SECTION A

OBJECTIVE QUESTIONS
1. Disulfiram (Antabuse) is prescribed for a client with alcoholism. The nurse
understands that this medication works on the principle of which of the following
therapies?
a. Aversion therapy
b. Desensitization
c. Milieu therapy
d. Self-control therapy

2. Which one of these measures is the most appropriate approach by the nurse to
control a manic client who monopolizes a group therapy session:
a. Ask the client to leave
b. Refer the client to another group.
c. Suggest that the client stop talling and try listening to others
d. Tell the client to stop monopolizing the group

3. A male client with delirium becomes agitated and confused in his room at night. The
best initial intervention by the nurse is to
a. keep the television and a soft light on during the night
b. move the client next to the nurse's station
c. play soft music during the night, and maintain a well-
lit room
d.use a night-light and turn off the television

4. A woman comes into the emergency room in a severe state of anxiety after a car
accident. The most important nursing intervention is to
a. encourage the client to talk about her feelings and concerns
b. put the client in a quiet room
c. remain with the client
d. teach the client deep breathing
5. As part of the nurse's responsibility of serving the antipsychotic drugs, she needs to
monitor the schizophrenic client with signs of tardive dyskinesia. The most likely
clinical manifestations of tardive dyskinesia are
a. abnormal breathing through the nostrils
b. abnormal movements and involuntary movements of the mouth, tongue and face
c. severe headache, flushing, tremor and ataxia
d. severe hypertension, migraine headache, and marbles in the mouth syndrome.
6. The best immediate priority of care to be rendered to a psychotic client who is
pacing, agitated, and presenting aggressive gestures is:
a. assist the staff in caring for the client in a controlled environment
b. offer the client a less stimulated area to calm down and gain control
c. provide safety for the client and other clients on the ward
d. provide the clients on the units with a sense of comfort and safety
7. A client was admitted to a medical unit with acute blindness without any organic
reason why client cannot see. Data collection reveals that client became blind after
witnessing a hit and run car accident, when a family of three was killed.
The nurse suspects that the client may be experiencing a
a. conversion disorder
b. dissociative disorder
c. psychosis
d. repression

8. The nurse recognizes that paranoid delusions usually are related to the defense
mechanism of ...
A. identification
B. projection
C. repression
D. regression

9. A client is observed to remain homebound except when accompanied outside by the

spouse. The nurse determine that the client has
a. agoraphobia
b. claustrophobia
c. hypochondriasis
d. social phobia

10. A nurse is monitoring a client who abuses alcohol for signs of alcohol withdrawal.
Which of the following would alert the nurse to the potential for delirium tremors
(DTs)?
a. Hypertension,
changes in level of consciousness,
hallucinations
b. Hypotension, ataxia, vomiting
c.Hypotension, coarse hand tremors, agitation.
d. Stupor, agitation, muscular rigidity

11. A client is admitted to the psychiatric unit after a serious suicidal attempt by
hanging. The nurse's most important aspect of care is to maintain client safety by
a. assigning a staff member to the client who will remain with the client at all
times
b. admitting the client to a seclusion room where all potentially dangerous articles are
removed.
c. removing the client's clothing and placing the client in a hospital gown.
d. requesting that a peer remain with the client at all times.
12. The police arrive at the emergency room with a client who has seriously lacerated
both wrists. The initial nursing action is to
a. administer an antianxiety drug
b. encourage and assist the client to ventilate feelings
c. examine and treat the wound sites
d. secure and record a detailed history
13. A nurse receives a telephone call from a male client who states that he wants to kill
himself and has a bottle of sleeping pills in front of him. The best nursing action is to
a. insist that the client give you his name and address so that you can get the police
there immediately.
b. keep the client talking and allow the client to ventilate feelings
c. keep the client talking, signal to another staff member to trace the call so that
appropriate help can be sent.
d. use therapeutic communications, especially the reflections of feelings

14. A nurse is planning care for a client who is being hospitalized because the client
has been displaying violent behavior and is at risk for potential harm to others. Which
of the following would NOT be a component of the plan of care?
a. assign the client to a room at the end of the hall to avoid disturbing the other
clients
b. ensure that a security officer is within the immediate area.
c. face the client when providing care
d. keep the door to the client's room open when with the client

