Psychiatric Disorders

Schizophrenia (10 questions)

1. The nurse is caring for a male client with schizophrenia. Which outcome is the least
desirable?
a. The client spends more time by himself
b. The client doesnt engage in delusional thinking
c. The client doesnt harm himself or others
d. The client demonstrates the ability to meet his own self-care needs
2. Which
a.
b.
c.
d.

of the following are considered the positive signs of schizoprenia?

delusions, anhedonia, ambivalence
Hallucinations, illusions, ambivalence
Delusions, hallucinations, disordered thinking
Disordered thinking, anhedonia, illusion

3. The nurse is planning discharge teaching for a client taking clozapine (clozaril). Which is the
following is essential to include?
a.
Caution the client not to be outdoors in the sunshine without protective clothing.
b.
Remind the client to go to the lab to have blood drawn for a white blood cell count.
c.
Instruct the client about dietary restriction
d.
Give the client a chart to record a daily pulse rate.
4. When the client describes fear of leaving his apartment as well as the desire to get out and
meet others, it is called:
a.
Ambivalence
b.
Anhedonia
c.
Alogia
d.
avoidance
5. Which types of schizophrenia according to the DSM-IV describes grossly inappropriate or flat
affect, incoherence, loose association, and extremely disorganizes behavior?
a.
b.
c.
d.

Schizophrenia,
Schizophrenia,
Schizophrenia,
Schizophrenia,

paranoid type
disorganize type
catatonic type
undifferentiated type

6. While pacing in the hall, a female patient with paranoid schizophrenia runs to the nurse and
says, Why are you poisoning me? I know you work for central thought control! You can keep
my thoughts. Give me back my soul! how should the nurse respond?
a. Im a nurse, Im not poisoning you. Its against the nursing code of ethics.
b. Im a nurse, and youre a patient in the hospital. Im not going to harm you.
c. Im not poisoning you. And how could I possibly steal your soul?
d. I sense anger, Are you feeling angry today?
7. A client is admitted to the mental health unit is experiencing disturbed thought process and
believes that the food is being poisoned. Which communication technique does the nurse
plan to encourage the client to eat?
a. Using open-ended questions and silence.
b. Focusing on self disclosure regarding food preferences.
c. Identifying the reasons that the client may not want to eat.

d. Offering opinions about the necessity of adequate nutrition

8. Nursing care for a male client with schizophrenia must be based on valid psychiatric and
nursing theories. The nurses interpersonal communication with the client and specific
nursing intervention must be:
a. Clearly identified with boundaries and specifically defined roles
b. Warn and non threatening
c. Centered on clearly defined limits and expression of empathy
d. Flexible enough for the nurse to adjust the care plan as the situation warrants
9. How soon after chlorpromazine administration should the nurse in charge expect to see a
patients delusion thoughts and hallucinations eliminated?
a. Several minutes
b. Several hours
c. Several days
d. Several weeks
10. How soon after chlorpromazine administration should the nurse in charge expect to see a
patients delusion thoughts and hallucinations eliminated?
a. Several minutes
b. Several hours
c. Several days
d. Several weeks
Anxiety (7 questions)
11. This type of anxiety that lead to personality disorganization is:
a. Mild
b. Moderate
c. Severe
d. Panic
12. The home care nurse is visiting an older female client whose husband died 6 months ago.
Which behavior by the client indicates ineffective coping?
a.
b.
c.
d.

Neglecting her personal grooming.

Looking at old snapshots of her family.
Participating in senior citizen program.
Visiting her husbands grave once a month.

13. The physician orders a new medication for a male client with generalized anxiety disorder.
During medication teaching, which statement or question by the nurse would be most
appropriate?
a. Take this medication. It will reduce your anxiety.
b. Do you have any concern about taking the medication?
c. Trust us. This medication has helped many people. We wouldnt have you take it if it were
dangerous.
d. How can we help you if you wont cooperate?
14. The client is brought to the emergency department by the local police. The client is told that
the physician will be in to see the client in about 30 minutes. The clients become loud and

offensive and want to be seen by the physician immediately. The appropriate nursing
intervention is which of the following?
a.
b.
c.
d.

