VANGUARDIA’S ONLINE REVIEW

NURSING PRACTICE 5
INSTRUCTIONS: Select the correct answer for each of the following questions. Mark only
one answer for each item by marking the box corresponding to the letter of your choice on the
answer sheet provided.

1. Which among the following is characterized by anxiety provoked by certain types of

social or performance situations that often leads to avoidance behavior?
a. Agoraphobia c. Social phobia
b. Panic disorder d. Acute stress disorder

2. A nurse enters the room of Mrs. Trixie Sy, a client with myocardial infarction (MI) and finds
him quietly crying. After determining that there is no physiological reason for the client’s
distress, the nurse replies:
a. “ Do you want me to call your daughter?”
b. “ Can you tell me a little about what has you so upset?
c. “I understand how you feel. I’d cry too if I had a major heart attack.”
d. “Try not to be upset. Psychological stress is bad for your health.”

3. Which of the following behaviors would the nurse most expect to find in someone with a
Type A personality?
a. Easy going, laid back, reposed, a relaxed lifestyle, and goal directed
b. Aggressive, vindictive, focused on getting even with others who have more
c. Pleasant, personable, friendly to strangers, and a willingness to offer help to others
d. Rapid speech and walking, irritability, time consciousness, and difficulty with relaxing

4. Nurse Kristi assigned to work with a client with a dissociative disorder that presents with a
number of somatic complaints. Which of the following will be her top priority?
a. Assess the client's physical status
b. Find out about the dissociative symptoms
c. Get a history of any psychiatric treatment
d. Determine which medications the client is taking

5. You notice that one of your assigned clients who has been very depressed suddenly
seems to have more energy. The client's significant other expresses relief that the client is
better and wants to have the client discharged from the hospital. Your best course of action
would be to:
a. Advise the significant other that they must wait until the physician comes
b. Notify the physician about this sudden change in energy level and chart it
c. Check with the client to see if she wants you to call the physician about discharge
d. Ask the client about any suicidal ideation and educate the significant other about suicide

6. A nurse and client are talking comfortably about the client’s progress as well as feeling
about the therapeutic relationship. Which phase of therapeutic relationship is typical of?
a. Assessment c. Working
b. Orientation d. Termination

7. In planning care with a client with somatoform, the nurse would avoid which of the
following.
a. Evaluating physical symptoms c. Limiting manipulative behavior
b. Reinforcing secondary gains d. Teaching relaxation technique

8. A client with the DSM-IV diagnosis of schizophrenia, undifferentiated type, reports that her
body is stiff and like wood. Which of the following symptoms is the client is manifesting?
a. Autism c. Depersonalization
b. Ambivalence d. Regression

9. A nurse would differentiate the cognitive impairment disorders of delirium and dementia in
which of the following ways?

VANGUARDIA’S ONLINE REVIEW

a. Delirium occurs slowly and responds to treatment
b. Delirium has a rapid onset and may be reversed
c. Dementia has a rapid onset and can be reversed
d. Dementia occurs slowly and may improve rapidly

10. A client taking the MAOI antidepressant isocarboxazid (Marplan) is instructed by the
nurse to avoid which of the following 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

11. What’s a nurse most important role in caring for an adult client with a mental disorder?
a. To offer advice
b. To know how to solve the client’s problem
c. To establish trust and rapport
d. To set limits with the client

12. The nurse formulates a nursing diagnosis of “impaired verbal communication” for a male
patient with schizotypal personality disorder. Based on this nursing diagnosis, which nursing
intervention is most appropriate?
a. Helping the patient to participate in social interactions
b. Establishing a one-on-one relationship with the patient
c. Establishing alternative forms of communication
d. Allowing the patient to decide when he wants to participate in verbal communication with
you

13. A female patient with obsessive-compulsive disorder tells the nurse that he must check
the lock on his apartment door 25 times before leaving for an appointment. The nurse knows
that this behavior represents the patient’s attempt to:
a. Call attention to himself c. Maintain the safety of his home
b. Control his thoughts d. Reduce anxiety