15. Which of the following laboratory studies will the nurse specifically review to
monitor for the adverse reaction associated with the use of a phenothiazine?
a. White blood cell count
b. Platelet count
c. Cholesterol level
d. Blood urea nitrogen

16. A client receiving thioridazine (Mellaril) complains that he feels very

, "faint" when he tries to get out of bed in the morning. The nurse recognizes this
compliant as a symptom of:
a. Cardiac dysrhythmias
b. Postural hypotension
c. Psychosomatic symptoms
d. Respiratory insufficiency
17. A psychiatrist orders Phenobarbital sodium 10mg by mouth daily. The medication
bottle is labeled 15mg per 5ml. What dosage will the nurse administer?
a. 2.5 ml
b. 3.3 ml
c. 5 ml
d. 10 ml
18. Which one of the following community groups provides support to clients with
problem of alcoholism?
a. Al Anon
b. Alcoholics Anonymous
c. Families Anonymous
d. Fresh Start.
19. Anxiety disorders are a group of disorders characterized by the following clinical
features EXCEPT
a. avoidance of the anxiety-provoking stimulus
b. chronic worry
c. delusions of unworthiness
d. physical symptoms

20. At a graduation ceremony of your school, your best friend was invited to give a
vote of thanks. As soon as she mounted the podium, she started sweating profusely,
shaking, had thought block, and could not alter a word until the master of the
ceremony saved her from an obvious embarrassment by collecting the microphone
from her. Which of the following conditions is your friend likely to suffer from?
a. Agoraphobia
b. Social phobia
c. Specific phobia
d. Panic attack

21.. In the management of alcoholism, A A refers to

a. Alcoholics Anymous
b. Alcoholics Anonymous
c. Alcohol Anymous
d. Alcohol Anonymous

22. Korsakoff's psychosis is characterized by the following except

a. arrhythmia
b. confabulation
c. confusion
d. loss of recent memory
23. Which of the following defense mechanisms are mostly used by alcoholics?
a. denial and projection
b. denial and rationalization
c. denial and sublimation
d. sublimation and rationalization
24. All the following are psychosomatic disorders except
a. bronchial asthma
b. epistaxis
c. migraine
d. peptic ulcer
25. All the following are effects of alcoholism except
a. Paralysis agitans
b. Wernicke's encephalopathy
c. Peripheral neuropathy
d. Korsakoff's psychosis

26. When a psychiatric patient impulsively acts out aggression against a member of the
therapeutic team, the most appropriate first aid treatment is
a. beat the patient up and calm him/her
b. both hands and feet of the patient should be tie behind him/her
c. stripping the patient naked and lock him/her up
d. to go to the aid of the member of the therapeutic team without causing harm to
the patient.

27. One of these psychiatric disorders in which psychological factors contribute to the
initiation or exacerbation of physical conditions is recognized as
a. anxiety disorders
b. organic brain syndrome
c. psychosomatic disorders
d. somatoform disorders

28. The psychiatric condition which is characterized by the belief that the body is
deformed in some specific way is termed
a. body dysmorphic disorder
b. body dysmorphoric disorder
c. hypochondriasis
d. somatization

29. Food substances that should be excluded from the diet of clients on MOAI should
NOT contain
a. Dopa
b. Dopamine
c. Tyramine-dopa
d. Serotonin

30. A typical hallucinatory content consists of a voice keeping up of running

commentary on the client's behavior or thoughts using the 1s person or third person
pronoun is indicative of
a. delirium
b. mania
c. major depression
d. schizophrenia
31. The tendency of a demented client leaving his home unnoticed to a familiar place
and could not recall land mark features to trace his /her way home is said to be
a. agnosia
b. anterograde amnesia
c. visuol-spatial orientation
d. wandering

32. By legal terms, a psychiatric hospital is established by the

a. chief administrator
b. legislative instrument
c. minister of health
d. President

33. A nurse is caring for a client with a diagnosis of depression.

The nurse monitors for signs of constipation and urinary retention knowing that these
problems are most likely due to
a. inadequate dietary intake and dehydration
b. lack of exercise and poor diet
c. poor dietary choices
d. psychomotor retardation and side effects of medication

34. A voluntary patient can be discharged after giving notice of

a. 3 days
b. 2 days
c. 72 days
d. 32 days

35. The duration for court order admission for prolonged treatment is:
a. 6 months
b. 12 months
c. 18 months
d. 16 months
36. For the overall administration of a psychiatric hospital, the Minister appoints a
a. chief administrator
b. hospital administrator
c. hospital secretary
d. Psychiatrist

