictions in activities.
C. Limit fluid intake.
D. Any beverage like coffee may be taken
47. Situation: A 20-year-old college student is
admitted to the medical ward because of
sudden onset of paralysis of both legs.
Extensive examination revealed no physical
basis for the complaint. The nurse plans
intervention based on which correct
statement about conversion disorder?
A. The symptoms are conscious effort to control
anxiety
B. The client will experience a high level of
anxiety in response to the paralysis.
C. The conversion symptom has symbolic
meaning to the client
D. A confrontational approach will be beneficial
for the client.
48. Nikki reveals that the boyfriend has been
pressuring her to engage in premarital sex.
The most therapeutic response by the nurse
is:
A. “I can refer you to a spiritual counselor if you
like.”
B. “You shouldn’t allow anyone to pressure you
into sex.”
C. “It sounds like this problem is related to your
paralysis.”
D. “How do you feel about being pressured into
sex by your boyfriend?”
49. Malingering is different from somatoform
disorder because the former:
A. Has evidence of an organic basis.
B. It is a deliberate effort to handle upsetting
events
C. Gratification from the environment are
obtained.
D. Stress is expressed through physical
symptoms.
50. Unlike psychophysiologic disorder Linda
may be best managed with:
A. Medical regimen
B. Milieu therapy
C. Stress management techniques
D. Psychotherapy
Answers and Rationale
1. Answer: B. A state of well-being where a
person can realize his own abilities can cope
with normal stresses of life and work
productively.
ADVERTISEMENT
1. Which nursing intervention is best
for facilitating communication with a
psychiatric client who speaks a foreign
language?
A. Rely on nonverbal communication.
B. Select symbolic pictures as aids.
C. Speak in universal phrases.
D. Use the services of an interpreter.
2. The nurse explains to a mental
health care technician that a client’s
obsessive-compulsive behaviors are
related to an unconscious conflict
between id impulses and the superego
(or conscience). On which of the
following theories does the nurse base
this statement?
A. Behavioral theory
B. Cognitive theory
C. Interpersonal theory
D. Psychoanalytic theory
3. The nurse observes a client pacing
in the hall. Which statement by the
nurse may help the client recognize
his anxiety?
A. “I guess you’re worried about
something, aren’t you?
b. “Can I get you some medication to help
calm you?”
c. “Have you been pacing for a long
time?”
d. “I notice that you’re pacing. How are
you feeling?”
4. A client with obsessive-compulsive
disorder is hospitalized on an
inpatient unit. Which nursing
response is most therapeutic?
A. Accepting the client’s
obsessive-compulsive behaviors
B. Challenging the client’s
obsessive-compulsive behaviors
C. Preventing the client’s
obsessive-compulsive behaviors
D. Rejecting the client’s
obsessive-compulsive behaviors
5. A 45-year-old woman with a history
of depression tells a nurse in her
doctor’s office that she has difficulty
with sexual arousal and is fearful that
her husband will have an affair. Which
of the following factors would the
nurse identify as least significant in
contributing to the client’s sexual
difficulty?
A. Education and work history
B. Medication used
C. Physical health status
D. Quality of spousal relationship
6. Which nursing intervention is most
appropriate for a client with anorexia
nervosa during initial hospitalization
on a behavioral therapy unit?
A. Emphasize the importance of good
nutrition to establish normal weight.
B. Ignore the client’s mealtime behavior
and focus instead on issues of
dependence and independence.
C. Help establish a plan using privileges
and restrictions based on compliance
with refeeding.
D. Teach the client information about the
long-term physical consequence of
anorexia.
7. A nurse is evaluating therapy with
the family of a client with anorexia
nervosa. Which of the following would
indicate that the therapy was
successful?
A. The parents reinforce increased
decision making by the client.
B. The parents clearly verbalize their
expectations for the client.
C. The client verbalizes that family meals
are now enjoyable.
D. The client tells her parents about
feelings of low self-esteem.
8. The nurse is working with a client
with a somatoform disorder. Which
client outcome goal would the nurse
most likely establish in this situation?
A. The client will recognize signs and
symptoms of physical illness.
B. The client will cope with physical
illness.
C. The client will take prescribed
medications.
D. The client will express anxiety verbally
rather than through physical symptoms.
9. Which method would a nurse use to
determine a client’s potential risk
for suicide?
A. Wait for the client to bring up the
subject of suicide.
B. Observe the client’s behavior for cues
of suicide ideation.
C. Question the client directly about
suicidal thoughts.
D. Question the client about future plans.
10. A client with a bipolar disorder
exhibits manic behavior. The nursing
diagnosis is Disturbed thought
processes related to difficulty
concentrating, secondary to flight of
ideas. Which of the following outcome
criteria would indicate improvement
in the client?
A. The client verbalizes feelings directly
during treatment.
B. The client verbalizes positive “self”
statement.
C. The client speaks in coherent
sentences.
D. The client reports feelings calmer.
11. A client tells a nurse. “Everyone
would be better off if I wasn’t alive.”
Which nursing diagnosis would be
made based on this statement?
A. Disturbed thought processes
B. Ineffective coping
C. Risk for self-directed violence
D. Impaired social interaction
12. Which information is the most
essential in the initial teaching session
for the family of a young adult
recently diagnosed with
schizophrenia?
A. Symptoms of this disease imbalance in
the brain.
B. Genetic history is an important factor
related to the development of
schizophrenia.
C. Schizophrenia is a serious disease
affecting every aspect of a person’s
functioning.
D. The distressing symptoms of this
disorder can respond to treatment with
medications.
13. A nurse is working with a client
who has schizophrenia, paranoid type.
Which of the following outcomes