14. Mental health laws in each state specify when restraints can be used and which type of
restraints are allowed. Most laws stipulate that restraints can be used:
a. For a maximum of 2 hours
b. As necessary to control the patient
c. If the patient poses a present danger to self or others
d. Only with the patient’s consent

15. The nurse is caring for a female client in the manic phase of bipolar disorder who’s ready
for discharge from the psychiatric unit. As the nurse begins to terminate the nurse-client
relationship, which client response is most appropriate?
a. Expressing feeling of anxiety
b. Displaying anger, shouting, and banging the table
c. Withdrawing from the nurse in silence
d. Rationalizing the termination, saying that “everything comes to an end”

16. The nurse is caring for a male client with schizophrenia. Which outcome is the least
desirable?
a. The client spends more time by himself
b. The client doesn’t engage in delusional thinking
c. The client doesn’t harm himself or others
d. The client demonstrates the ability to meet his own self-care needs

17. The nurse is assigned to care for a recently admitted female client who has attempted
suicide. What should the nurse do?
a. Search the client’s belongings and room carefully for items that could be used to attempt
suicide
b. Express trust that the client won’t cause self-harm while in the facility
c. Respect the client’s privacy by not searching any belongings

VANGUARDIA’S ONLINE REVIEW

d. Remind all staff members to check on the client frequently

18. Nursing preparations for a client undergoing electroconvulsive therapy (ECT) resembles
those used for:
a. Physical therapy c. General anesthesia
b. Neurologic examination d. Cardiac stress testing

19. A 23-year-old client is diagnosed with dependent personality disorder. Which behavior is
most likely to be evidence of ineffective individual coping?
a. In ability to make choices and decisions without advice
b. Showing interest only in solitary activities
c. Avoiding developing relationship
d. Recurrent self-destructive behavior with history of depression

20. After an upsetting divorce, a male client threatens to commit suicide with a handgun and
is involuntarily admitted to the psychiatric unit with major depression. Which nursing diagnosis
takes highest priority for this client?
a. Hopelessness related to recent divorce
b. Ineffective coping related to inadequate stress management
c. Spiritual distress related to conflicting thoughts about suicide and sin
d. Risk for self-directed-violence related to planning to commit suicide with a handgun

21. In group therapy, a male client angrily speaks up and responds to a peer, “You’re always
whining and I’m getting tired of listening to you! Here is the world’s smallest violin playing for
you.” Which role is the client playing?
a. Blocker c. Recognition seeker
b. Monopolizer d. Aggressor

22. When interviewing the parents of an injured child, which sign is the strongest indicator
that child abuse may be a problem?
a. The injury isn’t consistent with the history of the child’s age
b. The mother and father tell different stories regarding what happened
c. The family is poor
d. The parents are argumentative and demanding with emergency department personnel

23. Unhealthy personal boundaries are a product of dysfunctional families and a lack of
positive role models. Unhealthy boundaries may also be a result of:
a. Structured limit setting c. Abuse and neglect
b. Supportive environment d. Direction and attention

24. Conditions necessary for the development of a positive sense of self-esteem include:
a. Consistent limits c. Inconsistent boundaries
b. Critical environment d. Physical discipline

25. The charge nurse in an acute care setting assigns to a male client, who’s on one-to-one
suicide precautions, to a psychiatric aide. This assignment is considered:
a. Poor nursing practice because a registered nurse should work with this client
b. Reasonable nursing practice because one-to-one supervision requires the total attention of
a staff member
c. Outside the responsibility of an aide
d. Illegal to delegate to an aide

26. The nurse in-charge is displaying assertive behavior when she:

a. Says what’s on her mind at the expense of others
b. Expresses an air of superiority
c. Avoids unpleasant situations and circumstances
d. Stands up for her rights while respecting the rights of others.

27. Two nurses are discussing a female client’s condition in the elevator. The employer of the
mentioned client overhears the conversation and fires the client. The nurses may be liable for
which act?

