PNLE for Psychiatric Nursing 12.

A 75 year old client is admitted to the hospital with the diagnosis

of dementia of the Alzheimer’s type and depression. The symptom that
is unrelated to depression would be?
1. Marco approached Nurse Trish asking for advice on how to deal
A. Apathetic response to the environment
with his alcohol addiction. Nurse Trish should tell the client that the
B. “I don’t know” answer to questions
only effective treatment for alcoholism is:
C. Shallow of labile effect
A. Psychotherapy
D. Neglect of personal hygiene
B. Alcoholics anonymous (A.A.)
C. Total abstinence
13.Nurse Trish is working in a mental health facility; the nurse priority
D. Aversion Therapy
nursing intervention for a newly admitted client with bulimia nervosa
would be to?
2. Nurse Hazel is caring for a male client who experience false
A. Teach client to measure I & O
sensory perceptions with no basis in reality. This perception is known
B. Involve client in planning daily meal
as:
C. Observe client during meals
A. Hallucinations
D. Monitor client continuously
B. Delusions
C. Loose associations
14.Nurse Patricia is aware that the major health complication
D. Neologisms
associated with intractable anorexia nervosa would be?
A. Cardiac dysrhythmias resulting to cardiac arrest
3. Nurse Monet is caring for a female client who has suicidal
B. Glucose intolerance resulting in protracted hypoglycemia
tendency. When accompanying the client to the restroom, Nurse Monet
C. Endocrine imbalance causing cold amenorrhea
should…
D. Decreased metabolism causing cold intolerance
A. Give her privacy
B. Allow her to urinate
15.Nurse Anna can minimize agitation in a disturbed client by?
C. Open the window and allow her to get some fresh air
A. Increasing stimulation
D. Observe her
B. limiting unnecessary interaction
C. increasing appropriate sensory perception
4. Nurse Maureen is developing a plan of care for a female client
D. ensuring constant client and staff contact
with anorexia nervosa. Which action should the nurse include in the
plan?
16.A 39 year old mother with obsessive-compulsive disorder has
A. Provide privacy during meals
become immobilized by her elaborate hand washing and walking
B. Set-up a strict eating plan for the client
rituals. Nurse Trish recognizes that the basis of O.C. disorder is often:
C. Encourage client to exercise to reduce anxiety
A. Problems with being too conscientious
D. Restrict visits with the family
B. Problems with anger and remorse
C. Feelings of guilt and inadequacy
5. A client is experiencing anxiety attack. The most appropriate
D. Feeling of unworthiness and hopelessness
nursing intervention should include?
A. Turning on the television
17.Mario is complaining to other clients about not being allowed by
B. Leaving the client alone
staff to keep food in his room. Which of the following interventions
C. Staying with the client and speaking in short sentences
would be most appropriate?
D. Ask the client to play with other clients
A. Allowing a snack to be kept in his room
B. Reprimanding the client
6. A female client is admitted with a diagnosis of delusions of
C. Ignoring the clients behavior
GRANDEUR. This diagnosis reflects a belief that one is:
D. Setting limits on the behavior
A. Being Killed
B. Highly famous and important
18.Conney with borderline personality disorder who is to be discharge
C. Responsible for evil world
soon threatens to “do something” to herself if discharged. Which of the
D. Connected to client unrelated to oneself
following actions by the nurse would be most important?
A. Ask a family member to stay with the client at home temporarily
7. A 20 year old client was diagnosed with dependent personality
B. Discuss the meaning of the client’s statement with her
disorder. Which behavior is not likely to be evidence of ineffective
C. Request an immediate extension for the client
individual coping?
D. Ignore the clients statement because it’s a sign of manipulation
A. Recurrent self-destructive behavior
B. Avoiding relationship
19.Joey a client with antisocial personality disorder belches loudly. A
C. Showing interest in solitary activities
staff member asks Joey, “Do you know why people find you
D. Inability to make choices and decision without advise
repulsive?” this statement most likely would elicit which of the
following client reaction?
8. A male client is diagnosed with schizotypal personality disorder.
A. Depensiveness
Which signs would this client exhibit during social situation?
B. Embarrassment
A. Paranoid thoughts
C. Shame
B. Emotional affect
D. Remorsefulness
C. Independence need
D. Aggressive behavior

9. Nurse Claire is caring for a client diagnosed with bulimia. The

20.Which of the following approaches would be most appropriate to
most appropriate initial goal for a client diagnosed with bulimia is?
use with a client suffering from narcissistic personality disorder when
A. Encourage to avoid foods
discrepancies exist between what the client states and what actually
B. Identify anxiety causing situations
exist?
C. Eat only three meals a day
A. Rationalization
D. Avoid shopping plenty of groceries
B. Supportive confrontation
C. Limit setting
10. Nurse Tony was caring for a 41 year old female client. Which
D. Consistency
behavior by the client indicates adult cognitive development?
A. Generates new levels of awareness
21.Cely is experiencing alcohol withdrawal exhibits tremors,
B. Assumes responsibility for her actions
diaphoresis and hyperactivity. Blood pressure is 190/87 mmhg and
C. Has maximum ability to solve problems and learn new skills
pulse is 92 bpm. Which of the medications would the nurse expect to
D. Her perception are based on reality
administer?
11.A neuromuscular blocking agent is administered to a client before
A. Naloxone (Narcan)
ECT therapy. The Nurse should carefully observe the client for?
B. Benzlropine (Cogentin)
A. Respiratory difficulties
C. Lorazepam (Ativan)
B. Nausea and vomiting
D. Haloperidol (Haldol)
C. Dizziness
D. Seizures
22.Which of the following foods would the nurse Trish eliminate from
the diet of a client in alcohol withdrawal?
A. Milk
B. Orange Juice
C. Soda
D. Regular Coffee
23.Which of the following would Nurse Hazel expect to assess for a
client who is exhibiting late signs of heroin withdrawal?
A. Yawning & diaphoresis
B. Restlessness & Irritability
C. Constipation & steatorrhea
D. Vomiting and Diarrhea
24.To establish open and trusting relationship with a female client who
has been hospitalized with severe anxiety, the nurse in charge should?
A. Encourage the staff to have frequent interaction with the client
B. Share an activity with the client
C. Give client feedback about behavior
D. Respect client’s need for personal space
25. Nurse Monette recognizes that the focus of environmental
(MILIEU) therapy is to:
A. Manipulate the environment to bring about positive changes
in behavior
B. Allow the client’s freedom to determine whether or not they will
be involved in activities
C. Role play life events to meet individual needs
D. Use natural remedies rather than drugs to control behavior
26.Nurse Trish would expect a child with a diagnosis of reactive
attachment disorder to:
A. Have more positive relation with the father than the mother
B. Cling to mother & cry on separation
C. Be able to develop only superficial relation with the others
D. Have been physically abuse
27.When teaching parents about childhood depression Nurse Trina
should say?
A. It may appear acting out behavior
B. Does not respond to conventional treatment
C. Is short in duration & resolves easily
D. Looks almost identical to adult depression
28.Nurse Perry is aware that language development in autistic
child resembles:
A. Scanning speech
B. Speech lag
C. Shuttering
D. Echolalia
29.A 60 year old female client who lives alone tells the nurse at
the community health center “I really don’t need anyone to talk to”.
The TV is my best friend. The nurse recognizes that the client is using
the defense mechanism known as?
A. Displacement
B. Projection
C. Sublimation
D. Denial
30.When working with a male client suffering phobia about black cats,
Nurse Trish should anticipate that a problem for this client would be?
A. Anxiety when discussing phobia
B. Anger toward the feared object
C. Denying that the phobia exist
D. Distortion of reality when completing daily routines
31.Linda is pacing the floor and appears extremely anxious. The duty
nurse approaches in an attempt to alleviate Linda’s anxiety. The
most therapeutic question by the nurse would be?
A. Would you like to watch TV?
B. Would you like me to talk with you?
C. Are you feeling upset now?
D. Ignore the client
32.Nurse Penny is aware that the symptoms that distinguish post
traumatic stress disorder from other anxiety disorder would be:
A. Avoidance of situation & certain activities that resemble the
stress
B. Depression and a blunted affect when discussing the
traumatic situation
C. Lack of interest in family & others
D. Re-experiencing the trauma in dreams or flashback
33.Nurse Benjie is communicating with a male client with substance-
induced persisting dementia; the client cannot remember facts and fills
in the gaps with imaginary information. Nurse Benjie is aware that this
is typical of?
A. Flight of ideas
B. Associative looseness
C. Confabulation
D. Concretism
34.Nurse Joey is aware that the signs & symptoms that would be
most specific for diagnosis anorexia are?
A. Excessive weight loss, amenorrhea & abdominal distension
B. Slow pulse, 10% weight loss & alopecia
C. Compulsive behavior, excessive fears & nausea
D. Excessive activity, memory lapses & an increased pulse
35.A characteristic that would suggest to Nurse Anne that an
adolescent may have bulimia would be:
A. Frequent regurgitation & re-swallowing of food
B. Previous history of gastritis
C. Badly stained teeth
D. Positive body image
36.Nurse Monette is aware that extremely depressed clients seem to do
best in settings where they have:
A. Multiple stimuli
B. Routine Activities
C. Minimal decision making
D. Varied Activities
37.To further assess a client’s suicidal potential. Nurse Katrina should
be especially alert to the client expression of:
A. Frustration & fear of death
B. Anger & resentment
C. Anxiety & loneliness
D. Helplessness & hopelessness
38.A nursing care plan for a male client with bipolar I disorder should
include:
A. Providing a structured environment
B. Designing activities that will require the client to maintain
contact with reality
C. Engaging the client in conversing about current affairs
D. Touching the client provide assurance
39.When planning care for a female client using ritualistic behavior,
Nurse Gina must recognize that the ritual:
A. Helps the client focus on the inability to deal with reality
B. Helps the client control the anxiety
C. Is under the client’s conscious control
D. Is used by the client primarily for secondary gains
40.A 32 year old male graduate student, who has become
increasingly withdrawn and neglectful of his work and personal
hygiene, is brought to the psychiatric hospital by his parents. After
detailed assessment, a diagnosis of schizophrenia is made. It is unlikely
that the client will demonstrate:
A. Low self esteem
B. Concrete thinking
C. Effective self boundaries
D. Weak ego
41.A 23 year old client has been admitted with a diagnosis of
schizophrenia says to the nurse “Yes, its march, March is little
woman”. That’s literal you know”. These statement illustrate:
A. Neologisms
B. Echolalia
C. Flight of ideas
D. Loosening of association
42.A long term goal for a paranoid male client who has unjustifiably
accused his wife of having many extramarital affairs would be to help
the client develop:
A. Insight into his behavior
 B. Better self control
C. Feeling of self worth
D. Faith in his wife

43.A male client who is experiencing disordered thinking about food

being poisoned is admitted to the mental health unit. The nurse uses
which communication technique to encourage the client to eat dinner?
A. Focusing on self-disclosure of own food preference
B. Using open ended question and silence
C. Offering opinion about the need to eat
D. Verbalizing reasons that the client may not choose to eat

44.Nurse Nina is assigned to care for a client diagnosed with

Catatonic Stupor. When Nurse Nina enters the client’s room, the client
is found lying on the bed with a body pulled into a fetal position. Nurse
Nina should?
A. Ask the client direct questions to encourage talking
B. Rake the client into the dayroom to be with other clients
C. Sit beside the client in silence and occasionally ask open-
ended question
D. Leave the client alone and continue with providing care to the
other clients

45.Nurse Tina is caring for a client with delirium and states that “look
at the spiders on the wall”. What should the nurse respond to the
client?
A. “You’re having hallucination, there are no spiders in this room
at all”
B. “I can see the spiders on the wall, but they are not going to
hurt you” PNLE IV for Psychiatric Nursing
C. “Would you like me to kill the spiders”
Answers and Rationales
D. “I know you are frightened, but I do not see spiders on the wall”
1. C. Total abstinence is the only effective treatment for alcoholism