related to the client’s delusional
perceptions would the nurse
establish?
A. The client will demonstrate realistic
interpretation of daily events in the unit.
B. The client will perform daily hygiene
and grooming without assistance.
C. The client will take prescribed
medications without difficulty.
D. The client will participate in unit
activities.
14. A client with bipolar disorder,
manic type, exhibits extreme
excitement, delusional thinking, and
command hallucinations. Which of the
following is the priority nursing
diagnosis?
A. Anxiety
B. Impaired social interaction
C. Disturbed sensory-perceptual
alteration (auditory)
D. Risk for other-directed violence
15. A client who abuses alcohol and
cocaine tells a nurse that he only uses
substances because of his stressful
marriage and difficult job. Which
defense mechanisms is this client
using?
A. Displacement
B. Projection
C. Rationalization
D. Sublimation
16. An 11-year-old child diagnosed
with conduct disorder is admitted to
the psychiatric unit for treatment.
Which of the following behaviors
would the nurse assess?
A. Restlessness, short attention span,
hyperactivity
B. Physical aggressiveness,
low-stress tolerance disregard for the
rights of others
C. Deterioration in social functioning,
excessive anxiety, and worry, bizarre
behavior
D. Sadness, poor appetite and
sleeplessness, loss of interest in activities
17. The nurse understands that if a
client continues to be dependent on
heroin throughout her pregnancy, her
baby will be at high risk for:
A. Mental retardation.
B. Heroin dependence.
C. Addiction in adulthood.
D. Psychological disturbances.
18. The emergency department nurse
is assigned to provide care for a victim
of a sexual assault. When following
legal and agency guidelines, which
intervention is most important?
A. Determine the assailant’s identity.
B. Preserve the client’s privacy.
C. Identify the extent of an injury.
D. Ensure an unbroken chain of evidence.
19. Which factor is least important in
the decision regarding whether a
victim of family violence can safely
remain in the home?
A. The availability of appropriate
community shelters
B. The non-abusing caretaker’s ability to
intervene on the client’s behalf
C. The client’s possible response to
relocation
D. The family’s socioeconomic status
20. The nurse would expect a client
with early Alzheimer’s disease to have
problems with:
A. Balancing a checkbook.
B. Self-care measures.
C. Relating to family members.
D. Remembering his own name
21. Which nursing intervention is most
appropriate for a client with
Alzheimer’s disease who has frequent
episodes emotional lability?
A. Attempt humor to alter the client
mood.
B. Explore reasons for the client’s altered
mood.
C. Reduce environmental stimuli to
redirect the client’s attention.
D. Use logic to point out reality aspects.
22. Which neurotransmitter has been
implicated in the development of
Alzheimer’s disease?
A. Acetylcholine
B. Dopamine
C. Epinephrine
D. Serotonin
23. Which factors are the most
essential for the nurse to assess when
providing crisis intervention foer a
client?
A. The client’s communication and coping
skills
B. The client’s anxiety level and ability to
express feelings
C. The client’s perception of the triggering
event and availability of situational
supports
D. The client’s use of reality testing and
level of depression
24. The nurse considers a client’s
response to crisis intervention
successful if the client:
A. Changes coping skills and behavioral
patterns.
B. Develops insight into reasons why the
crisis occurred.
C. Learns to relate better to others.
D. Returns to his previous level of
functioning.
25. Two nurses are co-leading group
therapy for seven clients in the
psychiatric unit. The leaders observe
that the group members are anxious
and look to the leaders for answers.
Which phase of development is this
group in?
A. Conflict resolution phase
B. Initiation phase
C. Working phase
D. Termination phase
26. Group members have worked very
hard, and the nurse reminds them
that termination is approaching.
Termination is considered successful if
group members:
A. Decide to continue.
B. Elevate group progress
C. Focus on positive experience
D. Stop attending prior to termination.
27. The nurse is teaching a group of
clients about the mood-stabilizing
medications lithium carbonate. Which
medications should she instruct the
clients to avoid because of the
increased risk of lithium toxicity?
A. Antacids
B. Antibiotics
C. Diuretics
D. Hypoglycemic agents
28. When providing family therapy,
the nurse analyzes the functioning of
healthy family systems. Which
situations would not
increase stress on a healthy family
system?
A. An adolescent’s going away to college
B. The birth of a child
C. The death of a grandparent
D. Parental disagreement
29. A client taking the monoamine
oxidase inhibitor (MAOI)
antidepressant isocarboxazid
(Marplan) is instructed by the nurse to
avoid which foods and beverages?
A. Aged cheese and red wine
B. Milk and green, leafy vegetables
C. Carbonated beverages and tomato
products
D. Lean red meats and fruit juices
30. Prior to
administering chlorpromazine (Thoraz
ine) to an agitated client, the nurse
should:
A. Assess skin color and sclera
B. Assess the radial pulse
C. Take the client’s blood pressure
D. Ask the client to void
31. The nurse understands that
electroconvulsive therapy is primarily
used in psychiatric care for the
treatment of:
A. Anxiety disorders.
B. Depression.
C. Mania.
D. Schizophrenia.
32. A client taking the MAOI
phenelzine (Nardil) tells the nurse that
he routinely takes all of the
medications listed below. Which
medication would cause the nurse to
express concern and therefore initiate
further teaching?
A. Acetaminophen (Tylenol)
B. Diphenhydramine (Benadryl)
C. Furosemide (Lasix)
D. Isosorbide dinitrate (Isordil)
33. The nurse is administering a
psychotropic drug to an elderly client
who has a history of benign prostatic
hypertrophy. It is most important for
the nurse to teach this client to:
A. Add fiber to his diet.
B. Exercise on a regular basis.
C. Report incomplete bladder emptying
D. Take the prescribed dose at bedtime.
34. The nurse correctly teaches a
client taking the Benzodiazepine
Oxazepam (Serax) to avoid excessive