37. An involuntary patient can be discharged without going to court when his case is
addressed by the
a. Hospital visitor
b. Mental health review tribunal
c. Psychiatrist
d. Visiting committee
38. The diagnostic criteria for post-traumatic stress disorder includes the following
except
a. feeling of detachment
b. persistent avoidance of non-stimuli associated with the trauma
c. person's response involves intense fear and horror
d. reliving of the tragic event

39. A client with major depression is unable to address activities of daily living. The
most appropriate nursing intervention is to
a. feed, bath and dress the client as needed until the client can perform these activities
independently
b. structure the client daily activities so that adequate time can be devoted to the
client's assuming responsibility for the activities of daily living
c. offer the client choices and consequences to the failure to comply with the
expectation of maintaining activities of daily living
d. have the client's peers confront the client about how the noncompliance in
addressing activities of daily living affects the management.

40. A psychological disorder in which an anxiety-provoking impulse is converted

unconsciously into functional symptoms is
a. conversion
b. dissociative
c. hypochondriasis
d. somatization

41. One of these is NOT an immediate clinical manifestation of post-traumatic stress

disorder:
a. Irritability
b. Lack of concentration
c. Recurring flashbacks
d. Tremors

42. One of these is of the highest nursing action to be taken when organizing indoor
recreational activities for in-patients?
a. Assist client to identify recreational activity of interest
b. Allow client to express his. emotions and anxieties before or during the activity
c. Arrange seats in recreational ward according to types of games to be played:
d. Observe patient's attitude and behaviour during the activity

43. Photosensitization is a side effect associated with the use of

a. artane
b. lithium carbonate
c. ritalin
d. thorazine
44. If a client refuse to abide by his diet restrictions while taking a MAOI, he is likely
to develop
a. an occipital headache
b. generalized urticaria
c. severe muscle spasm
d. sudden severe hypotension

45. An extra pyramidal symptom that is potentially irreversible side effect of a

antipsychotic drugs is
a. oculogyric crisis
b. pseudo parkinsonism
c. tardive dyskinesia
d. torticollis

46. Trihexyphenidyl (artane) or benztropine (cogentin) is often prescribed in conjuction

with
a. antidepressants
b. antianxiety agents
c. antipsychotic agents
d. barbiturates

47. Abrupt withdrawal from barbiturate could cause a person to experience

a. ataxia
b. urticaria
c. diarrhea
d. seizures

48. A client was observed to be pacing, making rocking motions while sitting and
frequently changing positions. This feeling of restlessness experienced by this client is
recognized as
a. agitation
b. akathisia
c. bradykinesia
d. cogwheel rigidity

49. Ama complaints of having difficulty in initiating movement, decreased arm-swing

while walking with typical shuffling gait and flat affect. This is recognized as
a. akinesia
b. bradykinesia
c. muscle rigidity
d. neuroleptic-induced parkinsonism
50. The relatives of James were questioning the efficacy of the antipsychotic agents
administered to James within thelst week of his admission. In your response to their
concern, how many weeks does it takes the antipsychotic agent, when it is
administered, to produce its desire effect on client?
a. 1 to 2
b. 1 to 3
c. 2 to 3
d. 3

51. A méntal subnormal personal who is capable of performing simple tasks under
close supervision is recognized as having an IQ of
a. 50-70
b. 35-50
с. 20 - 35
d. below 20 e.

52. Xenyo, a presenile demented client, persistently exhibits a cognitive disturbance of

a failure to recognize or identify objects despite intact sensory function. This is
recognized as a symptom of Alzheimer's disease known as
a. agnosia
b. amnesia
c. aphasia
d. apraxia

53. In focal lobe epilepsy, client is MOST likely to exhibit a experienced. This is said to
be
sense of feeling that the present situation has been previously
a. déjà vais
b. déjà vecu
c. déjà vu
d. j'amais yu
54. A client is identified to becoming stooped with festinating gait making stopping
difficult when he walks and predisposed him to falls. This is a recognized feature of
a. Alzheimer's' disease
b. Huntington's chorea
c. Parkinsonism
d. Pick's disease
55. A nurse is informed that a client is presenting with specific phobic disorder. Which
one of these cognitive- behavioural therapies would she considers MOST appropriate
for this client?
a. Flooding
b. Implosion
c. Social skills training
d. Systematic desensitization
56. Pathological intoxication is otherwise known ...
a. Alcoholic hallucinations
b. alcoholic paranoia
c. dipsomania
d. mania à potu