2. A. Hallucinations are visual, auditory, gustatory, tactile or

46.Nurse Jonel is providing information to a community group about
violence in the family. Which statement by a group member would
indicate a need to provide additional information?
A. “Abuse occurs more in low-income families”
B. “Abuser Are often jealous or self-centered”
C. “Abuser use fear and intimidation”
D. “Abuser usually have poor self-esteem”
47.During electroconvulsive therapy (ECT) the client receives oxygen
by mask via positive pressure ventilation. The nurse assisting with
this procedure knows that positive pressure ventilation is necessary
because?
A. Anesthesia is administered during the procedure
B. Decrease oxygen to the brain increases confusion
and disorientation
C. Grand mal seizure activity depresses respirations
D. Muscle relaxations given to prevent injury during seizure
activity depress respirations.
48.When planning the discharge of a client with chronic anxiety, Nurse
Chris evaluates achievement of the discharge maintenance goals.
Which goal would be most appropriately having been included in the
plan of care requiring evaluation?
A. The client eliminates all anxiety from daily situations
B. The client ignores feelings of anxiety
C. The client identifies anxiety producing situations
D. The client maintains contact with a crisis counselor
49.Nurse Tina is caring for a client with depression who has not
responded to antidepressant medication. The nurse anticipates that
what treatment procedure may be prescribed.
A. Neuroleptic medication
B. Short term seclusion
C. Psychosurgery
D. Electroconvulsive therapy
50.Mario is admitted to the emergency room with drug-included
anxiety related to over ingestion of prescribed antipsychotic
medication. The most important piece of information the nurse in
charge should obtain initially is the:
A. Length of time on the med.
B. Name of the ingested medication & the amount ingested
C. Reason for the suicide attempt
D. Name of the nearest relative & their phone number
olfactory perceptions that have no basis in reality.
3. D. The Nurse has a responsibility to observe continuously the acutely
suicidal client. The Nurse should watch for clues, such as communicating
suicidal thoughts, and messages; hoarding medications and talking about
death.
4. B. Establishing a consistent eating plan and monitoring client’s weight
are important to this disorder.
5. C. Appropriate nursing interventions for an anxiety attack include using
short sentences, staying with the client, decreasing stimuli, remaining
calm and medicating as needed.
6. B. Delusion of grandeur is a false belief that one is highly famous
and important.
7. D. Individual with dependent personality disorder typically
shows indecisiveness submissiveness and clinging behavior so that
others will make decisions with them.
8. A. Clients with schizotypal personality disorder experience excessive
social anxiety that can lead to paranoid thoughts
9. B. Bulimia disorder generally is a maladaptive coping response to stress
and underlying issues. The client should identify anxiety causing
situation that stimulate the bulimic behavior and then learn new ways of
coping with the anxiety.
10. A. An adult age 31 to 45 generates new level of awareness.
11. A. Neuromuscular Blocker, such as SUCCINYLCHOLINE
(Anectine) produces respiratory depression because it inhibits
contractions of respiratory muscles.
12. C. With depression, there is little or no emotional involvement therefore
little alteration in affect.
13. D. These clients often hide food or force vomiting; therefore they must
be carefully monitored.
14. A. These clients have severely depleted levels of sodium and
potassium because of their starvation diet and energy expenditure, these
electrolytes are necessary for cardiac functioning.
15. B. Limiting unnecessary interaction will decrease stimulation and
agitation.
16. C. Ritualistic behavior seen in this disorder is aimed at controlling guilt
and inadequacy by maintaining an absolute set pattern of behavior.
17. D. The nurse needs to set limits in the client’s manipulative behavior to
help the client control dysfunctional behavior. A consistent approach by
the staff is necessary to decrease manipulation.
18. B. Any suicidal statement must be assessed by the nurse. The nurse
should discuss the client’s statement with her to determine its meaning in
terms of suicide.
19. A. When the staff member ask the client if he wonders why others find
him repulsive, the client is likely to feel defensive because the question
is belittling. The natural tendency is to counterattack the threat to self-
image.
20. B. The nurse would specifically use supportive confrontation with the
client to point out discrepancies between what the client states and what
actually exists to increase responsibility for self.
21. C. The nurse would most likely administer benzodiazepine, such as
lorazepan (ativan) to the client who is experiencing symptom: The
client’s experiences symptoms of withdrawal because of the rebound
phenomenon when the sedation of the CNS from alcohol begins to
decrease.
22. D. Regular coffee contains caffeine which acts as psychomotor
stimulants and leads to feelings of anxiety and agitation. Serving coffee
top the client may add to tremors or wakefulness.
23. D. Vomiting and diarrhea are usually the late signs of heroin
withdrawal, along with muscle spasm, fever, nausea, repetitive,
abdominal cramps and backache.
24. D. Moving to a client’s personal space increases the feeling of threat,
which increases anxiety.
25. A. Environmental (MILIEU) therapy aims at having everything in the
client’s surrounding area toward helping the client.
26. C. Children who have experienced attachment difficulties with
primary caregiver are not able to trust others and therefore relate
superficially
27. A. Children have difficulty verbally expressing their feelings, acting
out behavior, such as temper tantrums, may indicate underlying
depression.
28. D. The autistic child repeat sounds or words spoken by others.
29. D. The client statement is an example of the use of denial, a defense
that blocks problem by unconscious refusing to admit they exist
30. A. Discussion of the feared object triggers an emotional response to
the object.
31. B. The nurse presence may provide the client with support & feeling
of control.
32. D. Experiencing the actual trauma in dreams or flashback is the
major symptom that distinguishes post traumatic stress disorder from
other anxiety disorder.
33. C. Confabulation or the filling in of memory gaps with imaginary facts is
a defense mechanism used by people experiencing memory deficits.
34. A. These are the major signs of anorexia nervosa. Weight loss is
excessive (15% of expected weight)
35. C. Dental enamel erosion occurs from repeated self-induced vomiting.
36. B. Depression usually is both emotional & physical. A simple daily
routine is the best, least stressful and least anxiety producing.
37. D. The expression of these feeling may indicate that this client is unable
to continue the struggle of life.
38. A. Structure tends to decrease agitation and anxiety and to increase
the client’s feeling of security.
39. B. The rituals used by a client with obsessive compulsive disorder
help control the anxiety level by maintaining a set pattern of action.
40. C. A person with this disorder would not have adequate self-boundaries
41. D. Loose associations are thoughts that are presented without the
logical connections usually necessary for the listening to interpret the
message.
42. C. Helping the client to develop feeling of self worth would reduce the
client’s need to use pathologic defenses.
43. B. Open ended questions and silence are strategies used to
encourage clients to discuss their problem in descriptive manner.
44. C. Clients who are withdrawn may be immobile and mute, and
require consistent, repeated interventions. Communication with
withdrawn clients requires much patience from the nurse. The nurse
facilitates communication with the client by sitting in silence, asking
open-ended question and pausing to provide opportunities for the client
to respond.
45. D. When hallucination is present, the nurse should reinforce reality with
the client.
46. A. Personal characteristics of abuser include low self-esteem,
immaturity, dependence, insecurity and jealousy.
47. D. A short acting skeletal muscle relaxant such as succinylcholine
(Anectine) is administered during this procedure to prevent injuries
during seizure.
48. C. Recognizing situations that produce anxiety allows the client to
prepare to cope with anxiety or avoid specific stimulus.
49. D. Electroconvulsive therapy is an effective treatment for depression that
has not responded to medication
50. B. In an emergency, lives saving facts are obtained first. The name and
the amount of medication ingested are of outmost important in treating
this potentially life threatening situation.
Psych NCLEX Exam for Therapeutic
Communication
1. A patient with a diagnosis of major depression who has
attempted suicide says to the nurse, “I should have died! I’ve always
been a failure. Nothing ever goes right for me.” Which response
demonstrates therapeutic communication?
A. “You have everything to live for.”
B. “Why do you see yourself as a failure?”
C. “Feeling like this is all part of being depressed.”
D. “You’ve been feeling like a failure for a while?”
2. When the community health nurse visits a patient at home, the
patient states, “I haven’t slept the last couple of nights.” Which
response by the nurse illustrates a therapeutic communication response
to this patient.
A. “I see.”
B. “Really?”
C. “You’re having difficulty sleeping?”
D. “Sometimes, I have trouble sleeping too.”
3. A patient experiencing disturbed thought processes believes that his
food is being poisoned. Which communication technique should the use
to encourage the patient to eat?
A. Using open-ended questions and silence
B. Sharing personal preference regarding food choices
C. Documenting reasons why the patient does not want to eat
D. Offering opinions about the necessity of adequate nutrition
4. A patient admitted to a mental health unit for treatment of psychotic
behavior spends hours at the locked exit door shouting. “Let me out.
There’s nothing wrong with me. I don’t belong here.” What defense
mechanism is the patient implementing?
Denial
Projection
Regression
Rationalization
5. A patient diagnosed with terminal cancer says to the nurse “I’m going
to die, and I wish my family would stop hoping for a cure! I get so angry
when they carry on like this. After all, I’m the one who’s dying.” Which
response by the nurse is therapeutic?
“Have you shared your feelings with your family?”
“I think we should talk more about your anger with your family.”
“You’re feeling angry that your family continues to hope for you to be
cured?”
“You are probably very depressed, which is understandable with such a
diagnosis.”
6. On review of the patients record, the nurse notes the admission was
voluntary. Based on this information, the nurse anticipates which patient
behavior?
Fearfulness regarding treatment measures.
Anger and aggressiveness directed toward others.
An understanding of the pathology and symptoms of the diagnosis.
A willingness to participate in the planning of the care and treatment plan.
7. A patient admitted voluntarily for treatment of an anxiety disorder
demands to be released from the hospital. Which action should the nurse
take INITIALLY?
Contact the patient’s health care provider (HCP).
Call the patient’s family to arrange for transportations.
Attempt to persuade the patient to stay for only a few more days.
Tell the patient that leaving would likely result in an involuntary
commitment.
8. When reviewing the admission assessment, the nurse notes that a patient
was admitted to the mental health unity involuntarily. Based on this type of
admission, the nurse should provide which intervention for this patient?
Monitor closely for harm to self or others.
Assist in completing an application for admission.
Supply the patient with written information about their mental illness.
Provide an opportunity for the family to discuss why they felt the admission
was needed.
9. The nurse is preparing a patient for the termination phase of the nurse- 17. Which therapeutic communication technique is being used in this
patient relationship. The nurse prepares to implement which nursing task nurse-client interaction?
that is MOST APPROPRIATE for this phase? Client: “My father spanked me often.”
Planning short-term goals Nurse: “Your father was a harsh disciplinarian.”
Making appropriate referrals A. Restatement
Developing realistic solutions B. Offering general leads
Identifying expected outcomes C. Focusing
D. Accepting
10. The nurse employed in a mental health clinic is greeted by a neighbor in
a local grocery store. The neighbors says to the nurse, “How is Mary doing? 18. Which therapeutic communication technique is being used in this
She is my best friend and is seen at your clinic every week.” Which is the nurse-client interaction?
MOST APPROPRIATE nursing response? Client: “When I am anxious, the only thing that calms me down is
“I can not discuss any patient situation with you.” alcohol.”
“If you want to know about Mary, you need t ask her yourself.” Nurse: “Other than drinking, what alternatives have you explored to
“Only because you’re worried about a friend, I’ll tell you that she is decrease anxiety?”
improving.” A. Reflecting
“Being her friend, you know she is having a difficult time and deserves her B. Making observations
privacy.” C. Formulating a plan of action
D. Giving recognition
11. The nurse calls security and has physical restraints applied when a
client who was admitted voluntarily becomes both physically and verbally 19. Nurse Patrick is interviewing a newly admitted psychiatric client.
abusive while demanding to be discharged from the hospital. Which Which nursing statement is an example of offering a “general lead”?
represents the possible legal ramifications for the nurse associated with A. “Do you know why you are here?”
these interventions? Select all that apply. B. “Are you feeling depressed or anxious?”
Libel C. “Yes, I see. Go on.”
Battery D. “Can you chronologically order the events that led to your
Assault admission?”
Slander
False Imprisonment 20. A nurse states to a client, “Things will look better tomorrow after a
good night’s sleep.” This is an example of which communication
12. The nurse in the mental health unit recognizes which of the following as technique?
therapeutic communication techniques? Select all that apply. A. The therapeutic technique of “giving advice”
Restating B. The therapeutic technique of “defending”
Listening C. The nontherapeutic technique of “presenting reality”
Asking the patient “Why?” D. The nontherapeutic technique of “giving false reassurance”
Maintaining neutral responses
Providing acknowledgment and feedback 21. A client diagnosed with post-traumatic stress disorder is admitted
Giving advice and approval or disapproval to an inpatient psychiatric unit for evaluation and medication
stabilization. Which therapeutic communication technique used by the
13. A patient being seen in the emergency department immediately after nurse is an example of a broad opening?
being sexually assaulted appears calm and controlled. The nurse analyzes A. “What occurred prior to the rape, and when did you go to the
this behavior as indicating which defense mechanism? emergency department?”
Denial B. “What would you like to talk about?”
Projection C. “I notice you seem uncomfortable discussing this.”
Rationalization D. “How can we help you feel safe during your stay here?”
Intellectualization

14. A patient’s unresolved feelings related to loss would be MOST

LIKELY observed during which phase of the therapeutic nurse-patient
relationship?
Trusting
Working 22. A nurse is assessing a client diagnosed with schizophrenia for the
Orientation presence of hallucinations. Which therapeutic communication
Termination technique used by the nurse is an example of making observations?
A. “You appear to be talking to someone I do not see.”
B. “Please describe what you are seeing.”
C. “Why do you continually look in the corner of this room?”
D. “If you hum a tune, the voices may not be so distracting.”