Watch the behavior escalates before intervening.

Attempt to talk with the client to de-escalate the behavior.
Offer to take the client to an examination room until the client can be treated.
Inform the client that the client will be asked to leave if the behavior continues.

15. The nurse observes a client who is becoming increasingly upset. He is rapidly pacing,
hyperventilating, clenching his jaws, wringing his hands, and trembling. His speech is high
pitched and random; he seems preoccupied with his thoughts. He is pounding his fist into his
other hands. The nurse identifies his anxiety level as:
a.
Mild
b.
Moderate
c.
Severe
d.
Panic
16. Which of the following the main goal of client with panic level of anxiety?
a.
Requires no direct intervention.
b.
Lower persons anxiety.
c.
Safety
d.
Redirect the client back to the task.
17. Which of the following would be the best intervention for a client having a panic attack?
a.
Involve the client in a physical activity.
b.
Offer a distraction such as music
c.
Remain with the client.
d.
Teach a client with relaxation technique.
Mood disorders (9 questions)
18. A client with bipolar disorder begins taking lithium carbonate (lithium), 300mg four times a
day. After 3 days of therapy, the client says, My hands are shaking. The best response by
the nurse is:
a. Fine motor tremors are an early effect of lithium therapy that usually subsides in a few
weeks.
b. It is nothing to worry about unless it continues for the next month.
c. Tremors can be an early sign of toxicity, but well keep monitoring your lithium level to
make sure youre okay.
d. You can expect tremors with lithium. You seem very concerned about such a small tremor.
19. What is the rationale for a person taking lithium to have enough water and salt in his or her
diet?
a.
b.
c.
d.

Salt and water are necessary to dilute lithium to avoid toxicity.

Water and salt convert lithium into a usable solute.
Lithium is metabolized in the liver, necessitating increase water and salt.
Lithium is a salt that has greater affinity for receptor sites than sodium chloride.

20. Which major depression with loss of pleasure in all or most activities? Begins with 40-60
years old.
a.
Cyclothymia
b.
Dysthymia

c.
d.

Depressive neuroses
Melancholia

21. The nurse is caring for a female client in the manic phase of bipolar disorder whos ready for
discharge from the psychiatric unit. As the nurse begins to terminate the nurse-client
relationship, which client response is most appropriate?
a. Expressing feeling of anxiety
b. Displaying anger, shouting, and banging the table
c. Withdrawing from the nurse in silence
d. Rationalizing the termination, saying that everything comes to an end
22. A client with a diagnosis of major depression who has attempted suicide says to the nurse, I
should have died. Ive always been a failure. Nothing goes ever right to me. The
therapeutic response to the client is:
a.
b.
c.
d.

I dont see you as a failure.

You have everything to live for.
Feeling like this is all part of being ill.
Youve been feeling like a failure for a while?

23. Nursing preparations for a client undergoing electroconvulsive therapy (ECT) resembles
those used for:
a. Physical therapy
b. Neurologic examination
c. General anesthesia
d. Cardiac stress testing
24. The nurse is assigned to care for a recently admitted female client who has attempted
suicide. What should the nurse do?
a. Search the clients belongings and room carefully for items that could be used to attempt
suicide
b. Express trust that the client wont cause self-harm while in the facility
c. Respect the clients privacy by not searching any belongings
d. Remind all staff members to check on the client frequently
25. After an upsetting divorce, a male client threatens to commit suicide with a handgun and is
involuntarily admitted to the psychiatric unit with major depression. Which nursing diagnosis
takes highest priority for this client?
a. Hopelessness related to recent divorce
b. Ineffective coping related to inadequate stress management
c. Spiritual distress related to conflicting thoughts about suicide and sin
d. Risk for self-directed-violence related to planning to commit suicide with a handgun
26. the nurse is teaching a client taking an MAOI about which foods with tyramine that he or
she should avoid. Which of the following indicates the clients needs further teaching?
a.
Im so glad I can have pizza as long as I dont order pepperoni.
b.
I will be able to eat cottage cheese without worrying.
c.
I will have to avoid drinking nonalcoholic beer.
d.
I can eat green beans on this diet.