VANGUARDIA’S ONLINE REVIEW

a. Assault c. Neglect
b. Battery d. Breach of confidentiality

28. A voluntary male client in a health care facility decided to leave the unit before treatment
is complete. To detain the client, the nurse refuses to return his personal effects. This is an
example of:
a. False imprisonment c. Slander
b. Limit setting d. Violation of confidentiality

29. An adult client in an acute care mental health program refuses his morning dose of an
oral antipsychotic medication and believes he’s being poisoned. The nurse should respond by
taking which action?
a. Administering the medication by injection
b. Omitting the dose and trying again the next day
c. Crushing the medication and putting it in his food
d. Consulting with the physician about a care plan

30. The nurse is aware that the goal of crisis intervention is:
a. To solve the client’s problems for him
b. Psychological resolution of the immediate crisis
c. To establish a means for long-term therapy
d. To provide a means for admission to an acute care facility

31. A client taking antipsychotic medications for treatment of schizophrenia complains to the
nurse of feeling nervous. The nurse notices that the client is pacing the long hallway and is
unable to remain still even when other clients are talking with him. This client is most likely
experiencing:
a. Akinesia c. Dystonia
b. Akathisia d.Tardive dyskinesia

32. A client tells the nurse, “I am a spy for the FBI. I am an eye, an eye in the sky.” The nurse
recognizes that this is an example of:
a. Loosed associations c. Clang association
b. Echolalia d. Word salad

33. A client with somatoform disorder experiences chronic headaches and fatigue. When her
family helps her with housecleaning, she’s experiencing which of the following?
a. Primary gain c. La belle indifference
b. Secondary gain d. Pain disorder

34. One afternoon Mrs. Lim remarked, “I have given up hope. I shall soon die.” The most
therapeutic response you would make is:
a. “Let us discuss dying”
b. “You should never give up hope”
c. “I suggest you see your chaplain”
d. “you have given up hope”

35. Which of the following manifestations is not related to alcohol intoxication?

a. Inappropriate sexual behavior
b. Impaired memory and judgment
c. Unsteady gait
d. Bradycardia and hypotension

36. The nurse is interviewing a newly admitted schizophrenic patient. The patient speaks very
softly making it very difficult for the nurse to understand what the patient is saying. What is
the best approach by the nurse?
a. “ You must speak louder and more clearly.”
b. “You are safe here. You can tell me anything”.
c. “You seen upset, this may be a good time for you to familiarize yourself with the unit.”
d. “I’m not sure I understood what you just said. I wonder if you could please repeat it and
speak up a little louder so may I hear you?”

VANGUARDIA’S ONLINE REVIEW

37. When speaking with the client who has just experienced a panic attack, the nurse can
address the client’s concerns most therapeutically by stating:
a. “You must have been really upset.”
b. “You are concerned that this might happen again.”
c. “Episodes like this can be upsetting, but they do end.”
d. “Your family was concerned that you were having a heart attack.”

38. Which of the following groups of characteristics most nearly represent persons with
antisocial behavior patterns?
a. Seclusive and suspicious c. Untruthful and irresponsible
b. Negativistic and hostile d. Promiscuous and forgetful

39. A patient is admitted to the psychiatric unit with the diagnosis of bulimia nervosa. In
admission, the nurse notes there are some very obvious differences between anorexia and
bulimia. The nurse recognizes all the following are characteristic of bulimia EXCEPT:
a. The bulimic is of average weight or just a bit overweight.
b. The bulimic has recurrent episodes of binge eating followed by purging.
c. The bulimic knows there is a problem with her eating habits.
d. The bulimic has amenorrhea for several months.

40. A patient believes that one of the staff is secretly plotting to murder him. The nurse
recognizes this behavior as:
a. A delusion c. An illusion
b. A hallucination d. Depersonalization

41. Understanding the progression of Alzheimer’s Disease helps the nurse to better plan care
for such patients. Which of the following is a likely assessment finding in a patient with Stage
III Alzheimer’s Disease?
a. Apraxia
b. Forgetfulness related to vocabulary, and difficulty expressing self
c. Hyperorality
d. Incontinence of both bowel and bladder

42. A busy attorney with a successful law practice is admitted to an acute care facility with
epigastric pain. Since admission, the patient has called the nurse 15 minutes with one
request or another. This patient is exhibiting:
a. Repression c. Regression
b. Somatization d. Conversion