23. A nurse maintains an uncrossed arm and leg posture. This

nonverbal behavior is reflective of which letter of the SOLER acronym
15. Which statement demonstrates the BEST understanding of the for active listening?
nurse’s role regarding ensuring that each client’s rights are respected? A. S
A. “Autonomy is the fundamental right of each and every client.” B. O
B. “A patient’s rights are guaranteed by both state and federal C. L
laws.” D. E
C. “Being respectful and concerned will ensure that I’m attentive to E. R
my patient’s rights.”
D. “Regardless of the patient’s conditions, all nurses have the duty 24. An instructor is correcting a nursing student’s clinical worksheet.
to respect patient rights.” Which instructor statement is the best example of effective feedback?
A. “Why did you use the client’s name on your clinical
16. Which therapeutic communication technique is being used in this worksheet?”
nurse-client interaction? B. “You were very careless to refer to your client by name on your
Client: “When I get angry, I get into a fistfight with my wife or I take it clinical worksheet.”
out on the kids.” C. “Surely you didn’t do this deliberately, but you breached
Nurse: “I notice that you are smiling as you talk about this physical confidentiality by using the client’s name.”
violence.” D. “It is disappointing that after being told, you’re still using client
A. Encouraging comparison names on your worksheet.”
B. Exploring
C. Formulating a plan of action 25. After assertiveness training, a formerly passive client appropriately
D. Making observations confronts a peer in group therapy. The group leader states, “I’m so
proud of you for being assertive. You are so good!” Which
communication technique has the leader employed?
 A. The nontherapeutic technique of giving approval
B. The nontherapeutic technique of interpreting
C. The therapeutic technique of presenting reality
D. The therapeutic technique of making observations
26. What is the purpose of a nurse providing appropriate feedback?
A. To give the client good advice
B. To advise the client on appropriate behaviors
C. To evaluate the client’s behavior
D. To give the client critical information
27. A client who frequently exhibits angry outbursts is diagnosed with
antisocial personality disorder. Which appropriate feedback should a
nurse provide when this client experiences an angry outburst?
A. “Why do you continue to alienate your peers by your angry
outbursts?”
B. “You accomplish nothing when you lose your temper like that.”
C. “Showing your anger in that manner is very childish and
insensitive.”
D. “During group, you raised your voice, yelled at a peer, left, and
slammed the door.”
28. A client diagnosed with dependant personality disorder states, “Do
you think I should move from my parent’s house and get a job?”
Which nursing response is most appropriate?
A. “It would be best to do that in order to increase independence.”
B. “Why would you want to leave a secure home?”
C. “Let’s discuss and explore all of your options.”
D. “I’m afraid you would feel very guilty leaving your parents.”
29. When interviewing a client, which nonverbal behavior should a
nurse employ?
A. Maintaining indirect eye contact with the client
B. Providing space by leaning back away from the client
C. Sitting squarely, facing the client
D. Maintaining open posture with arms and legs crossed
30. 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.”
31. A newly admitted client diagnosed with obsessive-compulsive
disorder (OCD) washes hands continually. This behavior prevents unit
activity attendance. Which nursing statement best addresses this
situation?
A. “Everyone diagnosed with OCD needs to control their ritualistic
behaviors.”
B. “It is important for you to discontinue these ritualistic
behaviors.”
C. “Why are you asking for help if you won’t participate in unit
therapy?”
D. “Let’s figure out a way for you to attend unit activities and still
wash your hands.”
32. Which example of a therapeutic communication technique would
be effective in the planning phase of the nursing process?
A. “We’ve discussed past coping skills. Let’s see if these coping
skills can be effective now.”
B. “Please tell me in your own words what brought you to the
hospital.”
C. “This new approach worked for you. Keep it up.”
D. “I notice that you seem to be responding to voices that I do not
hear.”
33. A client tells the nurse, “I feel bad because my mother does not
want me to return home after I leave the hospital.” Which nursing
response is therapeutic?
A. “It’s quite common for clients to feel that way after a lengthy
hospitalization.”
B. “Why don’t you talk to your mother? You may find out she
doesn’t feel that way.”
C. “Your mother seems like an understanding person. I’ll help you
approach her.”
D. “You feel that your mother does not want you to come back
home?”
34. A client’s younger daughter is ignoring curfew. The client states,
“I’m afraid she will get pregnant.” The nurse responds, “Hang in
there. Don’t you think she has a lot to learn about life?” This is an
example of which communication block?
A. Requesting an explanation
B. Belittling the client
C. Making stereotyped comments
D. Probing
35. Which nursing statement is a good example of the therapeutic
communication technique of giving recognition?
A. “You did not attend group today. Can we talk about that?”
B. “I’ll sit with you until it is time for your family session.”
C. “I notice you are wearing a new dress and you have washed your
hair.”
D. “I’m happy that you are now taking your medications. They will
really help.”
36. 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.”
37. 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
38. 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.”
39. 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.”
40. 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.”
41. 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.”
42. 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.”

43. A client on an inpatient 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.”

44. 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?”

45. 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.”

46. 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 hears
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.”

47. 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?”