intake of:
A. Cheese
B. Coffee
C. Sugar
D. Shellfish
35. The nurse provides a referral to
Alcoholics Anonymous to a client who
describes a 20-year history of alcohol
abuse. The primary function of this
group is to:
A. Encourage the use of a 12-step
program.
B. Help members maintain sobriety.
C. Provide fellowship among members.
D. Teach positive coping mechanisms.
36. Which client outcome is most
appropriately achieved in a
community approach setting in
psychiatric nursing?
A. The client performs activities of daily
living and learns about crafts.
B. The client is able to prevent aggressive
behavior and monitors his use of
medications.
C. The client demonstrates self-reliance
and social adaptation.
D. The client experience experiences
anxiety relief and learns about his
symptoms.
37. A client with panic disorder
experiences an acute attack while the
nurse is completing an admission
assessment. List the following
interventions according to their level
of priority.
A. Remain with the client.
B. Encourage physical activity.
C. Encourage low, deep breathing.
D. Reduce external stimuli.
E. Teach coping measures.
38. The doctor has prescribed
haloperidol (Haldol) 2.5 mg. I.M. for an
agitated client. The medication is
labeled haloperidol 10 mg/2 ml. The
nurse prepares the correct dose by
drawing up how many milliliters in the
syringe?
A. 0.3
B. 0.4
C. 0.5
D. 0.6
39. The nurse enters the room of a
client with a cognitive impairment
disorder and asks what day of the
week it is: what the date, month, and
year are; and where the client is. The
nurse is attempting to assess:
A. Confabulation
B. Delirium
C. Orientation
D. Perseveration
40. Which of the following will the
nurse use when communicating with a
client who has a cognitive
impairment?
A. Complete explanations with multiple
details
B. Picture or gestures instead of words
C. Stimulating words and phrases to
capture the client’s attention
D. Short words and simple sentences
41. A 75-year-old client has dementia
of the Alzheimer’s type and
confabulates. The nurse understands
that this client:
A. Denies confusion by being jovial.
B. Pretends to be someone else.
C. Rationalizes various behaviors.
D. Fills in memory gaps with fantasy.
42. An elderly client with Alzheimer’s
disease 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 family 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.
43. In clients with a cognitive
impairment disorder, the
phenomenon of increased confusion
in the early evening hours is called:
A. Aphasia
B. Agnosia
C. Sundowning
D. Confabulation
44. Which of the following outcome
criteria is appropriate for the client
with dementia?
A. The client will return to an adequate
level of self-functioning.
B. The client will learn new coping
mechanisms to handle anxiety.
C. The client will seek out resources in
the community for support.
D. The client will follow an establishing
schedule for activities of daily living.
45. The school guidance counselor
refers a family with an 8-year-old child
to the mental health clinic because of
the child’s frequent fighting in school
and truancy. Which of the following
data would be a priority to the nurse
doing the initial family assessment?
A. The child’s performance in school
B. Family education and work history
C. The family’s perception of the current
problem
D. The teacher’s attempt to solve the
problem
46. The parents of a young man with
schizophrenia express feelings of
responsibility and guilt for their son’s
problems. How can the nurse best
educate the family?
A. Acknowledge the parent’s
responsibility.
B. Explain the biological nature of
schizophrenia.
C. Refer the family to a support group
D. Teach the parents various ways they
must change.
47. The nurse collecting family
assessment data asks. “Who is in your
family and where do they live?” which
of the following is the nurse
attempting o identify?
A. Boundaries
B. Ethnicity
C. Relationships
D. Triangles
48. According to the family systems
theory, which of the following best
describes the process of
differentiation?
A. Cooperative action among members of
the family
B. Development of autonomy within the
family
C. Incongruent messages wherein the
recipient is a victim
D. Maintenance of system continuity or
equilibrium
49. The nurse is interacting with a
family consisting of a mother, a
father, and a hospitalized adolescent
who has a diagnosis of alcohol abuse.
The nurse analyzes the situation and
agrees with the adolescent’s view
about family rules. Which intervention
is most appropriate?
A. The nurse should align with the
adolescent, who is the family scapegoat.
B. The nurse should encourage the
parents to adopt more realistic rules.
C. The nurse should encourage the
adolescent to comply with parental rules.
D. The nurse should remain objective and
encourage mutual negotiation of issues.
50. A 16-year-old girl
has returned home following
hospitalization for treatment of
anorexia nervosa. The parents tell
the family nurse performing a home
visit that their child has always done
everything to please them and they
cannot understand her current
stubbornness about eating. The nurse
analyzes the family situation and
determines it is characteristic of
which relationship style?
A. Differentiation
B. Disengagement
C. Enmeshment
D. Scapegoating
Answers and Rationale
1. Answer: D. Use the services of an
interpreter.
ADVERTISEMENT
● 1. A client is struggling to explore
and solve a problem. Which
nursing statement would
verbalize the implication of the
client’s actions?
● A. “You seem to be motivated to
change your behavior.”
B. “How will these changes affect
your family relationships?”
C. “Why don’t you make a list of the
behaviors you need to change.”
 D. “The team recommends that you
make only one behavioral change
at a time.”
● 2. The nurse asks a newly
admitted client, “What can we do
to help you?” What is the
purpose of this therapeutic
communication technique?
● A. To reframe the client’s thoughts
about mental health treatment
B. To put the client at ease
C. To explore a subject, idea,
experience, or relationship
D. To communicate that the nurse
is listening to the conversation
● 3. A student nurse tells the
instructor, “I’m concerned that
when a client asks me for advice
I won’t have a good solution.”