Personality Disorders (8 questions)

27. The nurse formulates a nursing diagnosis of impaired verbal communication for a male
patient with schizotypal personality disorder. Based on this nursing diagnosis, which nursing
intervention is most appropriate?
a. Helping the patient to participate in social interactions
b. Establishing a one-on-one relationship with the patient
c. Establishing alternative forms of communication
d. Allowing the patient to decide when he wants to participate in verbal communication with
you
28. A female patient with obsessive-compulsive disorder tells the nurse that he must check the
lock on his apartment door 25 times before leaving for an appointment. The nurse knows
that this behavior represents the patients attempt to:
a. Call attention to himself
b. Control his thoughts
c. Maintain the safety of his home
d. Reduce anxiety
29. Before eating a meal, a female client with obsessive-compulsive disorder (OCD) must wash
his hands for 18 minutes, comb his hair 444 strokes, and switch the bathroom lights 44
times. What is the most appropriate goal of care for this client?
a. Omit one unacceptable behavior each day
b. Increase the clients acceptance of therapeutic drug use
c. Allow ample time for the client to complete all rituals before each meal
d. Systematically decrease the number of repetitions of rituals and the amount of time spent
performing them
30. A 23-year-old client is diagnosed with dependent personality disorder. Which behavior is
most likely to be evidence of ineffective individual coping?
a. In ability to make choices and decisions without advice
b. Showing interest only in solitary activities
c. Avoiding developing relationship
d. Recurrent self-destructive behavior with history of depression
31. An unemployed woman, age 24, seeks help because she feels depressed and abandoned
and doesnt know what to do with her life. She says she has quit her last five jobs because
her co-workers didnt like her and didnt train her adequately. Last week, her boyfriend broke
up with her after she drove his care into a tree after an argument. The clients initial
diagnosis is borderline personality disorder which nursing observations support this
diagnosis?
a.
b.
c.
d.

Flat affect, social withdrawal, and unusual dress.

Suspiciousness, hyper vigilance, and emotional coldness
Lack of self-esteem, strong dependency needs and impulsive behavior.
Insensitivity to others, sexual acting out, and violence.

32. A young man is remanded by the courts for psychiatric treatment. His police record, which
dates to his early teenage years, includes running away, auto theft, and vandalism. He

a.
b.
c.
d.

dropped out of school at age 16 and has been living on his own since then. His history
suggests maladaptive coping, which associates with:
Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder
Narcissistic personality disorder.

33. Which personality disorder exhibit if the client uncomfortable when they are not center of
attention. They use their physical appearance and dress to gain attention.
a.
Histrionic personality disorder
b.
Narcissistic personality disorder
c.
Dependent personality disorder
d.
Avoidant personality disorder
34. When interviewing any client with personality disorder, the nurse would assess for which of
the following:
a.
Ability to charm and manipulate people
b.
Desire for interpersonal relationship
c.
Disruption in some aspect of his or her life.
d.
Increase need for approval from others.

Therapeutic Communication and Relationship (10 questions)

35. A client with a diagnosis of major depression who has attempted suicide says to the nurse, I
should have died. Ive always been a failure. Nothing goes ever right to me. The
therapeutic response to the client is:
e.
f.
g.
h.

I dont see you as a failure.

You have everything to live for.
Feeling like this is all part of being ill.
Youve been feeling like a failure for a while?

36. The community health nurse visits a client at home. The client states, I havent slept at all
the last couple of nights. Which response by the nurse illustrates a therapeutic
communication technique for this client?
a.
b.
c.
d.

Go on
Sleeping?
Youre having difficulty sleeping?
Sometimes. I have trouble sleeping too.