48. 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

49. 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

50. 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.”
Answers and Rationales
D. “It’s best if you try not to think about what happened. Try to (Therapeutic Communication)
move on.”
1. Answer: D. “You’ve been feeling like a failure for a
while?” Responding to the feelings expressed by a patient is an
effective therapeutic communication technique. The correct option is
an example of the use of restating. The remaining options block
communication because they minimize the patient’s experience and
 do not facilitate exploration of the patient’s expressed feelings. In
addition, use of the word “why” is nontherapeutic.
2. Answer: C. “You’re having difficulty sleeping?” The correct
option uses the therapeutic communication technique of restatement.
Although restatement is a technique that has a prompting component
to it, it repeats the patients major theme, which assists the nurse to
obtain a more specific perception of the problem from the patient.
The remaining options are not therapeutic responses since none
encourage the patient to expand on the problem. Offering personal
experiences moves the focus away from the patient and onto the
nurse
3. Answer: A. Using open-ended questions and silence. Open-ended
questions and silence are strategies use to encourage patients to
discuss their problems. Sharing personal food preferences is not a
patient-centered intervention. The remaining options are not helpful
to the patient because they do not encourage the patient to express
feelings. The nurse should not offer opinions and should encourage
the patient to identify the reasons for the behavior.
4. Answer: A. Denial. Denial is refusal to admit to a painful reality,
which is treated as if it does not exist. In projection, a person
unconsciously rejects emotionally unacceptable features and
attributes them to other persons, objects, or situations. Regression
allows the patient to return to an earlier, more comforting, although
less mature, way of behaving. Rationalization is justifying illogical
or unreasonable ideas, actions, or feelings by developing acceptable
explanations that satisfy the teller and the listener.
5. Answer: C. “You’re feeling angry that your family continues to
hope for you to be cured?” Restating is a therapeutic
communication technique in which the nurse repeats what the
patient says to show understanding and to review what was said.
While it is appropriate for the nurse to attempt to assess the patient’s
ability to discuss feelings openly with family members, it does not
help the patient discuss the feelings causing the anger. The nurse’s
attempt to focus on the central issue of anger is premature. The nurse
would never make a judgment regarding the reason for the patient’s
feeling, this is non-therapeutic in the one-to-one relationship.
6. Answer: D. A willingness to participate in the planning of the
care and treatment plan. In general, patients seek voluntary
admission. If a patient seeks voluntary admission, the most likely
expectations is the patient will participate in the treatment program
since they are actively seeking help. The remaining options are not
characteristics of this type of admission. Fearfulness, anger, and
aggressiveness are more characteristic of an involuntary admission.
Voluntary admission does not guarantee a patient’s understanding of
their illness, only of their desire for help.
7. Answer: A. Contact the patient’s health care provider (HCP). In
general, patients seek, voluntary admission. Voluntary patients have
the right to demand and obtain release. The nurse needs to be
familiar with the state and facility policies and procedures. The best
nursing action is to contact the HCP, who has the authority to
discuss discharge with the patient. While arranging for safe
transportation is appropriate it is premature in this situation and
should be done only with the patient’s’ permission. While it is
appropriate to discuss why the patient feels the need to leave and the
possible outcomes of leaving against medical advice, attempting to
get the patient to agree to staying “a few more days” has little value
and will not likely be successful. Many states require that the patient
submit a written release notice to the facility staff members, who
reevaluate the patient’s condition for possible conversion to
involuntary status if necessary, according to criteria established by
law. While this is a possibility, it should not be used as a threat to
the patient.
8. Answer: A. Monitor closely for harm to self or
others. Involuntary admission is necessary when a person is a
danger to self or others or is in need of psychiatric treatment
regardless of the patient’s willingness to consent to the
hospitalization. A written request is a component of a voluntary
admission. Providing written information regarding the illness is
likely premature initially. The family may have had no role to play
in the patient’s’ admission.
9. Answer: B. Making appropriate referrals. Tasks of the
termination phase include evaluating patient performance,
evaluating achievement of expected outcomes, evaluating future
needs, making appropriate referrals and dealing with the common
behaviors associated with termination. The remaining options
identify tasks appropriate for the working phase of the relationship.
10. Answer: A. “I cannot discuss any patient situation with
you.” The nurse is required to maintain confidentiality regarding the
patient and the patient’s care. Confidentiality is basic to the
therapeutic relationship and is a patient’s right. The most appropriate
response to the neighbor is the statement of that responsibility in a
direct, but polite manner. A blunt statement that does not
acknowledge why the nurse cannot reveal patient information may
be taken as disrespectful and uncaring. The remaining options
identify statements that do not maintain patient confidentiality.
11. Answers: B, C and E. False imprisonment is an act with the
intent to confine a person to a specific area. The nurse can be
charged with false imprisonment if the nurse prohibits a patient from
leaving the hospital if the patient has been admitted voluntarily and
if no agency or legal policies exist for detaining the patient. Assault
and battery are related to the act of restraining the patient in a
situation that did not meet criteria for such an intervention. Libel and
slander are not applicable here since the nurse did not write or
verbally make untrue statements about the patient.
12. Answer: A, B, D, and E. Therapeutic communication techniques
include listening, maintaining silence, maintaining neutral responses,
using broad openings and open-ended questions, focusing and
refocusing, restating, clarifying and validating, sharing perceptions,
reflecting, providing acknowledgment and feedback, giving
information, presenting reality, encouraging formulation of a plan of
action, providing nonverbal encouragement, and summarizing
Asking why is often interpreted as being accusatory by the patient
and should also be avoided. Providing advice or giving approval or
disapproval are barriers to communication.
13. Answer: A. Denial. Denial is refusal to admit to a painful reality
and may be a response by a victim of sexual abuse. In this case the
patient is not acknowledging the trauma of the assault either verbally
or nonverbally. Projection is transferring one’s internal feelings,
thoughts, and unacceptable ideas and traits to someone else.
Rationalization is justifying the unacceptable attributes about
oneself. Intellectualization is the excessive use of abstract thinking
or generalizations to decrease painful thinking.
14. Answer: D. Termination. In the termination phase, the relationship
comes to a close. Ending treatment sometimes may be traumatic for
patients who have come to value the relationship and the help.
Because loss is an issue, any unresolved feelings related to loss may
resurface during this phase. The remaining options are not
specifically associated with this issue of unresolved feelings.
15. Answer: C. “Being respectful and concerned will ensure that
I’m attentive to my patients’ rights.” The nurse needs to respect
and have concern for the patient; this is vital to protecting the
patient’s rights. While it is true the autonomy is a basic client right,
there are other rights that must also be both respected and facilitated.
State and federal laws do protect a patient’s rights, but it is
sensitivity to those rights that will ensure that the nurse secures these
rights for the patient. It is a fact that safeguarding a patient’s rights
are a nursing responsibility, but stating that fact does not show
understanding or respect for the concept.
16. Answer: D. Making observations. The nurse is using the
therapeutic communication technique of making observations when
noting that the client smiles when talking about physical violence.
The technique of making observations encourages the client to
compare personal perceptions with those of the nurse.
17. Answer: A. Restatement. The nurse is using the therapeutic
communication technique of restatement. Restatement involves
repeating the main idea of what the client has said. The nurse uses
this technique to communicate that the client’s statement has been
heard and understood.
18. Answer: C. Formulating a plan of action. The nurse is using the
therapeutic communication technique of formulating a plan of action
 to help the client explore alternatives to drinking alcohol. The use of
this technique, rather than direct confrontation regarding the client’s
poor coping choice, may serve to prevent anger or anxiety from
escalating.
19. Answer: C. “Yes, I see. Go on.” The nurse’s statement, “Yes, I see.
Go on.” is an example of the therapeutic communication technique
of a general lead. Offering a general lead encourages the client to
continue sharing information.
20. Answer: D. The nontherapeutic technique of “giving false
reassurance” The nurse’s statement, “Things will look better
tomorrow after a good night’s sleep.” is an example of the
nontherapeutic technique of giving false reassurance. Giving false
reassurance indicates to the client that there is no cause for anxiety,
thereby devaluing the client’s feelings.
21. Answer: B. “What would you like to talk about?” The nurse’s
statement, “What would you like to talk about?” is an example of the
therapeutic communication technique of giving broad openings.
Using a broad opening allows the client to take the initiative in
introducing the topic and emphasizes the importance of the client’s
role in the interaction.
22. Answer:A. “You appear to be talking to someone I do not
see.” The nurse is making an observation when stating, “You appear
to be talking to someone I do not see.” Making observations
involves verbalizing what is observed or perceived. This encourages
the client to recognize specific behaviors and make comparisons
with the nurse’s perceptions.
23. Answer: B. O. The nurse should identify that maintaining an
uncrossed arm and leg posture is nonverbal behavior that reflects the
“O” in the active-listening acronym SOLER. The acronym SOLER
includes sitting squarely facing the client (S), open posture when
interacting with the client (O), leaning forward toward the client (L),
establishing eye contact (E), and relaxing (R).
24. Answer: C. “Surely you didn’t do this deliberately, but you
breached confidentiality by using the client’s name.” The
instructor’s statement, “Surely you didn’t do this deliberately, but
you breached confidentiality by using the client’s name.” is an
example of effective feedback. Feedback is a method of
communication to help others consider a modification of behavior.
Feedback should be descriptive, specific, and directed toward a
behavior that the person has the capacity to modify and should
impart information rather than offer advice or criticize the
individual.
25. Answer: A. The nontherapeutic technique of giving approval.
The group leader has employed the nontherapeutic technique of
giving approval. Giving approval implies that the nurse has the right
to pass judgment on whether the client’s ideas or behaviors are
“good” or “bad.” This creates a conditional acceptance of the client.
26. Answer: D. To give the client critical information. The purpose of
providing appropriate feedback is to give the client critical
information. Feedback should not be used to give advice or evaluate
behaviors.
27. Answer: D. “During group, you raised your voice, yelled at a
peer, left, and slammed the door.” The nurse is providing
appropriate feedback when stating, “During group, you raised your
voice, yelled at a peer, left, and slammed the door.” Giving
appropriate feedback involves helping the client consider a
modification of behavior. Feedback should give information to the
client about how he or she is perceived by others. Feedback should
not be evaluative in nature or be used to give advice.
28. Answer: C. “Let’s discuss and explore all of your options.” The
most appropriate response by the nurse is, “Let’s discuss and explore
all of your options.” In this example, the nurse is encouraging the
client to formulate ideas and decide independently the appropriate
course of action.
29. Answer: C. Sitting squarely, facing the client. When interviewing
a client, the nurse should employ the nonverbal behavior of sitting
squarely, facing the client. Facilitative skills for active listening can
be identified by the acronym SOLER. SOLER includes sitting
squarely facing the client (S), open posture when interacting with a
client (O), leaning forward toward the client (L), establishing eye
contact (E), and relaxing (R).
30. Answer: B. “You’re feeling guilty because you weren’t able to
save your children.” The best response by the nurse is, “You’re
experiencing feelings of guilt because you weren’t able to save your
children.” This response utilizes the therapeutic communication
technique of reflection which identifies a client’s emotional response
and reflects these feelings back to the client so that they may be
recognized and accepted.
31. Answer: D. “Let’s figure out a way for you to attend unit
activities and still wash your hands.” The most appropriate
statement by the nurse is, “Let’s figure out a way for you to attend
unit activities and still wash your hands.” This statement reflects the
therapeutic communication technique of formulating a plan of
action. The nurse attempts to work with the client to develop a plan
without damaging the therapeutic relationship or increasing the
client’s anxiety.
32. Answer: A. “We’ve discussed past coping skills. Let’s see if these
coping skills can be effective now.” This is an example of the
therapeutic communication technique of formulating a plan of
action. By the use of this technique, the nurse can help the client
plan in advance to deal with a stressful situation which may prevent
anger and/or anxiety from escalating to an unmanageable level.
33. Answer: D. “You feel that your mother does not want you to
come back home?” This is an example of the therapeutic
communication technique of restatement. Restatement is the
repeating of the main idea that the client has verbalized. This lets the
client know whether or not an expressed statement has been
understood and gives him or her the chance to continue, or clarify if
necessary.
34. Answer: C. Making stereotyped comments. This is an example of
the nontherapeutic communication block of making stereotyped
comments. Clichés and trite expressions are meaningless in a
therapeutic nurse-client relationship.
35. Answer: C. “I notice you are wearing a new dress and you have
washed your hair.” This is an example of the therapeutic
communication technique of giving recognition. Giving recognition
acknowledges and indicates awareness. This technique is more
appropriate than complimenting the client which reflects the nurse’s
judgment.
36. Answer: A. “You seem to be motivated to change your
behavior.” This is an example of the therapeutic communication
technique of verbalizing the implied. Verbalizing the implied puts
into words what the client has only implied or said indirectly.
37. Answer: C. To explore a subject, idea, experience, or
relationship. This is an example of the therapeutic communication
technique of exploring. The purpose of using exploring is to delve
further into the subject, idea, experience, or relationship. This
technique is especially helpful with clients who tend to remain on a
superficial level of communication.
38. Answer: B. “Remember, clients, not nurses, are responsible for
their own choices and decisions.” Giving advice tells the client
what to do or how to behave. It implies that the nurse knows what is
best and that the client is incapable of any self-direction. It
discourages independent thinking.
39. Answer: A. “Touch carries a different meaning for different
individuals.” Touch can elicit both negative and positive reactions,
depending on the people involved and the circumstances of the
interaction.
40. Answer: D. “You mentioned your relationship with your father.
Let’s discuss that further.” This is an example of the therapeutic
communication technique of focusing. Focusing takes notice of a
single idea or even a single word and works especially well with a
client who is moving rapidly from one thought to another.
41. Answer: B. “I see that you are upset, but I feel uncomfortable
when you swear at me.” This is an example of the appropriate use
of feedback. Feedback should be directed toward behavior that the
client has the capacity to modify.
42. Answer: A. “Don’t worry. Everything will be alright.” This
nursing statement is an example of the nontherapeutic
 communication block of belittling feelings. Belittling feelings occur
when the nurse misjudges the degree of the client’s discomfort, thus
a lack of empathy and understanding may be conveyed.
43. Answer: C. “You’ve been feeling sad and alone for some time
now?” This nursing statement is an example of the therapeutic
communication technique of reflection. When reflection is used,
questions and feelings are referred back to the client so that they
may be recognized and accepted.
44. Answer: A. “Can you tell me why you said that?” This nursing
statement is an example of the nontherapeutic communication block
of requesting an explanation. Requesting an explanation is when the
client is asked to provide the reason for thoughts, feelings,
behaviors, and events. Asking “why” a client did something or feels
a certain way can be very intimidating and implies that the client
must defend his or her behavior or feelings.
45. Answer: D. “Describe what happened during your time with
your husband.” This is an example of the therapeutic
communication technique of exploring. The purpose of using
exploring is to delve further into the subject, idea, experience, or
relationship. This technique is especially helpful with clients who
tend to remain on a superficial level of communication.
46. Answer: B. “I understand that the voices seem real to you, but I
do not hear any voices.” This is an example of the therapeutic
communication technique of presenting reality. Presenting reality is
when the client has a misperception of the environment. The nurse
defines reality or indicates his or her perception of the situation for
the client.
47. Answer: B. “Would you like me to accompany you to your
electroconvulsive therapy treatment?” This is an example of the
therapeutic communication technique of offering self. Offering self
makes the nurse available on an unconditional basis, increasing
client’s feelings of self-worth. Professional boundaries must be
maintained when using the technique of offering self.
48. Answer: B. Verbalizing the implied and the defense mechanism
of denial. This is an example of the therapeutic communication
technique of verbalizing the implied. The nurse is putting into words
what the client has only implied by words or actions. Denial is the
refusal of the client to acknowledge the existence of a real situation,
the feelings associated with it, or both.
49. Answer: A, B, C, D. The nurse should determine that spanking,
isolating, getting tattoos, and writing are all ways in which people
communicate messages to others. It is estimated that about 70% to
90% of communication is nonverbal.
50. Answer: B. “You’re feeling guilty because you weren’t able to
save your children.” The best response by the nurse is, “You’re
experiencing feelings of guilt because you weren’t able to save your
children.” This response utilizes the therapeutic communication
technique of reflection which identifies a client’s emotional response
and reflects these feelings back to the client so that they may be
recognized and accepted.
Psych NCLEX Exam for Stress, Anxiety, Eating &
Mind-Body Disorders
1. Adam is a 20-year-old student diagnosed of having obsessive-
compulsive behavior. A psychiatrist prescribes clomipramine
(Anafranil) to treat his condition. Nurse Anna understands the
rationale for this treatment is that the clomipramine:
A. increases dopamine levels.
B. increases serotonin levels.
C. decreases norepinephrine levels.
D. decreases GABA levels.
2. Nurse Sarah is developing a care plan for a female client with post-
traumatic stress disorder. Which of the following would she do
initially?
A. Instruct the client to use distraction techniques to cope with
flashbacks.
B. Encourage the client to put the past in proper perspective.
C. Encourage the client to verbalize thoughts and feelings about the
trauma.
D. Avoid discussing the traumatic event with client.
3. A group of community nurses sees and plans care for various clients
with different types of problems. Which of the following clients would
they consider the most vulnerable to post-traumatic stress disorder?
A. An 8 year-old boy with asthma who has recently failed a grade
in school
B. A 20 year-old college student with DM who experienced date
rape
C. A 40 year-old widower who has recently lost his wife to cancer
D. A wife of an individual with a severe substance abuse problem
4. Which outcome is most appropriate for Francis who has a
dissociative disorder?
A. Francis will deal with uncomfortable emotions on a conscious
level.
B. Francis will modify stress with the use of relaxation techniques.
C. Francis will identify his anxiety responses.
D. Francis will use problem-solving strategies when feeling
stressed.
5. The psychiatric nurse uses cognitive-behavioral techniques when
working with a client who experiences panic attacks. Which of the
following techniques are common to this theoretical framework? Select
all that apply.
A. Administering anti-anxiety medication as prescribed
B. Encouraging the client to restructure thoughts
C. Helping the client to use controlled relaxation breathing
D. Helping the client examine evidence of stressors
E. Questioning the client about early childhood relationships
F. Teaching the client about anxiety and panic
6. Marty is pacing and complains of racing thoughts. Nurse Lally asks
the client if something upsetting happened, and Marty’s response is
vague and not focused on the question. Nurse Lally assess Marty’s level
of anxiety as:
A. mild.
B. moderate.
C. severe.
D. panic.
7. Nurse Martha is teaching her students about anxiety medications,
she explains that benzodiazepines affect which brain chemical?
A. Acetylcholine
B. Gamma-aminobutyric acid (GABA)
C. Norepinephrine
D. Serotonin
8. Nurse Mandy is assessing a client for recent stressful life events. She
recognizes that stressful life events are both:
A. desirable and growth-promoting.
B. positive and negative.
C. undesirable and harmful.
D. predictable and controllable.
9. During a community visit, volunteer nurses teach stress management
to the participants. The nurses will most likely advocate which belief 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.
10. Genevieve only attends social events when a family member is also
present. She exhibits behavior typical of which anxiety disorder?
A. Agoraphobia
B. Generalized anxiety disorder
C. Obsessive-compulsive disorder
D. Post-traumatic stress disorder
11. Mr. Johnson is newly admitted to a psychiatric unit because of
severe obsessive compulsive behavior. Which initial response by the
nurse would be most therapeutic for him?
A. Accepting the client’s ritualistic behaviors
B. Challenging the client’s need for rituals
C. Expressing concern about the harmfulness of the client’s rituals
D. Limiting the client’s rituals that are excessive
12. Nurse Vicky is assessing a newly admitted client for symptoms of
post-traumatic stress disorder (PTSD). Which symptoms are typically
seen with this diagnosis? Select all that apply.
 A. Anger with numbing of other emotions D. Fear of having a serious illness
B. Exaggerated startle response E. Irregular or absent menses
C. Feeling that one is having a heart attack F. Refusal to maintain minimally normal weight
D. Frequent thoughts about contamination
E. Frequent nightmares 22. Mr. Bartowski who is newly diagnosed with rheumatoid arthritis
F. Survivor’s guilt asks the community nurse how stress can affect his disease. The nurse
would explain that:
13. Jordanne is a client with a fear of air travel. She is being treated in A. the psychological experience of stress will not affect symptoms
a mental institution for phobic disorder. The treatment method of physical disease.
involves systematic desensitization. The nurse would consider the B. psychological stress can cause painful emotions, which are
treatment successful if: harmful to a person with an illness.
A. Jordanne plans a trip requiring air travel. C. stress can overburden the body’s immune system, and therefore
B. Jordanne takes a short trip in an airplane. one can experience increased symptoms.
C. Jordanne recognizes the unrealistic nature of the fear of riding D. the body’s stress response is stimulated when there are major
on airplanes. disruptions in one’s life.
D. Jordanne verbalizes a decreased fear about air travel.