Which should be the nursing
instructor‘s best response?
● A. “It’s scary to feel put on the spot
by a client. Nurses don’t always
have the answer.”
B. “Remember, clients, not nurses,
are responsible for their own
choices and decisions.”
C. “Just keep the client’s best
interests in mind and do the best
that you can.”
D. “Set a goal to continue to work
on this aspect of your practice.”
● 4. A student nurse is learning
about the appropriate use
of touch when communicating
with clients diagnosed with
psychiatric disorders. Which
statement by the instructor best
provides information about this
aspect of therapeutic
communication?
● A. “Touch carries a different
meaning for different individuals.”
B. “Touch is often used when
deescalating volatile client
situations.”
C. “Touch is used to convey interest
and warmth.”
D. “Touch is best combined with
empathy when dealing with
anxious clients.”
● 5. Which nursing statement is a
good example of the therapeutic
communication technique of
focusing?
● A. “Describe one of the best things
that happened to you this week.”
B. “I’m having a difficult time
understanding what you mean.”
C. “Your counseling session is in 30
minutes. I’ll stay with you until
then.”
D. “You mentioned your
relationship with your father. Let’s
discuss that further.”
● 6. After fasting from 10 p.m. the
previous evening, a client finds
out that the blood test has been
canceled. The client swears at
the nurse and states, “You are
 incompetent!” Which is the
nurse’s best response?
● A. “Do you believe that I was the
cause of your blood test being
canceled?”
B. “I see that you are upset, but I
feel uncomfortable when you
swear at me.”
C. “Have you ever thought about
ways to express anger
appropriately?”
D. “I’ll give you some space. Let me
know if you need anything.”
● 7. During a nurse-client
interaction, which nursing
statement may belittle the
client’s feelings and concerns?
● A. “Don’t worry. Everything will be
alright.”
B. “You appear uptight.”
C. “I notice you have bitten your
nails to the quick.”
D. “You are jumping to
conclusions.”
● 8. A client on an in-patient
psychiatric unit tells the nurse, “I
should have died because I am
totally worthless.” In order to
encourage the client to continue
talking about feelings, which
should be the nurse’s initial
response?
● A. “How would your family feel if
you died?”
B. “You feel worthless now, but that
can change with time.”
C. “You’ve been feeling sad and
alone for some time now?”
D. “It is great that you have come in
for help.”
● 9. Which nursing response is an
example of the nontherapeutic
communication block of
requesting an explanation?
● A. “Can you tell me why you said
that?”
B. “Keep your chin up. I’ll explain
the procedure to you.”
C. “There is always an explanation
for both good and bad behaviors.”
D. “Are you not understanding the
explanation I provided?”
● 10. A client states, “You won’t
believe what my husband said to
me during visiting hours. He has
no right treating me that way.”
Which nursing response would
best assess the situation that
occurred?
● A. “Does your husband treat you
like this very often?”
B. “What do you think is your role in
this relationship?”
C. “Why do you think he behaved
like that?”
D. “Describe what happened during
your time with your husband.”
● 11. Which therapeutic
communication technique
should the nurse use when
 communicating with a client
who is experiencing auditory
hallucinations?
● A. “My sister has the same
diagnosis as you and she also hear
voices.”
B. “I understand that the voices
seem real to you, but I do not hear
any voices.”
C. “Why not turn up the radio so
that the voices are muted.”
D. “I wouldn’t worry about these
voices. The medication will make
them disappear.”
● 12. Which nursing statement is a
good example of the therapeutic
communication technique of
offering self?
● A. “I think it would be great if you
talked about that problem during
our next group session.”
B. “Would you like me to
accompany you to your
electroconvulsive therapy
treatment?”
C. “I notice that you are offering
help to other peers in the milieu.”
D. “After discharge, would you like
to meet me for lunch to review
your outpatient progress?”
● 13. A client slammed a door on
the unit several times. The nurse
responds, “You seem angry.” The
client states, “I’m not angry.”
What therapeutic
communication technique has
the nurse employed and what
defense mechanism is the client
unconsciously demonstrating?
● A. Making observations and the
defense mechanism of suppression
B. Verbalizing the implied and the
defense mechanism of denial
C. Reflection and the defense
mechanism of projection
D. Encouraging descriptions of
perceptions and the defense
mechanism of displacement
● 14. Which of the following
individuals are communicating a
message? (Select all that apply.)
● A. A mother spanking her son for
playing with matches
B. A teenage boy isolating himself
and playing loud music
C. A biker sporting an
eagle tattoo on his biceps
D. A teenage girl writing, “No one
understands me.”
E. A father checking for new e-mail
on a regular basis
● 15. A mother rescues two of her
four children from a house fire.
In the emergency department,
she cries, “I should have gone
back in to get them. I should
have died, not them.” What is
the nurse’s best response?
● A. “The smoke was too thick. You
couldn’t have gone back in.”
B. “You’re feeling guilty because
 you weren’t able to save your
children.”
C. “Focus on the fact that you could
have lost all four of your children.”
D. “It’s best if you try not to think
about what happened. Try to move
on.”
● Answers and Rationale
● B. Providing linens and toiletries for Mr.
● 1. Answer: A. “You seem to be
motivated to change your
behavior.”
● ADVERTISEMENT
1. A man is admitted to the nursing
care unit with a diagnosis of cirrhosis.
He has a long history of alcohol
dependence. During the late evening
following his admission, he becomes
increasingly disoriented and agitated.
Which of the following would the
client be least likely to experience?
A. Diaphoresis and tremors.
B. Increased blood pressure and heart
rate.
C. Illusions.
D. Delusions of grandeur.
2. Mr. Peterson, 35, is admitted for
bipolar illness, manic phase, after
assaulting his landlord in an argument