43. Which of the following medications would the nurse in-charge expect the doctor to order
to reverse a dystonic reaction?
a. Procholorperazine (Compazine) c. Haloperidol (Haldol)
b. Diphenhydramine (Benadryl) d. Midazolam (Versed)

44. A patient, age 42, is admitted for surgical biopsy of a suspicious lump in her left breast.
When the nurse comes to her surgery, she is tearfully finishing a letter to her children. She
tells the nurse, “I want to leave this for my children in case anything goes wrong today.
“Which response by the nurse would be most therapeutic?
a. “In case anything goes wrong? What are your thoughts and feelings right now?”
b. “I can’t understand that you’re nervous, but this is really a minor procedure. You’ll be back
in your room before you know it.”
c. “Try to take a few deep breaths and relax. I have some medication that will help.”
d. “I’m sure your children know how much you love them. You’ll be able to talk to them on the
phone in a few hours.”

45. How soon after Chlorpromazine administration should the nurse in charge expect to see a
patient’s delusion thoughts and hallucinations eliminated?
a. Several minutes c. Several days
b. Several hours d. Several weeks

VANGUARDIA’S ONLINE REVIEW

46. The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting:
a. Tardive dyskinesia c. Akinesia
b. Pseudoparkinsonism d. Dystonia

47. A nurse is having a one-to-one interaction with a newly assigned client. The nurse's goals
include learning more about the client's relationship with his family. Which of the following
statements by the nurse would be best in this situation?
a. "Are your parents alive?" c. "Tell me a little about your family."
b. "Where does your family live?" d. "Do you get along with your family?"

48. You enter the room of your depressed client and find him crying. What is your best
response?
a. “I’m sorry, I will come back later when you are not so upset.”
b. “Don’t worry, everything will be much better tomorrow.”
c. “I’m sorry you are upset. I will stay with you awhile.”
d. “You should not be crying. Things could be so much worse.”

49. You are assigned to a client diagnosed with a somatization disorder. Your initial approach
should be to:
a. Explain to the client that there is no physiologic basis to the problems
b. Ask the client to describe the physical problems which caused this admission
c. Assure the client that you have cared for many other clients with similar problems
d. Discuss the client’s relationship with family and friends in order to assess the client’s
support system

50. During the initial care of rape victims the following are to be considered EXCEPT:
a. Assure privacy.
b. Touch the client to show acceptance and empathy
c. Accompany the client in the examination room.
d. Maintain a non-judgmental approach.

Situation: A young woman is brought to the emergency room appearing depressed. The
nurse learned that her child died a year ago due to an accident.

51. The initial nursing diagnosis is dysfunctional grieving. The statement of the woman that
supports this diagnosis is:
a. “I feel envious of mothers who have toddlers”
b. “I haven’t been able to open the door and go into my baby’s room “
c. “I watch other toddlers and think about their play activities and I cry.”
d. “I often find myself thinking of how I could have prevented the death.

52. The client said “I can’t even take care of my baby. I’m good for nothing.” Which is the
appropriate nursing diagnosis?
a. Ineffective individual coping related to loss.
b. Impaired verbal communication related to inadequate social skills.
c. Low esteem related to failure in role performance
d. Impaired social interaction related to repressed anger.

53. The following medications will likely be prescribed for the client EXCEPT:
a. Prozac c. Parnate
b. Tofranil d. Zyprexa

54. Which is the highest priority in the post ECT care?

a. Observe for confusion
b. Monitor respiratory status
c. Reorient to time, place and person
d. Document the client’s response to the treatment

55. Which of the following interventions should be prioritized in the care of the suicidal client?
a. Remove all potentially harmful items from the client’s room.

VANGUARDIA’S ONLINE REVIEW

b. Allow the client to express feelings of hopelessness.
c. Note the client’s capabilities to increase self esteem.
d. Set a “no suicide” contract with the client.

Situation: The nurse may encounter clients with concerns on sexuality.