14. Nurse Kerrick observes Toni who is hospitalized on an eating

disorder unit during mealtimes and for 1 hour after eating. An
explanation for this intervention is:
A. to develop trusting relationship.
B. to maintain focus on importance of nutrition.
C. to prevent purging behaviors.
D. to reinforce the behavioral contact.

15. Marlyn is diagnosed of anorexia nervosa and is admitted in the

special eating disorder unit. The initial treatment priority for her is: 23. During a mother’s class, the nurse who is teaching the participants
A. to determine her current body image. on stress management is questioned about the use of alternative
B. to identify family interaction patterns. treatments, such as herbal therapy and therapeutic touch. She explains
C. to initiate a refeeding program. that the advantage of these methods would include all of the following
D. to promote the client’s independence. except:
A. they are congruent with many cultural belief systems.
B. they encourage the consumer to take an active role in health
management.
C. they promote interrelationships within the mind-body-spirit.
16. The nurse evaluates the treatment of Mrs. Montez with somatoform D. they usually work better than traditional medical practice.
disorder as successful if:
A. Mrs. Montez practices self-medication rather than changing 24. David is preoccupied with numerous bodily complaints even after a
health care providers. careful diagnostic workup reveals no physiologic problems. Which
B. Mrs. Montez recognizes that physical symptoms increase nursing intervention would be therapeutic for him?
anxiety level. A. Acknowledge that the complaints are real to the client, and
C. Mrs. Montez researches treatment protocols for various refocus the client on other concerns and problems.
illnesses. B. Challenge the physical complaints by confronting the client with
D. Mrs. Montez verbalizes anxiety directly rather than displacing it. the normal diagnostic findings.
C. Ignore the client’s complaints, but request that the client keep a
17. Which of the following attitudes from a nurse would hinder a list of all symptoms.
discussion with an adolescent client about sexuality? D. Listen to the client’s complaints carefully, and question him
A. Accepting about specific symptoms.
B. Matter-of-fact
C. Moralistic 25. Nurse Kenzo is teaching a client about sertraline (Zoloft), which has
D. Nonjudgemental been prescribed for depression. A significant side effect is interference
with sexual arousal by inhibiting erectile function. How should
18. Nurse David is planning a psychoeducational discussion for a group the Nurse Kenzo approach this topic?
of adolescent clients with anorexia nervosa. Which of the following A. Nurse Kenzo should avoid mentioning the sexual side effects to
topics would Nurse David select to enhance understanding about prevent the client from having anxiety about potential erectile
central issues in this disorder? problems.
A. Anger management B. Nurse Kenzo should advise the client to report any changes in
B. Parental expectations sexual functioning in case medication adjustments are needed.
C. Peer pressure and substance abuse C. Nurse Kenzo should explain that the client’s sexual desire will
D. Self-control and self-esteem probably decrease while on this medication.
D. Nurse Kenzo should tell the client that sexual side effects are
19. Nurse Ginia understands that her client Glenda who is bulimic feels expected, but that they will decrease when his depression lifts.
shame and guilt over binge eating and purging. This disorder is
therefore considered:
A. ego-distorting.
B. ego-dystonic.
C. ego-enhancing.
D. ego-syntonic.

20. The psychoanalytic theory explains the etiology of anorexia nervosa

as:
A. the achievement of secondary gain through control of eating.
B. a conflict between mother and child over separation and
individualization.
C. family dynamics that lead to enmeshment of members.
D. the incorporation of thinness as an ideal body image.

21. The school nurse assesses for anorexia nervosa in an adolescent girl.
Which of the following findings are characteristic of this
disorder? Select all that apply.
A. Bradycardia
B. Hypotension
C. Chronic pain in one or more sites
 11. Answer: A. Accepting the client’s ritualistic behaviors. It is
important to accept the client’s need to perform ritualistic behaviors
in this situation; admission to a psychiatric unit is stressful, and this
client will tend to increase rituals when anxious. Other options are
not appropriate for a newly admitted client.

12. Answer: A, B, E, F. These are common symptoms of PTSD. Option

C is common in panic disorder, and option D is characteristic of
obsessive-compulsive disorder.

13. Answer: B. Jordanne takes a short trip in an

airplane. Systematic desensitization is a behavioral technique in
which the client with a specific phobia is gradually able to work
Answers and Rationales through hierarchal fears until the most fearful situation is
encountered. In this case, the most fearful is riding an airplane. The
(Stress, Anxiety, Eating & Mind-Body Disorders) responses in options A and D may occur earlier in treatment, but not
indicative of success. Generally, a phobic individual recognizes that
his fear is disproportionate to the things he fears.
1. Answer: B. increases serotonin levels. According to the
psychobiologic theory, dysregulation of the neurotransmitter
14. Answer: C. to prevent purging behaviors. Toni may experience
serotonin is thought to contribute to obsessive-compulsive behavior.
increased anxiety during treatment and, therefore, may resume
Clomipramine (Anafranil) is used to increase serotonin levels,
behaviors designed to prevent weight gain, such as vomiting or
thereby decreasing the need for obsessive-compulsive behaviors.
excessive exercise.
2. Answer: C. Encourage the client to verbalize thoughts and
15. Answer: C. to initiate a refeeding program. The physical need to
feelings about the trauma. Planning care for a client with post-
reestablish near-normal weight takes priority because of the
traumatic stress disorder would involve helping the client to
physiologic, life-threatening consequences of anorexia.
verbalize thoughts and feelings about the trauma. This will help the
client work through the strong emotions connected with the trauma
16. Answer: D. Mrs. Montez verbalizes anxiety directly rather than
and, therefore foster the belief that she is able to cope. Avoiding
displacing it. Mrs. Montez with somatoform disorder unconsciously
discussion and using distraction techniques would be inappropriate.
displaces anxiety onto physical symptoms. The ability to recognize
Option B may be possible later, after the client is able to verbalize
and verbalize anxious feelings directly rather than displacing them is
strong emotions.
a criterion of treatment success. Options A and C indicate
continuation of the problem.
3. Answer: B. A 20 year-old college student with DM who
experienced date rape. Post-traumatic stress disorder is caused by
17. Answer: C. Moralistic. Adolescents are not likely to feel free to ask
the the experience of severe, specific trauma. Rape is a severely
questions and participate in a discussion if the nurse has a moralistic
traumatic event. Although the situations in options A, C, and D are
attitude toward sexual issues. Having an accepting, matter-of-fact, or
certainly stressful, they are not at the level of severe trauma.
nonjudgmental attitude will be helpful in allowing adolescents to
feel comfortable discussing sexual issues.
4. Answer: A. Francis will deal with uncomfortable emotions on a
conscious level. Dissociative disorders occur when traumatic events
18. Answer: D. Self-control and self-esteem. Self-control and self-
are beyond an individual’s recall because this memories have been
esteem are central issues for clients with eating disorders. Such
“blocked” from conscious awareness. Bringing the feelings
clients feel a loss of self-control over their life and experience
associated with these events into conscious awareness and coping
diminished self-esteem and severe doubts about their self-worth.
with these feelings will decrease the need for dissociation.
19. Answer: B. ego-dystonic. An ego dystonic disorder is one in which
5. Answer: B, C, D, F. These are all appropriate techniques based on
the client views behaviors or symptoms as incongruent with self-
the framework of cognitive-behavioral therapy.
image and therefore feels guilt, shame, and distress about the
symptoms. An ego-syntonic disorder is one which the client views
6. Answer: C. severe. When the client has difficulty focusing and
behaviors as congruent with her self-image (as in anorexia nervosa).
exhibits excessive motor activity, the level of anxiety is severe. Mild
anxiety is characterized by increased alertness and problem-solving
20. Answer: B. a conflict between mother and child over separation
ability. Moderate anxiety is characterized by the ability to focus on
and individualization. According to psychoanalytic theory, early
central concerns but the inability to problem-solve without
mother-child dynamics lead to difficulty with a child establishing a
assistance. Panic level of anxiety is characterized by complete
sense of separateness from the mother. Control of eating becomes
inability to focus and reduced perceptions.
one area in which the child establishes a sense of independence.
Option A is the behavioral view of anorexia nervosa. Option C
7. Answer: B. Gamma-aminobutyric acid (GABA). Antianxiety
reflects the family theory view of anorexia nervosa, which deals
medications stimulate the neurotransmitter GABA, which is a
with the issue of lack of generational boundaries. Option D
chemical associated with relaxation. The other options are not
characterizes the sociocultural view of anorexia nervosa, which
affected by benzodiazepines.
identifies thinness as being a culturally determined ideal.
8. Answer: B. positive and negative. The concept of stressful life
21. Answer: A, B, E, F. These are all characteristics of anorexia
event is based on the research of Holmes and Rahe, who found that
nervosa. Option C is common for somatoform pain disorder and
both positive and negative changes result on stress. Stressful life
option D is common in hypochondriasis.
events are not always desirable and growth promoting, nor are they
always undesirable and harmful. Some stressful life events can be
22. Answer: C. Stress can overburden the body’s immune system, and
predictable and controllable; however, many life events are entirely
therefore one can experience increased symptoms. The stress
unpredictable.
response causes stimulation of the hypothalamic-pituitary-adrenal
axis, which can further compromise an immune system that has been
9. Answer: B. Control over one’s response to stress is
activated by the autoimmune disorder of rheumatoid arthritis.
possible. When learning to manage stress, clients find it helpful to
Consequently, the client can expect disease symptoms to exacerbate
believe that they have the ability to control their response to it. It is
when under stress.
impossible to avoid stress, which is a normal life experience. Stress
can be positive and growth enhancing as well as harmful. The belief
23. Answer: D. they usually work better than traditional medical
that one has some control is the significant factor in minimizing
practice. Complementary alternative medicine treatments are often
stress response.
used as adjuncts to traditional medical treatment. Although an
individual may choose a particular alternative treatment method,
10. Answer: A. Agoraphobia. Agoraphobia is a disorder characterized
there is really no current scientific proof that these methods will
by avoidance of situations in which escape may not be possible or
work better than traditional medicine.
help may be unavailable.
24. Answer: A. Acknowledge that the complaints are real to the client,
and refocus the client on other concerns and problems. After
physical factors are ruled out, somatic complaints are thought to be
expressions of anxiety. The complaints are real to the client, but the
nurse should not focus on them. Prompting the client about other
concerns will encourage expression of anxiety and dependency
needs.