over Mr. Peterson is staying up all
night playing loud music. Mr.
Peterson is hyperactive, intrusive, and
has rapid, pressured speech. He has
not slept in three days and appears
thin and disheveled. Which of the
following is the most essential nursing
action at this time?
A. Providing a meal and beverage for Mr.
Peterson to eat in the dining room.
Peterson to attend to his hygiene.
C. Consulting with the psychiatrist to
order a hypnotic to promote sleep.
D. Providing for client safety by limiting
his privileges.
3. Which of the following would best
indicate to the nurse that a depressed
client is improving?
A. Reduced levels of anxiety.
B. Changes in vegetative signs.
C. Compliance with medications.
D. Requests to talk to the nurse.
4. An elderly man is admitted to the
hospital. He was alert and oriented
during the admission interview.
However, his family states that he
becomes disruptive and disoriented
around dinnertime. One night he was
shouting furiously and didn’t know
where he was. He was sedated and the
next morning he was fine. At
dinnertime, the disruptive behavior
returned. The client is diagnosed as
having sundown syndrome. The
client’s son asks the nurse what
causes sundown syndrome. The
nurse’s best response is that it is
attributed to
A. An underlying depression.
B. Inadequate cerebral flow.
C. Changes in the sensory environment.
D. Fuctuating levels of oxygen exchange.
5. The nurse is discussing
electroconvulsive therapy (ECT) with a
client who asks how long it will be
before she feels better. The nurse
explains that the beneficial effects of
ECT usually occur within
A. One week.
B. Three weeks.
C. Four weeks.
D. Six weeks.
6. The nurse is assessing a 17-year-old
female who is admitted to the eating
disorders unit with a history of weight
fluctuation, abdominal pain, teeth
erosion, receding gums, and bad
breath. She states that her health has
been a problem but there are no other
concerns in her life. Which of the
following assessments will be the least
useful as the nurse develops the care
plan?
A. Information regarding recent mood
changes.
B. Family functioning using a genogram.
C. Ability to socialize with peers.
D. Whether she has a sexual relationship
with a boyfriend.
7. A 34-year-old woman is admitted for
treatment of depression. Which of
these symptoms would the nurse be
least likely to find in the initial
assessment?
A. Inability to make decisions.
B. Feelings of hopelessness.
C. Family history of depression.
D. Increased interest in sex.
8. The nurse is planning care for a
client who has a phobic disorder
manifested by a fear of elevators.
Which goal would need to be
accomplished first? The client
A. Demonstrates the relaxation response
when asked.
B. Verbalizes the underlying cause of the
disorder.
C. Rides the elevator in the company of
the nurse.
D. Role plays the use of an elevator.
9. A teenage female is admitted with
the diagnosis of anorexia nervosa.
Upon admission, the nurse finds
a bottle of assorted pills in the client’s
drawer. The client tells the nurse that
they are antacids for stomach pains.
The best response by the nurse would
be
a. “These pills aren’t antacids since they
are all different.”
b. “Some teenagers use pills to lose
weight.”
c. “Tell me about your week prior to being
admitted.”
d. “Are you taking pills to change your
weight?”
10. A mother with a Roman Catholic
belief has given birth in an ambulance
on the way to the hospital. The
neonate is in very critical condition
with little expectation of surviving the
trip to the hospital. Which of these
requests should the nurse in the
ambulance anticipate and be prepared
to do?
A. The refusal of any treatment for self
and the neonate until she talks to a
reader
B. The placement of a rosary necklace
around the neonate’s neck and not to
remove it unless absolutely necessary
C. Arrange for a church elder to be at the
emergency department when the
ambulance arrives so a “laying on hands”
can be done
D. Pour fluid over the forehead backward
towards the back of the head and say “I
baptize you in the name of the father, the
son and the holy spirit. Amen.”
11. Which statement by the client
during the initial assessment in the
emergency department is most
indicative of suspected domestic
violence?
a. “I am determined to leave my house in
a week.”
b. “No one else in the family has been
treated like this.”
c. “I have only been married for two (2)
months.”
d. “I have tried leaving, but have always
gone back.”
12. Which of these statements by the
nurse reflects the best use of
therapeutic interaction techniques?
a. “You look upset. Would you like to talk
about it?”
b. “I’d like to know more about your
family. Tell me about them.”
c. “I understand that you lost your
partner. I don’t think I could go on if that
happened to me.”
d. “You look very sad. How long have you
been this way?”
13. When planning the therapeutic
milieu, it is MOST important to select
group activities which
A. Match the clients’ preferences
B. Are consistent with clients’ skills
C. Achieve clients’ therapeutic goals
D. Build skills of group participation
14. A client was admitted to the
psychiatric unit for severe depression.
After several days, the client
continues to withdraw from other
clients. Which of the following would
be the MOST appropriate statement
by the nurse to promote interaction
with other clients?
a. “Your doctor thinks its good for you to
spend time with others.”
b. “It is important for you to participate in
group activities.”
c. “Painting this picture will help you feel
better.”
d. “Come play Chinese Checkers with
Gerry and me.”
15. The nurse can BEST ensure the
safety of a demented client who
wanders from the room by
A. Repeatedly reminding the client of
time and place
B. Explaining the risks of becoming lost
C. Using soft restraints
D. Attaching a wander guard sensor band
to the client’s wrist
16. A client with paranoid thoughts
refuses to eat because he believes the
food has poisoned. The MOST
appropriate initial action is to
A. Taste the food in the client’s presence
B. Suggest that food be brought from
home
C. Simply state the food is not poisoned
D. Inform the client he will be tube fed if
he does not eat
17. The nurse is caring for a severely
depressed client who has just been