56. The basic factor in the intervention with clients in the area of sexuality is:
a. Knowledge about sexuality.
b. Experience in dealing with clients with sexual problems
c. Comfort with one’s sexuality
d. Ability to communicate effectively

57. Which of the following statements is true for gender identity disorder?
a. It is the sexual pleasure derived from inanimate objects.
b. It is the pleasure derived from being humiliated and made to suffer
c. It is the pleasure of shocking the victim with exposure of the genitalia
d. It is the desire to live or involve in reactions of the opposite sex

58. The sexual response cycle in which the sexual interest continues to build:
a. Sexual Desire c. Orgasm
b. Sexual arousal d. Resolution

59. The inability to maintain the physiologic requirements in sexual intercourse is:
a. Sexual Desire Disorder c. Orgasm Disorder
b. Sexual Arousal Disorder d. Sexual Pain disorder

60. The nurse asks a client to roll up his sleeves so she can take his blood pressure. The
client replies “If you want I can go naked for you.” The most therapeutic response by the
nurse is:
a. “You’re attractive but I’m not interested.”
b. “You wouldn’t be the first that I will see naked.”
c. “I will report you to the guard if you don’t control yourself.”
d. “I only need access to your arm. Putting up your sleeve is fine.”

61. Which of the following is included in the health teachings among clients receiving Valium?
a. Avoid foods rich in tyramine.
b. Take the medication after meals.
c. It is safe to stop it anytime after long term use.
d. Double up the dose if the client forgets her medication.

62. Anxiety is caused by:

a. An objective threat c. Hostility turned to the self
b. A subjectively perceived threat d. Masked depression

63. Maricar a 29 year old client newly diagnosed with breast cancer is pacing, with rapid
speech headache and inability to focus with what the doctor was saying. The nurse assesses
the level of anxiety as:
a. Mild c. Severe
b. Moderate d. Panic

64. Five months after the incident the client complains of difficulty to concentrate, poor
appetite, inability to sleep and guilt. She is likely suffering from:
a. Adjustment disorder c. Generalized Anxiety Disorder
b. Somatoform Disorder d. Post traumatic disorder

65. During the initial care of rape victims the following are to be considered EXCEPT:
a. Assure privacy.
b. Touch the client to show acceptance and empathy
c. Accompany the client in the examination room.
d. Maintain a non-judgmental approach.

VANGUARDIA’S ONLINE REVIEW

66. A client tends to be insensitive to others, engages in abusive behaviors and does not
have a sense of remorse. Which personality disorder is he likely to have?
a. Narcissistic c. Histrionic
b. Paranoid d. Antisocial

67. A client joins a support group and frequently preaches against abuse, is demonstrating
the use of:
a. Denial c. Rationalization
b. Reaction formation d. Projection

68. A 40 year old male client, is admitted in the ward because of bizarre behaviors. He is
given a diagnosis of schizophrenia paranoid type. The client should have achieved the
developmental task of:
a. Trust vs. mistrust c. Generativity vs. stagnation
b. Industry vs. inferiority d. Ego integrity vs. despair

69. Clients who are suspicious primarily use projection for which purpose:
a. Deny reality
b. To deal with feelings and thoughts that are not acceptable
c. To show resentment towards others
d. Manipulate others

70. The plan of care for clients with borderline personality should include:
a. Limit setting and flexibility in schedule
b. Giving medications to prevent acting out
c. Restricting her from other clients
d. Ensuring she adheres to certain restrictions

71. Trust may develop in the nurse-client relationship when the nurse:
a. Avoids limit setting
b. Encourages the client to use “testing” behaviors
c. Tells the client how he should behave
d. Uses consistency in approaching the client

72. A client is admitted with Wernicke’s encephalopathy. The nurse anticipates that the first
physician’s order will include:
a. Ordering an MRI
b. Administering a steroid medication, such as Decadron
c. Giving thiamine 100 mg IM STAT
d. Ordering an ECG

73. A client diagnosed with major depression spends the majority of the day lying in bed with
the sheet pulled over is head. Which of the following approaches by the nurse would be most
therapeutic?
a. Wait for the client to begin the conversation.
b. Initiate contact with the client frequently.
c. Sit outside the client’s room.
d. Question the client until he responds.