25. Answer: B. Nurse Kenzo should advise the client to report any
changes in sexual functioning in case medication adjustments are
needed. Clients commonly discontinue medications to avoid or
correct sexual side effects, but they are less likely to do that when
health professionals offer assistance with sexual issues. Generally,
clients avoid discussing sexual issues unless health professionals
give permission by raising the issue first.

Psychiatric Nursing Practice Exam

for Defense Mechanism
1. On a sunny afternoon at the pediatric clinic, Nurse Olivia observes
baby Mia during her regular checkup. Amid the coos and giggles, she
knows there’s a particular developmental milestone that Mia should
reach soon. At what age can she anticipate Mia will start sitting up
without any assistance?
A. When she’s 4 months old.
B. At the age of 6 months.
C. Once she turned 8 months old.
D. By the time she’s 10 months old.

2. As an experienced nurse, Robert is caring for a patient who exhibits

signs of paranoid delusions. Robert understands there’s a connection
between these delusions and a particular psychological defense
mechanism. Which defense mechanism is generally linked with the
occurrence of paranoid delusions in Robert’s patient?
A. The possibility is Regression.
B. Another potential mechanism could be Repression.
C. Identification might also be the defense mechanism at play.
D. It could be a case of Projection.

3. In the realm of psychiatric nursing, Nurse Emily comes across

different coping mechanisms her patients use, some healthier than
others. She knows there’s one specific term that refers to the
unconscious act of attributing one’s undesirable characteristic to
someone else. Which of these terms aligns with this definition?
 A. The act of Compensation.
B. The process of Projection.
C. The mechanism of Rationalization.
D. The state of Dysphoria.
4. While attending a seminar on grief counseling, Nurse Alex
encounters a question: “Out of the listed phases, can you pinpoint
which one does not fall within the standard stages of the grieving
process?”
A. Anger
B. Denial
C. Rejection
D. Bargaining
5. During her shift, Nurse Jenna takes a quick break and engages in a
quiz meant to reinforce her understanding of psychological defense
mechanisms. A question reads: “Can you identify the term used when
an individual creates seemingly logical excuses for actions that were
driven by different, often subconscious, motivations?”
A. Compensation
B. Projection
C. Rationalization
D. Dysphoria
6. As Nurse John navigates his bustling day on the neurology floor, he
comes across various psychological disorders. Among these, he reflects
on one particular disorder where severe emotional stress provokes an
involuntary disruption in physical functions. What is this disorder
known as?
A. Alzheimer’s disease.
B. Conversion disorder.
C. Depressive reaction.
D. Bipolar disorder.
7. In the bustling world of a hospital’s sleep disorders clinic, Nurse
Emily is analyzing EEG (electroencephalogram) recordings of various
patients. While reviewing the different waveforms observed during
wakefulness, she wonders which one is the most commonly found.
Which waveform is it?
A. Beta
B. Theta
C. Zeta
D. Alpha
8. In the serene atmosphere of the sleep laboratory, Nurse Michelle is
closely monitoring a patient’s sleep patterns. As she observes the
different stages of sleep, she contemplates the frequency of the REM
(Rapid Eye Movement) sleep cycle. How often does the REM sleep
cycle occur, approximately?
A. 75 minutes
B. 60 minutes
C. 90 minutes
D. 45 minutes
9. In the nurturing environment of a maternity ward, Nurse Sarah is
conducting routine neonatal assessments. While examining the
newborns, she recalls the various reflexes present in these infants.
Which of the following reflexes is absent at birth?
A. Moro reflex
B. Rooting reflex
C. Pincer grasp reflex
D. Sucking reflex
10. In a vibrant and joyful preschool setting, Nurse Lily is observing
toddlers as they engage in various activities. While witnessing the
children’s interactions, she reflects on the development of parallel play.
During which age range does parallel play typically emerge?
A. Between the ages of 5 to 10 months.
B. Around 10 to 14 months of age.
C. Typically seen in toddlers aged 12 to 24 months.
D. Emerging during the period of 24 to 48 months.
11. In the midst of her day at a bustling city healthcare facility, Nurse
Jane finds herself reflecting on psychological defense mechanisms,
specifically those she’s observed in her patient interactions. In this
context, which mechanism could be defined as covering up a weakness
by emphasizing a desirable or stronger trait?
A. Experiencing feelings of dysphoria.
B. Engaging in rationalization as a coping mechanism.
C. Utilizing compensation to address weaknesses.
D. Projecting emotions onto others.
12. As Nurse Amanda tends to her patients in a busy emergency room,
she ponders the various signs and symptoms of anxiety. Among the
listed options, which one is not typically considered a sign of anxiety?
A. Experiencing a moist mouth.
B. Feeling dyspnea (shortness of breath).
C. Exhibiting gastrointestinal (GI) symptoms.
D. Demonstrating hyperventilation (rapid breathing).
13. In a bustling sleep disorders clinic, Nurse Michelle encounters a
unique case where an individual who is fully awake suddenly falls
asleep without warning. How can this condition be best described?
A. Experiencing narcolepsy.
B. Undergoing transitional sleep.
C. Experiencing REM absence.
D. Experiencing cataplexy.
14. Amidst the bustling activity of a neurology clinic, Nurse Sarah
encounters a patient with a unique condition. The patient has difficulty
identifying the location of their hand or foot. Which term best
describes this condition?
A. Experiencing symptoms of cataplexy.
B. Dealing with feelings of ergophobia.
C. Showing signs of anosognosia.
D. Having difficulties related to autotopagnosia.
15. In a bustling emergency department, Nurse Alex encounters
patients with various medical conditions. As he reviews the symptoms
associated with panic disorder, he identifies some common
characteristics. Among the following options, which one is not typically
associated with panic disorder?
A. Experiencing chest pain.
B. Dealing with excessive perspiration.
C. Experiencing nausea.
D. Feeling the urge to urinate.
16. In a vibrant and supportive senior living community, Nurse Lisa
interacts with elderly residents daily. As she contemplates the
psychological stages of development in older adults, she wonders which
category a 70-year-old adult would fall into.
A. Experiencing the stage of integrity vs. despair.
B. Going through the stage of generativity vs. stagnation.
C. Engaging in the stage of longevity vs. guilt.
D. Encountering the stage of intimacy vs. isolation.
17. In a vibrant and supportive senior living community, Nurse Lisa
interacts with elderly residents daily. As she contemplates the
psychological stages of development in older adults, she wonders which
category a 60-year-old adult would fall into.
A. Experiencing the stage of longevity vs. guilt.
B. Going through the stage of intimacy vs. isolation.
C. Engaging in the stage of generativity vs. stagnation.
D. Encountering the stage of integrity vs. despair.
18. In a bustling university campus, Nurse Lisa engages with young
adults daily. As she contemplates the psychological stages of
development in young adulthood, she wonders which category a 20-
year-old adult would fall into.
A. Experiencing the stage of generativity vs. stagnation.
B. Going through the stage of intimacy vs. isolation.
C. Engaging in the stage of integrity vs. despair.
D. Encountering the stage of longevity vs. guilt.
19. In a serene sleep clinic, Nurse Michelle observes various sleep
patterns in different individuals. Among these, she contemplates the
most common waveform associated with light sleepers. What is this
waveform?
A. Experiencing brainwave activity in the Theta frequency range.
B. Having brainwave activity in the Beta frequency range.
C. Showing brainwave activity in the Alpha frequency range.
D. Zeta that is commonly found in sleep patterns.
20. In a bustling psychiatric ward, Nurse Sarah encounters a patient
who is using words with no known meaning. As she ponders the
condition associated with this language pattern, which term best
describes it?
A. Neolithic
B. Displaying neologisms.
C. Demonstrating verbalism.
D. Experiencing delusional blocking.
 Psychiatric Nursing Practice Exam
for Defense Mechanism
Answers & Rationales

1. Correct answer: B. At the age of 6 months. Most babies start sitting up

on their own around the age of 6 months. This is a significant
developmental milestone as it indicates that the baby’s muscles in the neck,
back, and abdomen have developed enough strength to keep them upright.
This also coincides with the development of their balance and coordination
skills. Imagine learning to ride a bicycle. Initially, you need training wheels
(like the support of a caregiver or a baby seat for the baby) to stay upright.
But as you practice and your muscles get stronger, you can balance and ride
the bike without any assistance. Similarly, as babies grow and their muscles
strengthen, they learn to sit up independently.

Incorrect answer options:

A. When she’s 4 months old. While some babies might start showing signs
of sitting up at this age, they usually need assistance to stay upright. Their
muscles and coordination skills are still developing, much like a young
sapling that needs a stake for support until it grows stronger.

C. Once she turned 8 months old. & D. By the time she’s 10 months old.
While every child develops at their own pace, most babies can sit up
without assistance by the age of 6 months. If a baby is not sitting up by 8 or
10 months, it may be a sign of a developmental delay, and it would be
advisable to consult a pediatrician. This is akin to a student who is falling
behind in class; it doesn’t necessarily mean there’s a problem, but it’s worth
checking to make sure everything is on track.

2. Correct answer: D. It could be a case of Projection. Projection is a

psychological defense mechanism where individuals attribute their own
unacceptable thoughts, feelings, or motives to another person. In the case of
paranoid delusions, the individual often projects their own feelings of
hostility, aggression, or other negative sentiments onto others, believing
that these others are out to harm them.
For example, a person who is harboring dishonest thoughts might accuse
others of being deceitful without any evidence. They are “projecting” their
own dishonesty onto others.

Incorrect answer options:

A. The possibility is Regression. Regression is a defense mechanism where
an individual reverts to an earlier stage of development in response to
stressful situations. While it can manifest in various ways, it’s not typically
associated with paranoid delusions. For instance, an adult who is under a lot
of stress might start exhibiting behaviors from their childhood, like
throwing tantrums or sucking their thumb. This is regression, as they are
reverting to behaviors from a time when they felt safer.

B. Another potential mechanism could be Repression. Repression is a

defense mechanism where an individual unconsciously blocks out
distressing thoughts or feelings. While repression can contribute to a range
of psychological issues, it’s not directly linked to the development of
paranoid delusions.
For example, a person who had a traumatic experience might not remember
the event at all. Their mind “represses” the memory to protect them from
the distress it causes.