admitted to the in-client psychiatric
unit. Which of the following is a
PRIORITY of care?
A. Nutrition
B. Elimination
C. Rest
D. Safety
18. A nurse is teaching
a stress-management program for a
client. Which of the following beliefs
will the nurse advocate as a method of
coping with stressful life events?
A. Avoidance of stress is an important
goal for living.
B. Control over one’s response to stress
is possible.
C. Most people have no control over their
level of stress.
D. Significant others are important to
provide care and concern.
19. A student nurse is caring for a
75-year-old client who is very
confused. The student’s
communication tools should include:
A. Written directions for bathing.
B. Speaking very loudly.
C. Gentle touch while guiding ADLs
(activities of daily living).
D. Flat facial expression.
20. When a husband takes out his
work frustrations and anger by
abusing his wife at home, the nurse
will identify this crisis as which type?
A. Psychiatric emergency crisis
B. Developmental crisis
C. Anticipated life transition
D. Dispositional crisis
Answers and Rationale
1. Answer D. Delusions of grandeur
ADVERTISEMENT
● 12.Cognitive
Mental Ch. 2
Study online at quizlet.com/_2jjeee
1.3 paradigms for aversive techniques: 1. paring
maladaptive behavior w/ noxious stimuli so anxiety/fear
becomes ass. w/ once-pleasurable stimulus
2. punishment
3. avoidance training
2.According to Freud, which aspect of the personality
motivates an individual to seek perfection?
A. Id
B. Ego
C. Superego: C. Superego
3.The art of nursing: Provide care, compassion, and
advocacy; enhance comfort and well-being
4.Automatic thoughts/cognitive distortions: rapid,
unthinking responses based on schemas; intense and
frequent in psychiatric disorders such as depression and
anxiety; irrational and lead to false assumptions and
misinterpretations
5.Aversion thearpy: Punishment; used to treat addictions,
hallucinations, etc; treatment of choice when other less
drastic measures have failed to produce desired effects
6.Behavior therapy: Based on assumption that changes in
maladaptive behavior can occur without insight into
underlying cause
7.Biofeedback: Form of behavior therapy and is
successfully used today, esp. for controlling body's
physiological response to stress and anxiety
8.Biological theories: focus on neurological, chemical,
biological, and genetic; how body and brain interact to
create emotions, memories, and perceptual experiences
9.Biological theories and nursing: Social, environmental,
cultural, and economic all play a role in treatment and
development of mental disorders; focuses on qualities of
a therapeutic relationship, understanding pt's
perspective, communicating to facilitate recovery
10.Classical responses are...: involuntary
11.Cognitive-Behavioral therapy (beck): test distorted
beliefs and change way of thinking; reduce symptoms
(schemata, automatic thoughts, and cognitive
distortions)
theory: Dynamic interplay b/w individuals and
environment; thoughts come before feelings and actions;
thoughts about work and our place in it are based on
 own UNIQUE perspectives which may or may not be 25.Hildegard Peplau's Theory of Interpersonal
based on reality Relationships in Nursing: Influenced by Sullivan's work
(mother of psychiatric nursing)
13.Conditioning: pairing a behavior with a condition that
reinforces or diminishes the behavior's occurence 26.Id: Source of all drives, instincts, reflexes, needs, genetic
inheritance, and capacity to respond as well as the
14.Conscious: Tip of iceberg; all material a person is aware wishes that motivate us; cannot tolerate frustration and
of at one time such as perceptions, memories, thoughts, seeks to discharge tension and return to a more
fantasies, and feelings comfortable level of energy; lacks ability to problem
solve (it is not logical and operates according to pleasure
15.Countertransference: Unconscious feelings that the
principle); only needs that counts are its own (ex.
health care worker has toward patient
hungry, screaming infant)
16.Defense mechanisms: Automatic coping sytles that
27.Implicationof nursing for behavioral
protect people from anxiety and maintain self-image by
theories: modifying or replacing behaviors and behavior
blocking feeling, conflicts, and memory (ex. denial,
management
regression)
28.Interpersonalpsychotherapy has approved
17.Developmental model is important part of nursing
successfully in the treatment of 
assessment: helps determine what types of
A. Depression
interventions are most likely to be effective
B. Bipolar
(age-appropriate interventions)
C. Schizophrenia
18.Ego: Problem solver and reality tester; able to D. OCD: A. Depression
differentiate subjective experiences, memory images,
29.Maslow's Hierarchy of Needs: Human beings are active
and objective reality and attempts to negotiate with the
participants in life, striving for self-actualization; when
outside world (ex. hungry adult knows to seek where he
needs are met, higher needs are able to emerge; when
can go eat and do it)
lower level needs are met, then higher needs can
19.Erikson's eight stages of psychosocial emerge
development: Infancy (0-1.5y), early childhood (1.5-3),
30.MilieuTherapy: Use of total environment; people,
preschool (3-6), school age (6-12), adolescence (12-20),
setting, structure, and emotional climate are all important
early adulthood (20-35), middle adulthood (35-65), later
to healing
years (65-death)
31.Modeling: therapist provides role model for specific
20.Extinction: Absence of reinforcement; decreases
identified behaviors and pt learns through imitation
behavior by withholding a reward that has become
habitual 32.Negative reinforcement: removal of an objectionable or
aversive stimulus (ex. walking through park once viscous
21.Foundation for Hildegard Peplau's theory: Participant
dog is pickedup)
observer; mutuality, respect for patient, unconditional
acceptance, empathy 33.Operantconditioning: bases for behavior modification
and uses positive reinforcement to increases desired
22.Freud's Psychoanalytic theory: Personality structure,
behaviors (ex. kid throwing fit for candy)
level of awareness, anxiety, role of defense
mechanisms, and psychosexual development 34.Operant conditioning is...: voluntary