74. A client with acute mania has been taking lithium (Lithium Carbonate) 600 mg PO three
times daily for 14 days. The nurse analyzes the client’s serum lithium level, noting that it is
therapeutic when the level is within which of the following ranges?
a. 0.5 to 1.5 mEq/L c. 2.6 to 3.2 mEq/L
b. 1.6 to 2.5 mEq/L d. 3.3 to 4.0 mEq/L

75. A patient with history of alcoholism is brought to the emergency room in an agitate state.
He is vomiting and diaphoretic. He says he had his last drink five hours ago. The nurse would
expect to administer which of the following medications?
a. Chlordiazepoxide hydrochloride (Librium)
b. Disulfiram (Antabuse)
c. Methadone Hydrochloride ( Dolophine)

VANGUARDIA’S ONLINE REVIEW

d. Noloxone Hydrochloride (Narcan)

Situation : In the experimental study to test the “Effect of Peer Counseling on the Students’
Study Habits”, identify the following variables:

76. “Exposure to Peer Counseling”

a. Independent Variable c. Intervening Variable
b. Dependent Variable d. Directional Variable

77. “Study Habits”

a. Independent Variable c. Intervening Variable
b. Dependent Variable d. Antecedent Variable

78. Which among the following statements is incorrect regarding review of related literature?
a. It helps the researcher identify and define a research problem.
b. It helps prevent unnecessary duplication of a study.
c. It can not be a theoretical basis for the study.
d. It helps justify the need for studying.

79. A client who has been receiving haloperidol (Haldol) for 2 days develop muscular rigidity,
altered consciousness, a temperature of 109°F, and trouble breathing on day 3. The nurse
interprets these findings as indicating which of the following?
a. Neuroleptic malignant syndrome c. Extrapyramidal side effects
b. Tardive dyskinesia d. Drug induced parkinsonism

80. A client with the diagnosis of manic episode is racing around the psychiatric unit trying to
organize games with the clients. An appropriate nursing intervention is to:
a. Have the client play Ping-pong.
b. Suggest video exercise with other client.
c. Take the client outside for a walk.
d. Do nothing, as organizing a game is considered therapeutic.

81. After completing chemical detoxification and a 12-step program to treat crack addiction, a
male patient is being prepared for discharge. Which remark by the patient indicates a realistic
view of the future?
a. “I’m never going to use crack again.”
b. “I know what I have to do. I have to limit my crack use.”
c. “I’m going to take 1 day at a time. I’m not making any promises.”
d. “I can’t touch crack again, but I sure could use a drink. I’ve earned it.”

82. Which nursing intervention is most important when restraining a violent male patient?
a. Reviewing hospital policy regarding how long the patient can be restrained
b. Preparing a p.r.n. dose of the patient’s psychotropic medication
c. Checking that the restraints have been applied correctly
d. Asking if the patient needs to use the bathroom or is thirsty

83. The physician orders a new medication for a male client with generalized anxiety disorder.
During medication teaching, which statement or question by the nurse would be most
appropriate?
a. “Take this medication. It will reduce your anxiety.”
b. “Do you have any concern about taking the medication?”
c. “Trust us. This medication has helped many people. We wouldn’t have you take it if it were
dangerous.”
d. “How can we help you if you won’t cooperate?”

84. Nursing interventions for a male client taking central nervous system (CNS) stimulants
include monitoring the client for which condition?
a. Hyperpyrexia, slow pulse, and weight gain
b. Tachycardia, weight loss, and mood swings
c. Hypotension, weight gain, and listlessness
d. All of the above

VANGUARDIA’S ONLINE REVIEW

85. In a group therapy setting, one male member is very demanding, repeatedly interrupting
others and taking most of the group time. The nurse’s best response would be:
a. “Will you briefly summarize your point because others need time also?”
b. “Your behavior is obnoxious and drains the group.”
c. To ignore the behavior and allow him vent
d. “I’m so frustrated with your behavior”

86. Which statement is guideline to help nurses avoid liability?

a. Follow every physician’s order
b. Do what the client desires even though you may disagree
c. Practice within the scope of the Nurse Practice Act
d. Obtain malpractice insurance

87. A nurse is working with a female dying client and his family. Which communication
technique is most important to use?
a. Reflection c. Clarification
b. Interpretation d. Active listening

88. A male client receiving morphine for long-term pain management develops tolerance.
Tolerance is defined as:
a. An increased response to a medication
b. A diminished response to a drug so that more is required to achieve the same effect
c. An allergic reaction to a medication
d. An ability to take the same drug for extended periods of time.