C. Identification might also be the defense mechanism at play.

Identification is a defense mechanism where an individual emulates the
behavior, traits, or attitudes of someone else, particularly someone more
powerful or superior. It’s not typically associated with paranoid delusions.
For instance, a young employee might start dressing like their boss and
adopting their mannerisms. This is identification, as they are trying to deal
with feelings of insecurity or inferiority by emulating someone they
perceive as successful or powerful.
3. Correct answer: B. The process of Projection. Projection is a
psychological defense mechanism where individuals attribute
characteristics, feelings, or impulses which are perceived as undesirable or
unacceptable to someone else. It’s an unconscious process that helps the
individual cope with difficult feelings or emotions. Imagine you’re
watching a movie in a theater. The projector takes the images from the film
and throws them onto the screen for everyone to see. Similarly, in the
psychological process of projection, an individual “projects” their own
undesirable characteristics or feelings onto someone else.
For example, a person who is being unfaithful in a relationship may accuse
their partner of infidelity. In this case, the person is not consciously aware
that the infidelity exists within themselves, so they project it onto their
partner.
Projection serves as a defense mechanism because it allows individuals to
avoid the discomfort or anxiety that can come from acknowledging these
undesirable feelings or traits in themselves. It’s like wearing a pair of
sunglasses that change the color of everything you see; the world hasn’t
changed color, but your perception of it has.
Incorrect answer options:
A. The act of Compensation. Compensation is a different type of defense
mechanism where an individual overachieves in one area to compensate for
failures or inadequacies in another. For example, a person who struggles
with social interactions might focus on excelling academically or
professionally.
C. The mechanism of Rationalization. Rationalization involves explaining
an unacceptable behavior or feeling in a rational or logical manner,
avoiding the true reasons for the behavior. For instance, a person who is
turned down for a promotion might rationalize it by saying they didn’t want
the additional responsibility.
D. The state of Dysphoria. Dysphoria is not a coping mechanism but a state
of unease or dissatisfaction with life. It’s often associated with mood
disorders, such as depression or bipolar disorder.
4. Correct answer: C. Rejection. The standard stages of the grieving
process, as proposed by psychiatrist Elisabeth Kübler-Ross in her 1969
book “On Death and Dying,” include five stages: Denial, Anger,
Bargaining, Depression, and Acceptance. These stages are often referred to
by the acronym DABDA. Rejection is not considered a standard stage of
the grieving process according to Kübler-Ross’s model. The term
“rejection” in the context of grief is not typically used in professional
literature and does not align with the established stages of grief.
Imagine you’re on a journey through a difficult terrain, like a dense forest
or a steep mountain. This journey represents the process of grieving. The
stages (Denial, Anger, Bargaining, Depression, and Acceptance) are like
the different types of challenges or landscapes you encounter on your
journey. For instance, denial could be compared to a thick fog that prevents
you from seeing the path ahead. Anger might be a steep, rocky incline
that’s difficult to climb. Bargaining could be a confusing crossroads where
you’re not sure which way to go. Depression might be a dark, shadowy
valley, and acceptance is the moment you see the light at the end of the
tunnel.
Rejection, in this context, doesn’t fit into the landscape of this journey. It’s
like a sudden cliff or a river that doesn’t naturally occur on the path you’re
following. It might be part of someone’s personal experience, but it’s not a
recognized stage in the established model of grief.
Incorrect answer options:
A. Anger. Anger is a recognized stage of the grieving process. It’s a natural
reaction to the loss and can be directed at oneself, others, or the situation.
B. Denial. Denial is the first stage of grief. It’s a common defense
mechanism that buffers the immediate shock of the loss, numbing us to our
emotions.
D. Bargaining. Bargaining is a typical reaction to feelings of helplessness
and vulnerability and is often a need to regain control.
5. Correct answer: C. Rationalization. Rationalization is a defense
mechanism in which controversial behaviors or feelings are justified and
explained in a seemingly rational or logical manner to avoid the true
explanation, and are made consciously tolerable—or even admirable and
superior—by plausible means. It is a form of making excuses.
Imagine you’re driving a car and you accidentally run a red light. Instead of
acknowledging that you made a mistake, you might rationalize it by saying,
“Well, there were no other cars around, so it was safe,” or “I’m in a hurry,
so it’s okay this time.” In reality, the subconscious motivation might be
impatience or lack of attention, but rationalization allows you to avoid
confronting these less favorable traits.
Rationalization not only prevents anxiety, it may also protect self-esteem
and self-concept. When conducted in moderation, rationalization can be an
effective defense mechanism. However, when done habitually, it can
prevent growth and development, and can lead to harmful behaviors being
overlooked.
Incorrect answer options:
A. Compensation. Compensation is a strategy whereby one covers up,
consciously or unconsciously, weaknesses, frustrations, desires, or feelings
of inadequacy or incompetence in one life area through the gratification or
(drive towards) excellence in another area. Compensation can cover a wide
range of areas from physical to intellectual to social. For instance, a person
who is not good at sports may focus on excelling academically.
B. Projection. Projection is a psychological defense mechanism in which
individuals attribute characteristics they find unacceptable in themselves to
another person. For example, a person who is rude may constantly accuse
other people of being rude.
D. Dysphoria. Dysphoria is a profound state of unease or dissatisfaction. In
a psychiatric context, dysphoria may accompany depression, anxiety, or
agitation. It is not a defense mechanism, but rather a state of emotional
distress.
6. Correct answer: B. Conversion disorder. Conversion disorder, also
known as functional neurological symptom disorder, is a condition where
patients present with physical neurological symptoms, such as weakness,
numbness, or seizures, but no neurological explanation can be found. It’s
believed that these symptoms arise in response to stressful or traumatic
situations, representing an attempt to resolve the conflict psychologically.
Imagine your brain as a computer that’s been working hard, processing a lot
of data. Suddenly, a particularly complex piece of data (representing a
stressful or traumatic event) comes in, and the computer can’t process it.
Instead of simply shutting down, the computer redirects the processing
power into another task, like running a screensaver. In the case of
conversion disorder, the brain “redirects” the stress into physical symptoms.
Conversion disorder is a complex and poorly understood condition. It’s
important to note that the symptoms are not under the patient’s conscious
control and are not considered to be feigned or intentionally produced.
Incorrect answer options:
A. Alzheimer’s disease. Alzheimer’s disease is a progressive
neurodegenerative disorder that affects memory, thinking, and behavior.
It’s primarily associated with the accumulation of beta-amyloid plaques and
tau tangles in the brain, leading to neuronal death. It’s not typically
associated with stress or trauma, and it doesn’t involve the sudden onset of
neurological symptoms in response to stress.
C. Depressive reaction. Depressive reaction, also known as major
depressive disorder, is a mental health disorder characterized by
persistently depressed mood or loss of interest in activities, causing
significant impairment in daily life. It’s associated with a variety of
symptoms, including sleep disturbances, changes in appetite or weight, and
feelings of worthlessness or guilt. While stress can be a trigger for
depressive episodes, the primary symptoms are emotional rather than
physical.
D. Bipolar disorder. Bipolar disorder is a psychiatric condition
characterized by extreme mood swings that include episodes of mania
(elevated mood, high energy, reduced need for sleep) and depression (low
mood, low energy, loss of interest in activities). While stress can trigger
episodes, the primary symptoms are mood disturbances, not physical
symptoms in response to stress.
7. Correct answer: A. Beta. Beta waves are the most commonly observed
waveform in an awake, alert individual who is actively thinking or
concentrating. They are high frequency (13-30 Hz), low amplitude brain
waves that are typically associated with active, busy or anxious thinking
and active concentration.
To visualize this, imagine a calm sea with small, frequent waves. These
waves represent the beta waves in our brain when we are awake and
actively engaged in mental activities. Just as the frequent waves on the sea
surface indicate a lot of activity, beta waves indicate a lot of mental
activity.