23.Freud's Psychosexual stages of development: oral, 35.Apatient is admitted to your unit who has an
anal, phallic, latency, genital uncanny resemblance to your older sister. As a
child, your older sister bossed you around and
24.Hierarchy levels: Physiological (basic needs - food,
criticized you constantly. You realize that you are
oxygen, water, sex), safety (security, law, order, freedom
responding negatively to this patient. What is going
from fear), belonging and love needs (intimate
on?
relationships, love, overcoming loneliness), esteem
What should the nurse do?: Countertransference
needs (high self-regard and can beel confident,
Nurse should realize importance of maintaining
valuable), self-actualization (striving to everything person
self-awareness and seeking supervisory guidance as the
is capable of becoming)
therapeutic relationship progresses
36.Pavlov's classical conditioning theory: noticed dogs 1948 is called
were able to anticipate when food would be coming and A. Cognition-Behavior Therapy
would salivate before tasting meat (psychic secretion); B. Milieu Therapy
theory found that when neutral stimulus was paired with C. Psychoanalytic Therapy
another stimulus, the neutral could stimulate the other D. Interpersonal Therapy: B. Milieu Therapy

37.Positivereinforcement: causes behavior to occur more
frequently (ex. 3.8 GPA after studying hard)
38.Preconscious: Below surface of awareness; contains
material that can be retrieved easily through conscious
effort
39.Punishment: unpleasant consequence;
positive - give; negative - take away
49.Transference: Feelings that the patient has toward
health care workers that were originally held toward
significant others in life
50.Unconscious: repressed memories, passions, and
unacceptable urges lying deep below surface; exerts a
powerful yet unseen effect on the conscious thoughts
and feelings of the individual; person is usually unable to
retrieve unconscious material w/out help of therapist