57. Differences in feelings and behaviour between mentally ill and mentally healthy
persons are thought to be just a matter of
a. Degree
b. Deviance
c. Quality
d. Vulnerability

58. Ama sees a piece of rag on her table and screams that it is a snake. This behaviour
is referred to as ...
a. Delusion
b. Hallucination
c. Illusion
d. Phobia

59. Flight of ideas means, the patient...

a. is overwhelm by his thoughts
b. repeats ideas suggested to him
c. sees birds flying from his head
d. verbalizes his thoughts

60. If a patient admits hearing his own voice repeated to him, he is most likely having
a. alcoholic hallucination
b. echo de pense
c. echolialia
d. pseudo-hallucinosis

61. Confabulation refers to

a. automatic speech
b. constant repetition of sound hears
c. going round and round object
d. fabrications invented to fill memory gap

62. In which of these forms of delusion does the patient deny the existing part of his
body?
a. grandiose delusion
b. nihilistic delusion
c. persecutory delusion
d. systematized delusion
63. A client expresses the belief that the BNI is out to kill him.
This is an example of:
a. a hallucination
b. an error in judgment
c. a delusion of persecution
d. a self-accusatory delusion
64. The most obvious symptom of catatonic schizophrenia is disturbance of
a. emotion
b. movement
c. speech
d. thought

65. In waxy flexibility, the patient

a. adopts an usual position himself for a long time
b. repeats all acts seen
c. repeats all sound heard
d. adopts strange position fixed by someone else

66. The major reason for treating severe emotional disorders with tranquilizers is to
a. reduce the antisocial symptoms
b. prevent secondary complication
c. prevent destructiveness by the client
d. make the more amenable to psychotherapy

A depressed patient on your ward who had taken lethal dose of a sedative in a bid to
commit suicide is unwilling to provide any history leading to her action. Use the above
for question 68 to 71.
67. The nurse's main task in this instance is to
a. allow her freedom of movement to enable her verbalize
b. allow the presence of friends to induce her to talk
c. maintain her safety and security
d. provide a calm and comfortable environment

68. Which of the following symptoms if they occurred in the above patient would
strongly suggest that the patient has had an organic brain damage from the drug?
a. auditory hallucination
b. elaborate delusions
c. sudden difficulty with memory and orientation
d. Withdrawal from others for a long time.
69. Later, the above patient told the nurse she planned killing herself "because her
enemies closed in on her". In evaluating her suicidal risk, the nurse should recall that.
a. patient is most likely to commit suicide again
b. females succeed in committing suicide more than men
c. patients who express suicidal gestures do not commit suicide
d. suicide patients are best nursed at the side-wards
70. Which one of this information suggests that the above patient just attempted suicide?
She
a. called for help soon after taking the drug
b. drunk a lethal dose of the drug
c. has since been saying 'life is not worth living'
d. is surprise she didn't die
Mary Ofori, 16, has been admitted to a Psychiatric hospital for further treatment after
she had drunk some DDT insecticide. She has been staying with her step mother after
her parents divorced twelve years ago. Use the above for question 71 and 72.

71. Which of these types of suicide was attempted by Mary?

a. anomic
b. altruistic
c. egoistic
d. parasuicide

72. The nursing management of Mary will focus on which of the following activities?
i protecting patient from injury
ii protecting staff and other patients
iii. reinforcing healthy coping mechanism iv. patient and family teaching
A. I, II, III only
B. I, II, IV only
C. III, IV & I only
D. I, II, III & IV
73. The commonest drugs prescribed to manage schizophrenia are chosen from
A.antidepressants
B. major tranquillizers
C. minor tranquilizers
D. sedatives

74. The nurse caring for the depressed patient should recall that
a. all depressed patients can commit suicide
b. depressed patient love being cheered up initially
c. patients do not commit suicide once they hint someone
d. self-destructive thoughts expressed by patient must be kept secret
75. Depressed clients seem to do best in settings where they have
a. a great deal of stimuli .
b. a simple daily schedule
c. many varied activities
d. to make only simple decision

76. Organic brain syndrome is caused by

I. social isolation
II. infection
III. neoplasm
IV. degenerafive disease
a. I, II & III only
b. II, III & IV only
c. III, TV & I only
d. I, II, III & IV