Incorrect answer options:
B. Theta. Theta waves are typically observed during light sleep or deep
relaxation, such as during meditation. They are low frequency (4-7 Hz),
high amplitude waves. Theta waves are like the larger, slower waves you
might see on the sea during a calm day, representing a state of relaxation or
light sleep.
C. Zeta. Zeta waves do not exist in the context of EEG waveforms.
D. Alpha. Alpha waves are typically observed when a person is awake but
in a relaxed state, often with eyes closed. They are moderate frequency (8-
13 Hz), moderate amplitude waves. Alpha waves can be thought of as the
waves you see on a calm sea when there’s a gentle breeze, representing a
state of calm wakefulness.
8. Correct answer: C. 90 minutes. During a typical night’s sleep, a person
goes through several sleep cycles, each lasting approximately 90 to 110
minutes. Each cycle includes stages of non-rapid eye movement (NREM)
sleep and a period of rapid eye movement (REM) sleep.
Imagine sleep as a journey on a circular train track. Each complete loop
around the track represents a sleep cycle. The train makes several stops
along the way, which represent the different stages of sleep. The REM sleep
stage is like a special stop where the train stays a bit longer and where
dreams occur. The train reaches this stop approximately every 90 minutes.
During the first sleep cycle, the REM sleep period is relatively short,
around 10 minutes. As the night progresses, REM sleep periods get longer,
with the final one lasting up to an hour.
Incorrect answer options:
A. 75 minutes.
B. 60 minutes.
D. 45 minutes.
While these time frames are close to the correct answer, they are not
accurate. The REM sleep cycle typically occurs approximately every 90
minutes, not every 75, 60, or 45 minutes. It’s like saying the train arrives
every hour when it actually arrives every 90 minutes. The difference might
seem small, but it’s important for understanding the structure of sleep.
9. Correct answer: C. Pincer grasp reflex. The pincer grasp reflex, which
involves the coordinated movement of the thumb and index finger to hold
an object, is not present at birth. This is a more complex motor skill that
typically develops around 9-10 months of age.
Imagine a baby’s motor skills as a building under construction. At birth, the
building’s foundation and first few floors (representing basic reflexes and
motor skills) are already built. However, the upper floors (representing
more complex skills like the pincer grasp) are still under construction. As
the baby grows and develops, construction progresses, and these upper
floors are gradually completed.
The development of the pincer grasp is a significant milestone in a baby’s
life because it allows them to feed themselves and explore their
environment in a more detailed way. It’s like giving the baby a set of tools
to interact more effectively with the world around them.
Incorrect answer options:
A. Moro reflex. The Moro reflex, also known as the startle reflex, is
present at birth and typically disappears around 4-6 months of age. It’s
elicited when the baby is startled by a loud sound or movement, especially
a falling movement. The baby reacts by throwing back their head,
extending out their arms and legs, crying, then pulling the arms and legs
back in.
B. Rooting reflex. The rooting reflex is present at birth and helps the baby
find the mother’s nipple or a bottle nipple for feeding. When the corner of
the baby’s mouth is touched or stroked, the baby will turn their head and
open their mouth to follow and “root” in the direction of the stroking. This
helps the baby find the breast or bottle to begin feeding.
D. Sucking reflex. The sucking reflex is also present at birth and is
triggered when something touches the roof of the baby’s mouth. The baby
will instinctively begin to suck on it. This reflex, along with the rooting
reflex, helps the baby feed.
10. Correct answer: C. Typically seen in toddlers aged 12 to 24
months.Parallel play is a form of play in which children play adjacent to
each other, but do not try to influence one another’s behavior. Children
usually play alone during parallel play but are interested in what other
children are doing. This is an important stage in a child’s social
development.
Imagine two toddlers as two ships sailing in the sea. During parallel play,
the ships are sailing in the same direction and can see each other, but they
are not interacting or influencing each other’s course. They are aware of
each other’s presence, but they are doing their own thing.
Parallel play allows children to enjoy the company of their peers without
the complexities of interaction. It’s like a stepping stone towards more
complex social interactions that come later in development, such as
associative play and cooperative play.
Incorrect answer options:
A. Between the ages of 5 to 10 months. At this age, infants are still
developing basic motor skills and are not yet ready for any form of social
play. They may enjoy watching other children, but their play is not
typically influenced by their peers.
B. Around 10 to 14 months of age. While some toddlers may start to show
signs of parallel play at this age, it’s not typically the predominant form of
play until a bit later, around 12 to 24 months of age.
D. Emerging during the period of 24 to 48 months. By this age, children
are typically engaging in more complex forms of social play. They are not
only aware of their peers but also start to interact with them more directly,
such as in associative play (where children play together but without a
common goal) or cooperative play (where children play together with a
common goal).
11. Correct answer: C. Utilizing compensation to address weaknesses.
Compensation is a psychological defense mechanism where people
overachieve in one area to compensate for failures or inadequacies in
another. It’s a way of covering up a perceived weakness by emphasizing a
strength or a trait that one considers more desirable.
Imagine a soccer player who isn’t very good at scoring goals. To
compensate for this weakness, the player might focus on becoming
excellent at passing the ball or defending, areas where they feel more
competent or confident. This way, they can still contribute significantly to
their team and feel valuable, despite their difficulty with scoring goals.
Compensation can be a healthy defense mechanism if it leads to
development of skills and doesn’t cause distress or harm. However, it can
be unhealthy if it leads to an imbalance in the person’s life or if it’s used to
cover up a problem that needs to be addressed directly.
Incorrect answer options:
A. Experiencing feelings of dysphoria. Dysphoria is a state of unease or
dissatisfaction with life, not a defense mechanism. It’s often associated with
depression, anxiety, or other mental health disorders.
B. Engaging in rationalization as a coping mechanism. Rationalization is
a defense mechanism where people create logical excuses for actions or
feelings that are socially unacceptable or uncomfortable. It’s a way of
explaining away behaviors or thoughts that might otherwise cause guilt or
embarrassment.
D. Projecting emotions onto others. Projection is a defense mechanism
where people attribute their own unacceptable thoughts, feelings, or
motives to another person. It’s a way of denying or externalizing
uncomfortable internal experiences.
12. Correct answer: A. Experiencing a moist mouth. A moist or wet
mouth is not typically associated with anxiety. In fact, the opposite is often
true. Anxiety and stress can activate the body’s “fight or flight” response,
which can lead to dry mouth, as the body diverts resources away from non-
essential functions like saliva production to more immediate needs.
Imagine being in a desert, where water is scarce. In this situation, you
would want to conserve water for the most essential functions, like
maintaining your body temperature and vital organ function. Similarly,
when you’re anxious, your body conserves resources for dealing with the
perceived threat, which can lead to a dry mouth.
Incorrect answer options:
B. Feeling dyspnea (shortness of breath). Shortness of breath or dyspnea
is a common symptom of anxiety. When a person is anxious, their body’s
“fight or flight” response can cause them to breathe faster and shallower,
which can make them feel like they’re not getting enough air.
C. Exhibiting gastrointestinal (GI) symptoms. Gastrointestinal
symptoms, such as stomachache, nausea, or diarrhea, are also common in
people with anxiety. The “fight or flight” response can disrupt the normal
functioning of the digestive system, leading to these symptoms.
D. Demonstrating hyperventilation (rapid breathing). Hyperventilation,
or rapid breathing, is another common symptom of anxiety. This is part of
the body’s “fight or flight” response, which prepares the body to respond to
a perceived threat. Hyperventilation can lead to feelings of breathlessness,
light-headedness, and other symptoms.
13. Correct answer: A. Experiencing narcolepsy. Narcolepsy is a
neurological disorder that affects the control of sleep and wakefulness.
People with narcolepsy experience excessive daytime sleepiness and
intermittent, uncontrollable episodes of falling asleep during the daytime.
These sudden sleep attacks may occur during any type of activity at any
time of the day.
In a typical sleep cycle, a person enters the early stages of sleep, followed
by deeper sleep stages and ultimately (after about 90 minutes) REM sleep.
For people suffering from narcolepsy, REM sleep occurs almost
immediately in the sleep cycle, as well as periodically during the waking
hours. It is in REM sleep that we can experience dreams and muscle
paralysis — which explains some of the symptoms of narcolepsy.
Incorrect answer options:
B. Undergoing transitional sleep. Transitional sleep refers to the stages of
sleep between wakefulness and deep sleep, not a condition where a person
falls asleep suddenly and without warning.
C. Experiencing REM absence. REM absence, or a lack of REM sleep,
would likely lead to symptoms of sleep deprivation, such as fatigue,
difficulty concentrating, and mood changes, but it would not cause a person
to fall asleep suddenly and without warning.
D. Experiencing cataplexy. Cataplexy is a symptom often seen in
narcolepsy, characterized by sudden muscle weakness triggered by strong
emotions such as laughter, anger, or surprise. While cataplexy can cause a
person to collapse, it does not cause them to fall asleep.
14. Correct answer: D. Having difficulties related to autotopagnosia.
Autotopagnosia, also known as somatotopagnosia, is a condition where a
person is unable to comprehend the orientation of different parts of their
body. This means they struggle to identify or acknowledge their own body
parts, such as their hand or foot, and their spatial relationships. This
condition is usually due to damage to the parietal lobe of the brain, which is
responsible for spatial sense and navigation.
Think of it like being lost in a city without a map or GPS. You know where
you want to go, but you can’t figure out which direction to take or how far
you need to go. Similarly, a person with autotopagnosia knows they have a
hand or foot, but they can’t figure out where it is in relation to the rest of
their body.
Incorrect answer options:
A. Experiencing symptoms of cataplexy. Cataplexy is a sudden and
uncontrollable muscle weakness or paralysis that comes on during the day
and is often triggered by a strong emotion such as laughter, surprise, or
anger. It is commonly associated with narcolepsy, a long-term neurological
disorder that involves a decreased ability to regulate sleep-wake cycles.
While it can be a debilitating condition, it does not affect a person’s ability
to recognize or locate their body parts.
B. Dealing with feelings of ergophobia. Ergophobia is an abnormal and
persistent fear of work or finding employment. It can be a debilitating
condition for some people, but it is a psychological issue rather than a
neurological one. It does not affect a person’s ability to recognize or locate
their body parts.
C. Showing signs of anosognosia. Anosognosia is a condition in which a
person who suffers from a disability seems unaware of or denies the
existence of their disability. This can happen in conditions like
schizophrenia, stroke, or brain injury. While it can affect a person’s
perception of their own health, it does not specifically cause difficulty in
identifying the location of body parts.
15. Correct answer: D. Feeling the urge to urinate. Panic disorder is
characterized by recurrent, unexpected panic attacks. Panic attacks are
sudden periods of intense fear that may include palpitations, sweating,
shaking, shortness of breath, numbness, or a feeling that something terrible
is going to happen. The maximum degree of symptoms occurs within
minutes and typically lasts for about 20 to 30 minutes.
While the urge to urinate can be a symptom of anxiety, it is not typically
associated with panic disorder. This symptom is more commonly associated
with conditions affecting the urinary system, such as urinary tract infections
or overactive bladder syndrome.
It’s like having a faulty alarm system in a building that goes off at the
slightest hint of trouble, even when there’s no real danger.
Incorrect answer options:
A. Experiencing chest pain. Chest pain is a common symptom of panic
disorder. During a panic attack, the body’s fight-or-flight response is
activated. This can cause the heart to beat faster and stronger, which can
lead to feelings of chest pain or discomfort. It’s like a car engine revving up
in response to a perceived threat, even if there’s no actual need for it.
B. Dealing with excessive perspiration. Excessive perspiration is another
common symptom of panic disorder. The body sweats as part of the fight-
or-flight response, which is activated during a panic attack. This is the
body’s way of trying to cool down as it prepares to respond to a perceived
threat. It’s like turning on the air conditioning in a car when the engine
starts to overheat.
C. Experiencing nausea. Nausea is also a common symptom of panic
disorder. Anxiety and fear can disrupt the normal functioning of the
digestive system, leading to feelings of nausea or upset stomach. It’s like a
roller coaster ride – the intense fear and anxiety can make your stomach
churn.
16. Correct answer: A. Experiencing the stage of integrity vs. despair.
According to Erik Erikson’s theory of psychosocial development, a 70-
year-old adult would be in the stage of integrity vs. despair. This is the final
stage of life, typically beginning at retirement and continuing until death.
During this stage, individuals reflect on the life they have lived and come to
terms with it.
If they look back on a life well-lived, they feel a sense of integrity and
satisfaction. It’s like reading a good book and feeling content when you
reach the end, even if there were some difficult chapters.
However, if they look back with regret and a sense of missed opportunities,
they may feel despair. This is akin to looking back on a journey and
regretting the paths not taken or the sights not seen.
Incorrect answer options:
B. Going through the stage of generativity vs. stagnation. The stage of
generativity vs. stagnation typically occurs during middle adulthood (ages
40 to 65). During this stage, individuals strive to create or nurture things
that will outlast them, often by having children or contributing to positive
changes that benefit other people. If they fail to achieve this sense of
generativity, they may feel stagnant and unproductive.
C. Engaging in the stage of longevity vs. guilt. There is no stage of
longevity vs. guilt in Erikson’s theory of psychosocial development. This
may be a misunderstanding or misinterpretation of the stages.
D. Encountering the stage of intimacy vs. isolation. The stage of
intimacy vs. isolation typically occurs during early adulthood (ages 20 to
40). During this stage, individuals explore relationships leading toward
longer-term commitments with others. Success in this stage leads to the
virtue of love. Failure results in feelings of isolation and loneliness.
17. Correct answer: C. Engaging in the stage of generativity vs.
stagnation. According to Erik Erikson’s theory of psychosocial
development, a 60-year-old adult would typically be in the stage of
generativity vs. stagnation. This stage generally occurs between the ages of
40 and 65. During this period, adults strive to create or nurture things that
will outlast them; often this takes the form of parenting or mentoring, but it
can also involve other forms of creative output and productivity.
Generativity is the sense of contribution to future generations, while
stagnation is the feeling of being unproductive or uninvolved in the world.
Think of it like gardening. A person in the generativity stage is like a
gardener who plants seeds and nurtures them to grow, taking satisfaction in
knowing that these plants will continue to live and bloom even after they’re
gone. On the other hand, someone experiencing stagnation might feel like a
gardener who’s stopped tending to their garden, leading to a sense of
dissatisfaction as they see the garden wither and fail to thrive.
Incorrect answer options:
A. Experiencing the stage of longevity vs. guilt. This is not a recognized
stage in Erikson’s theory of psychosocial development.
B. Going through the stage of intimacy vs. isolation. This stage typically
occurs during early adulthood (20s to early 40s). It’s a time when people
explore personal relationships and either form lasting intimate bonds or
become isolated from others.
D. Encountering the stage of integrity vs. despair. This stage is typically
experienced in late adulthood (65 years and older). It’s a time when people
reflect on their lives and either feel a sense of satisfaction (integrity) or
regret (despair).
18. Correct answer: B. Going through the stage of intimacy vs.
isolation. According to Erik Erikson’s theory of psychosocial development,
a 20-year-old adult would typically be in the stage of intimacy vs. isolation.
This stage generally occurs during early adulthood, from around 20 to 40
years of age. During this period, the main focus is on forming intimate,
loving relationships with other people. Success in this stage will lead to the
virtue of love. If young adults can form intimate relationships and get
through this stage, they can avoid feeling isolated and lonely.
Imagine this stage as a team-building exercise. The individual is like a team
member trying to form strong, supportive relationships with their peers. If
they succeed, they feel a sense of camaraderie and belonging (intimacy). If
they fail, they may feel like an outsider, disconnected and alone (isolation).

Incorrect answer options:

A. Experiencing the stage of generativity vs. stagnation. This stage
typically occurs during middle adulthood, from around 40 to 65 years of
age. It’s a time when people strive to create or nurture things that will
outlast them, such as through parenting or mentoring.

C. Engaging in the stage of integrity vs. despair. This stage is typically

experienced in late adulthood (65 years and older). It’s a time when people
reflect on their lives and either feel a sense of satisfaction (integrity) or
regret (despair).

D. Encountering the stage of longevity vs. guilt. This is not a recognized

stage in Erikson’s theory of psychosocial development.

19. Correct answer: A. Experiencing brainwave activity in the Theta

frequency range. During light sleep, which includes the first two stages of
the sleep cycle, the brain primarily exhibits Theta wave activity. Theta
waves, which have a frequency range of about 4 to 7 Hz, are associated
with reduced consciousness, relaxation, and light sleep. This is the stage
where you can be awakened easily, and if you were to wake up, you might
feel like you haven’t really been sleeping.
Think of Theta waves as the background music in a movie scene where a
character is just starting to drift off to sleep. It’s not the deep, dream-filled
sleep (which would be represented by different music), but the initial,
lighter stages of sleep.

Incorrect answer options:

B. Having brainwave activity in the Beta frequency range. Beta waves,
which range from 12 to 30 Hz, are typically associated with active, busy or
anxious thinking and active concentration. This is more common in wakeful
states.

C. Showing brainwave activity in the Alpha frequency range. Alpha

waves, which range from 8 to 12 Hz, are typically associated with relaxed,
calm wakefulness. They are present during things like meditation and quiet
reflection.

D. Zeta that is commonly found in sleep patterns. Zeta is not a

recognized category of brainwave activity in the context of sleep patterns.

20. Correct answer:

B. Displaying neologisms. Neologisms, in the context of psychiatry, refer
to made-up words or phrases that only have meaning to the individual who
uses them. This is often seen in conditions like schizophrenia or other types
of psychotic disorders. It’s like creating a new language that only the
individual understands.
Think of it like inventing a new word in a game of Scrabble that only
makes sense to you, but not to the other players. It’s a word that fits your
understanding of the game, but it doesn’t fit within the established rules or
language of the game.

Incorrect answer options:

A. Neolithic. The term “Neolithic” refers to the last stage of the Stone Age,
a period of human prehistory. It has no relevance to psychiatric conditions
or language patterns.

C. Demonstrating verbalism. Verbalism is not a recognized term in

psychiatry.
D. Experiencing delusional blocking. Delusional blocking is not a
recognized term in psychiatry. Blocking, or thought blocking, refers to a
sudden interruption in thought or speech that can occur in certain
psychiatric conditions, but it doesn’t involve the creation of new,
meaningless words.