40.Purpose of theories: help us explain behavior; 51.Watson's behaviorism theory: developed school of

foundation of mental health and mental health nursing; thought (behaviorism); personality traits and responses
treatment therapies are based on these were socially learned through classical conditioning

41.Rational-Emotive Behavior Therapy (ellis): aims to 52.Which theorist most influenced the professional
eradicate irrational beliefs; recognize thoughts that are practice of psychiatric nursing?
not accurate (thoughts tend to take form of shoulds, A. Harry Stack Sullivan
oughts, and musts) B. Hildegard Peplau
C. Erik Erikson
42.Schemata, automatic thoughts, and cognitive
D. Ivan Pavlov: B. Hildegard Peplau
distortions are terms that relate to
A. rational-emotive behavioral therapy 53.Who is the first nurse theorist to describe the
B. cognitive-behavioral therapy nurse-patient relationship as the foundation of
C. operant conditioning therapy nursing practice?
D. biofeedback: B. Cognitive-behavioral therapy A. Florence Nightingale
B. Jean Watson
43.The science of nursing: Application of knowledge to:
C. Hildegard Peplau
understand broad range of human problems and
D. Erik Erikson: C. Hildegard Peplau
psychosocial phenomena; intervene in relieving pt's
suffering and promote growth

44.Skinner'soperant conditioning theory: voluntary

behaviors are learned through consequences and
behavioral responses are elicited through reinforcement

45.Sullivan's Interpersonal Theory: Purpose of all

behavior is to get needs met through interpersonal
interactions and to reduce or avoid anxiety

46.Superego: Moral component of personality; has

conscious and ideas of reality; ideal rather than real,
seeks perfection as opposed to seeking pleasure or
engaging reason

47.Systematic desensitization: involves the development

of behavior tasks customized to the pt's specific fears;
four steps (break down fear, exposure to fear, design
hierarchy of fears, practice techniques to reduce fear)

48.Thetherapy that used total environment to treat

disturbed children created by Bruno Bettlehein in