77. Which of the following diets should be avoided by a patient taking monoamine
oxidaze inhibitors (MAOI)?
a. okro stew with kenkey
b. light soup with agidi
c. broad beans stew with gari
d. palm nut soup with fufu

78. on being discharged, a client with psychiatric problems should be encouraged to

a. go back to regular activities
b. call the unit whenever upset
c. continue in an aftercare situation
d. find a group that has similar problems
79. Which of the following is not a legal function of the psychiatric nurse?
a. advocating for patients
b. counseling
c. discharging patients
d. serving prescribed medication

80. Another term for the superego is

a. conscience .
b. ego strength
c. ideal self
d. executive power
81. A manic patient may refuse to eat because he feels he
a. doesn't need the food
b. doesn't deserve the food
c. should avoid other patients
d. is too busy to eat
82. Which of the following is NOT a symptom of Korsakoff's syndrome?
a. circumstantially
b. confabulation
c. intolerance to alcohol
d. peripheral neuritis

83. A recognized feature of alcohol withdrawal is

a. cessation of sweating
b. bradycardia
c. dilated pupils
d. tremors

84. The rationale for serving diazepam (valium) at night is

i. to reduce it side effects
ii. enable patient engage in activities during the day
iii. relieve anxiety more quickly
iv. increase patient's appetite for food
A. I & II only
B. II & III only
C. III & IV only
D. I,.I, III, IV

85. In communication, the nurse can MOST effectively achieve the goal of helping/
arriving at a decision by which of the following?
a. giving the patient advice about what is best
b. encouraging the patient to ask a spouse what to do
c. helping the patient to explore alternative choices
d. sharing feelings with patient if the decision is faulty

86. Benztropine (Congentin) is often used in conjunction with the

a. anti-depressants
b. barbiturates
c. anti-psychotic drugs
d. anxiolytics

87. A nurse bangs the door heavily before leaving the room after she was reprimanded
by her supervisor. This behaviour is an example of
a. displacement
b. projection
c. rationalization
d. sublimation
88. A voluntary patient can be discharged after giving notice of
a. 3 days
b. 2 days
c. 72 days
d. 32 days

89. The duration for, court order admission for prolonged treatment is:
a. 6 months
b. 12 months
c. 18 months
d. 24 months

90. A client is pacing the floor and appears extremely anxious.

The nurse approaches in an attempt to alleviate the client's anxiety. The most
therapeutic question by the nurse would be:
a. "Are you feeling upset right now?"
b. "Would you like me to walk with you?"
c. "Shall we sit and talk about your feelings?"
d. "Would you like to go to the gym and work out?"

91. A female client with aggressive behavior tells the nurse,

"Everyone hates me". The best response by the nurse would be:
a. "Everyone does not hate you"
b. "Tell me more about this"
c. "That feeling is part of your illness"
d. "You may be doing something to promote this feeling"

92. A client who has been hospitalized with schizophrenia tells the nurse, "My heart
has stopped and my veins have turned to glass". The nurse recognizes this as an
example of :
a. Hypochondriasis
b. Depersonalization
ç. Nihilistic delusion
d. Somatic delusion

93. A false sensory perception without any external stimuli may be exhibited by a
client who is suffering from one of these mental disorders
a. Anxiety reaction
b. Exogenous depression
c. Major depression
d. Social phobia
94. A discharged client in your neighborhood comments to you during one of your
home visits that "well I guess I can stop taking those medications". The most
appropriate response by you would be:
a. "I'm sorry to hear that"
b. "In your next review date seek the opinion of your doctor"
c. "No, it wouldn't be wise to stop taking them now"
d. "Why do you say that?"