89. A male client in a group therapy is restless. His face is flushed and he makes sarcastic
remarks to group members. The nurse responds by saying, “You look angry.” The nurse is
using which technique?
a. A broad opening statement c. Clarifying
b. Reassurance d. Making observations

90. During a panic attack, a male patient runs to the nurse and reports breathing difficulty,
chest pain, and palpitations. The patient is pale, with the mouth wide open and eyebrows
raised. What should the nurse do first?
a. Assist the patient to breath deeply into a paper bag
b. Orient the patient to person, place and time
c. Set limits for acting out delusional behaviors
d. Administer an I.M. anxiolytic agent

91. Mario is admitted to the psychiatric unit with a diagnosis of conversion disorder. Since
witnessing the beating of his wife Juliet at gunpoint, he has been unable to move his arms,
complaining that they are paralyzed. When planning the client’s care, the nurse should focus
on:
a. Helping the client identify and verbalize feelings about the incident.
b. Convincing the client that his arms aren’t paralyzed.
c. Developing rehabilitation strategies to help the client learn to live with the disability.
d. Talking about topics other than the beating to avoid causing anxiety.

92. The nurse is formulating a short-term goal for a client suffering form a severe obsessive-
compulsive disorder (OCD). An appropriate goal is that after 1 week, that client will:
a. Demonstrate decreased anxiety.
b. Participate in a daily exercise group.
c. Identify the underlying reasons for the rituals.
d. State that the rituals are irrational.

93. What occurs during the working phase of the nurse-patient relationship?
a. The nurse assesses the patient’s needs and develops a plan of care
b. The nurse and patient together evaluate and modify the goals of the relationship
c. The nurse and patient discuss their feelings about terminating the relationship
d. The nurse and patient explore each other’s expectations of the relationship

VANGUARDIA’S ONLINE REVIEW

94. The client is very hostile toward one of the staff for no apparent reason. The client is
manifesting:
a. Splitting c. Countertransference
b. Transference d. Resistance

95. While pacing in the hall, a female patient with paranoid schizophrenia runs to the nurse
and says, “Why are you poisoning me? I know you work for central thought control! You can
keep my thoughts. Give me back my soul!” how should the nurse respond?
a. “I’m a nurse, I’m not poisoning you. It’s against the nursing code of ethics.”
b. “I’m a nurse, and you’re a patient in the hospital. I’m not going to harm you.”
c. “I’m not poisoning you. And how could I possibly steal your soul?”
d. “I sense anger, Are you feeling angry today?”

96. A female patient has been severely depressed since her husband died 6 months ago. Her
doctor prescribes amitriptyline hydrochloride (Elavil), 50 mg P.O. daily. Before administering
amitriptyline, the nurse reviews the patient’s medical history. Which preexisting condition
would require cautions use of this drug?
a. Hiatal hernia c. Hepatic disease
b. Hypernatremia d. Hypokalemia

97. A newly admitted patient can't take care of his personal needs, shows insensitivity to
painful stimuli, and exhibits negativism, rigidity, and posturing. The nurse would suspect
which diagnosis?
a. Paranoid Schizophrenia c. Undifferentiated Schizophrenia
b. Residual Schizophrenia d. Catatonic Schizophrenia

98. A male client becomes angry and belligerent toward the nurse after speaking on the
phone with his mother. The nurse recognizes this as what defense mechanism?
a. Rationalization c. Displacement
b. Repression d. Suppression

99. During the mental status examination, a female client may be asked to explain such
proverbs as “Don’t cry over spilled milk.” The purpose is to evaluate the client’s ability to think:
a. Rationally c. Abstractly
b. Concretely d. Tangentially

100. Gina is unable to get out of bed and get dressed unless nurse Dolce prompts every step.
This is an example of which behavior?
a. Word salad c. Perseveration
b. Tangential d. Avolition

*** END OF EXAMINATION ***

VANGUARDIA’S ONLINE REVIEW