95. Which one of these hypothetical structures of the personality attempts to satisfy
drives immediately through impulse, irrational behaviors and fantasy?
a. Id
b. Ego
c. Super ego
d. Subconscious

96. Which one of the following disorders is characterized by persistent

recurrence of thought of hand washing accompanied by the acts that the sufferer
considers to be absurd but finds it very difficult to resist.
A. Anxiety neurosis
B. Panic attack
C. Obsessive-Compulsive neurosis
D. Phobia

97. One of these disorders is characterized by an intense, irrational fear of specific

objects:
A. Claustrophobia
B. Nycytophobia
C. Simple phobia
D. Social phobia

98. An individual is said to have developed tolerance to alcohol when he/she;

A. takes alcohol everyday
B. decreases the quantity each time to achieve the same desired effect
C. increases the quantity each time to achieve the same desired effect
D. takes the same amount each time to achieve the same desired effect

99. Which one of these antipsychotic drugs is very useful for management of a client
with anxiety state:
A. Artane
B. Largactil
C. Phenobarbitone
D. Valium
100. A nurse plans to assess a client for the physiological functioning of depression.
The nurse assesses for these signs by determining the client's
a. ability to drink, concentrate and make decisions
b. appetite, weight and sleep patterns
c. level of self esteem
d. level of suicidal ideations

OBJECTIVES SECTION B
101. 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"

102. 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. Short term seclusion
B. Neuroleptic medication
C. Electroconvulsive therapy
D. Psychosurgery

103. 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. "I know you are frightened, but I do not see spiders on the wall"
B. "You're having hallucination, there are no spiders in this room at all"
C."Would you like me to kill the spiders"
D."I can see the spiders on the wall, but they are not going to hurt you"

104. 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. Faith in his wife
C.Better self-control
D.Feeling of self-worth
105. 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 nearest relative & their phone number
C. Reason for the suicide attempt
D.Name of the ingested medication & the amount ingested
106. 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. Using open ended question and silence.
B. Focusing on self-disclosure of own food preference
C.Offering opinion about the need to eat
D. Verbalizing reasons that the client may not choose to eat

107. 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
statements illustrate:
A.Loosening of association
B. Neologisms
C. Flight of ideas
D. Echolalia

108. 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. Decrease oxygen to the brain increases confusion and disorientation
B. Grand mal seizure activity depresses respirations C.Anesthesia is administered
during the procedure
D.Muscle relaxations given to prevent injury during seizure activity depress
respirations.

109. 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 identifies anxiety producing situations
C. The client ignores feelings of anxiety
D. The client maintains contact with a crisis counselor

110. 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. Rake the client into the dayroom to be with other clients
B. Sit beside the client in silence and occasionally ask open-ended question
C.Leave the client alone and continue with providing care to the other clients
D. Ask the client direct questions to encourage talking
111. The initial nursing intervention for the significant others during shock phase of a
grief reaction should be focused on:
A.Presenting full reality of the loss of the individuals
B. Mobilizing the individual's support system
C.Directing the individual's activities at this time
D.Staying with the individuals involved

112. Jerry is diagnosed with amphetamine psychosis and was admitted in the
emergency room. Nurse Owusu would most likely prepare to administer which of the
following medication?
A. Valium
B. Haldol
C.Librium
D. Atiyan
113. John who has a chronic user of cocaine reports that he feels like he has
cockroaches crawling under his skin. His arms are red because of scratching. The nurse
in charge interprets these findings as possibly indicating which of the following?
A.Flashback
B. Formication
C.Delusion
D.Confusion

114. Which of the following liquids would Nurse Linda administer to a female client
who is intoxicated with phencyclidine (PCP) to hasten excretion of the chemical?
A.Shake
B. Cranberry Juice
C. Tea
D.Grape juice

115. Which of the following assessment would provide the best information about the
client's physiologicresponse and the effectiveness of the medication prescribed
specifically for alcohol withdrawal?
A. Nutritional status
B. Mental alertness
C. Vital signs
D. Sleeping pattern

116. The nursing assistant tells Nurse Diana that the client is not in the dining room for
lunch. Nurse Ronald would direct the nursing assistant to do which of the following?
A. Tell the client he'll need to wait until supper to eat if he misses lunch
B. Inform the client that he has 10 minutes to get to the dining room for lunch
C. Take the client a lunch tray and let the client eat in his room
D. Invite the client to lunch and accompany him to the dining room
117. When developing a plan of care for a female client with acute stress disorder who
lost her sister in a car accident. Which of the following would the nurse expect to
initiate?
A.Postponing discussion of the accident until the client brings it up
B. Helping the client to evaluate her sister's behavior
C.Facilitating progressive review of the accident and its consequences
D.Telling the client to avoid details of the accident

118. Which of the following would Nurse Rita use as the best measure to determine a
client's progress in rehabilitation?
A. The way he gets along with his parents
B. The amount of responsibility his job entails
C. The number of drug-free days he has
D. The kinds of friends he makes

119. After administering naloxone (Narcan), an opioid antagonist, Nurse Rita should
monitor the female client carefully for which of the following?
A.Epilepsy
B. Cerebral edema
C.Respiratory depression
D.Kidney failure

120. A female client is brought by ambulance to the hospital emergency room after
taking an overdose of barbiturates is comatose. Nurse Emma would be especially alert
for which of the following?
A.Myocardial Infarction
B. Epilepsy
C.Renal failure
D.Respiratory failure

121. The initial nursing intervention for the significant-others during shock phase of a
grief reaction should be focused on:
A. Presenting the full reality of the loss of the individuals.
B. Directing the individual's activities at this time.
C. Staying with the individuals involved.
D. Mobilizing the individual's support system.

122. One morning, nurse Diane finds a disturbed client curled up in the fetal position in
the corner of the dayroom. The most accurate initial evaluation of the behavior would
be that the client is:
A. Physically ill and experiencing abdominal discomfort.
B. Tired and probably did not sleep well last night.
C. Attempting to hide from the nurse.
D. Feeling more anxious today.
123. Nurse Bea notices a female client sitting alone in the corner smiling and talking to
herself. Realizing that the client is hallucinating. Nurse Bea should:
A. Invite the client to help decorate the dayroom.
B. Leave the client alone until he stops talking.
C. Ask the client why he is smiling and talking.
D. Tell the client it is not good for him to talk to himself

124. When being admitted to a mental health facility, a young female adult tells Nurse
Mylene that the voices she hears frighten her. Nurse Mylene understands that the client
tends to hallucinate more vividly:
A. While watching TV
B. During mealtime
C. During group activities
D. After going to bed

125. Nurse John recognizes that paranoid delusions usually are related to the defense
mechanism of:
A. Projection
B. Identification
C. Repression
D. Regression

126. Mr. Marquez reports losing his job, not being able to sleep at night, and feeling
upset with his wife. Nurse John responds to the client, "You may want to talk about
your employment situation in group today." The Nurse is using which therapeutic
technique?
A. Observations
B. Restating
C. Exploring
D. Focusing
127. Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely
agitated in the dayroom while other clients are watching television. He begins cursing
and throwing furniture. Nurse Oliver first action is to:
A. Check the client's medical record for an order for an as-needed I.M. dose of
medication for agitation.
B. Place the client in full leather restraints.
C. Call the attending physician and report the behavior.
D. Remove all other clients from the dayroom.
128. What is Nurse John likely to note in a male client being admitted for alcohol
withdrawal?
A. Perceptual disorders
B. Impending coma
C. Recent alcohol intake
D. Depression with mutism
129. Aira has taken amitriptyline HCL (Elavil) for 3 days, but now complains that it
"doesn't help" and refuses to take it. What should the nurse say or do?
A. Withhold the drug.
B. Record the client's response.
C. Encourage the client to tell the doctor.
D.Suggest that it takes a while before seeing the results.

130. Richard with agoraphobia has been symptom-free for 4 months. Classic signs and
symptoms of phobias include:
A. Insomnia and an inability to concentrate.
B. Severe anxiety and fear.
C. Depression and weight loss.
D. Withdrawal and failure to distinguish reality from fantasy.

131. Nurse Amy is providing care for a male client undergoing opiate withdrawal.
Opiate withdrawal causes severe physical discomfort and can be life-threatening. To
minimize these effects, opiate users are commonly detoxified with:
A. Barbiturates
B. Amphetamines
C. Methadone
D. Benzodiazepines

132. The nurse is aware that the side effect of electroconvulsive therapy that a client
may experience
133. A.Loss of appetite
B. Postural Hypotension
C. Confusion for a time after treatment
D. Complete loss of memory for a time

133., The initial nursing intervention for the significant-others during shock phase of a
grief reaction should be focused on:
A. Presenting the full reality of the loss of the individuals.
B. Directing the individual's activities at this time.
C. Staying with the individuals involved.
D. Mobilizing the individual's support system.

134. One morning, nurse Diane finds a disturbed client curled up in the fetal position in
the corner of the dayroom. The most accurate initial evaluation of the behavior would
be that the client is:
A. Physically ill and experiencing abdominal discomfort.
B. Tired and probably did not sleep well last night.
C. Attempting to hide from the nurse.
D. Feeling more anxious today.
135. When being admitted to a mental health facility, a young female adult tells Nurse
Mylene that the voices she hears frighten her. Nurse Mylene understands that the client
tends to hallucinate more vividly:
A. While watching TV
B. During mealtime
C. During group activities.
D. After going to bed

136. Mr. Marquez reports losing his job, not being able to sleep at night, and feeling
upset with his wife. Nurse John responds to the client, "You may want to talk about
your employment situation in group today." The Nurse is using which therapeutic
technique?
A. Observations
B. Restating
C. Exploring
D. Focusing

137. Tony refuses His evening dose of Haloperidol (Haldol), then becomes extremely
agitated in the dayroom while other clients are watching television. He begins cursing
and throwing furniture. Nurse Oliver first action is to:
A. Check the client's medical record for an order for an as-needed I. dose of medication
for agitation.
B. Place the client in full leather restraints.
C. Call the attending physician and report the behavior.
D. Remove all other clients from the dayroom.

138. What is Nurse John likely to note in a male client being admitted for alcohol
withdrawal?
A. Perceptual disorders
B. Impending coma
C. Recent alcohol intake
D. Depression with mutism

139. Kris periodically has acute panic attacks. These attacks are unpredictable and have
no apparent association with a specific object or situation. During an acute panic attack,
Kris may experience:
A. Heightened Concentration
B. Decreased Perceptual Field
C. Decreased Cardiac Rate
D. Decreased Respiratory Rate
140. The nurse describes a client as anxious. Which of the following statements about
anxiety is true?
A.Anxiety is usually pathological.
B. Anxiety is a response to a threat.
C. Anxiety is directly observable.
D. Anxiety is usually harmful.

141. Which of the following is the most distinguishing feature of a client with an
antisocial personality disorder?
A. Attention to detail and order
B. Bizarre Mannerisms and Though Processes
C. Submissive and Dependent Behavior
D. Disregard for Social and Legal Norms

142. Which nursing action is most appropriate when trying to diffuse a client's
impending violent behavior?
A. Place the client in seclusion.
B. Leaving the client alone until he can talk about his feelings.
C. Involving the client in a quiet activity to divert attention.
D. Helping the client identify and express feelings of anxiety and anger

143. Which of the following should be included in the anxiety and anger. health
teachings among clients receiving Valium:
A. Avoid taking CNS depressants like alcohol.
B. There are no restrictions in activities.
C. Limit fluid intake
D. Any beverage like coffee may be taken.

144. Marco approached Nurse Trisha asking for advice on how to deal with his alcohol
addiction. Nurse Trisha should tell the client that the only effective treatment for
alcoholism is:
A. Psychotherapy B
B. Alcoholics Anonymous (AA)
C. Total Abstinence
D. Aversion Therapy

145. Nurse Monet is caring for a female client who has suicidal tendencies. When
accompanying the client to the restroom, Nurse Monet should...
A.Give her privacy
B. Allow her to urinate
C. Open the window and allow her to get fresh air D
D. Observe her
146. Which activity would be most appropriate for a severely withdrawn client?
A. Art activity with a staff member
B. Board game with a small group of clients
C. Team sport in the gym
D. Watching TV in the dayroom

147.Jun has been hospitalized for major depression and suicidal ideation. Which of the
following statements indicates to the nurse that the client is improving?
A.I couldn't kill myself because I don't want to go to hell."
B. I know my kids don't need me anymore since they're grown
C.I'm of no use to anyone anymore
D.I don't think about killing myself as much as I used to

148.Joe who is very depressed exhibits psychomotor retardation, a flat affect and
apathy. The nurse in charge observes Joe to be in need of grooming and hygiene.
Which of the following nursing actions would be most appropriate?
A. Waiting until the client's family can participate in the client's care
B. Explaining the importance of hygiene to the client
C. Asking the client if he is ready to take shower
D.Stating to the client that it's time for him to take a shower

149. After administering naloxone (Narcan), an opioid antagonist, Nurse Ronald should
monitor the female client carefully for which of the following?
A. Cerebral edema
B. Epilepsy
C. Respiratory depression
D. Kidney failure

150. Within a few hours of aloohol withdrawal, nurse John should assess the male
client for the presence of:
A. Yawning, anxiety, convulsions
B. Disorientation, paranoia, tachycardia
C. Tremors, fever, profuse diaphoresis
D. Imitability, heightened alertness, jerky movements