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

38. A male client in a group therapy is restless. His face is flushed and he makes sarcastic
remarks to group members. The nurse responds by saying, You look angry. The nurse is
using which technique?
a. A broad opening statement
b. Reassurance
c. Clarifying
d. Making observations
39. Whats a nurse most important role in caring for an adult client with a mental disorder?
a. To offer advice
b. To know how to solve the clients problem
c. To establish trust and rapport
d. To set limits with the client
40. During the mental status examination, a female client may be asked to explain such
proverbs as Dont cry over spilled milk. The purpose is to evaluate the clients ability to
think:
a. Rationally
b. Concretely
c. Abstractly
d. Tangentially
41. The nurse is caring for a female client in the manic phase of bipolar disorder whos ready for
discharge from the psychiatric unit. As the nurse begins to terminate the nurse-client
relationship, which client response is most appropriate?
a. Expressing feeling of anxiety
b. Displaying anger, shouting, and banging the table
c. Withdrawing from the nurse in silence
d. Rationalizing the termination, saying that everything comes to an end
42. Unresolved feeling related to loss most likely maybe recognized during which phase of the
therapeutic nurse-client relationship?
a.
b.
c.
d.

Working
Trusting
Orientation
Termination

43. In group therapy, a male client angrily speaks up and responds to a peer, Youre always
whining and Im getting tired of listening to you! Here is the worlds smallest violin playing
for you. Which role is the client playing?
a. Blocker
b. Monopolizer
c. Recognition seeker
d. Aggressor

44. Laboratory work is prescribed to a client who has been experiencing delusions. When the
nurse approach the client to obtain a specimen of a clients blood, the client begin to shout
Youre all vampires. Let me out of here! The appropriate nursing response is which of the
following?
a.
b.
c.
d.

What makes you think that Im a vampire?

Ill leave and come back for your blood.
I am not going to hurt you; I am going to help you
It must be frightening to think that others want to hurt you.

Legal and Ethical Issue (4 questions)

45. Two nurses are discussing a female clients condition in the elevator. The employer of the
mentioned client overhears the conversation and fires the client. The nurses may be liable
for which act?
a. Assault
b. Battery
c. Neglect
d. Breach of confidentiality
46. A nurse at a substance abuse center answers the phone. A probation officer asks if the male
client is in treatment. The nurse responds, No, the client youre looking for isnt here.
Which statement best describes the nurses response?
a. Correct because she didnt give out information about the client
b. A violation of confidentiality because she informed the officer that the client wasnt there
c. A breach of the principle of veracity because the nurse is misleading the officer
d. Illegal because shes withholding information from law enforcement agents.
47. A nurse places a female client in full leather restraints. How often must the nurse check the
clients circulation?
a. Once per hour
b. Once per shift
c. Every 10 to 15 minutes
d. Every 2 hours
48. Which nursing intervention is most important when restraining a violent male patient?
a. Reviewing hospital policy regarding how long the patient can be restrained
b. Preparing a p.r.n. dose of the patients psychotropic medication
c. Checking that the restraints have been applied correctly
d. Asking if the patient needs to use the bathroom or is thirst

Defense Mechanism (2 questions)

49. A male client becomes angry and belligerent toward the nurse after speaking on the phone
with his mother. The nurse recognizes this as what defense mechanism?
a. Rationalization
b. Repression
c. Displacement
d. Suppression
50. A client who has just been sexually assaulted is quiet and calm. The nurse analyzes this
behavior as indicating of which defense mechanism?
a.
b.
c.
d.

Denial
Projection
Rationalization
Intellectualization

Respiratory Disorders
1.

A Mantoux test signifies exposure to Mycobacterium Tubercle Bacilli. The test is read for
how many hours after injection?
a. 1 hour
b. 12-24 hours
c. 48-72 hours

2.

A client is suspected to have an HIV. The nurse knows that in the Mantoux test result, a
client is considered positive with HV if he has an induration of:
a. More than 10 mm
b. 3mm
c. 4 mm
d. 5 mm

3. Mr. Lorenzo is schedule for a bronchography. Before the procedure the nurse least likely
performs which of the following?
a. Assist the client in a side-lying position

b.
c.
d.

Checking for allergies

Instructing the client to be on NPO for 6-8 hours
Administer atropine sulfate

4.

After thoracentesis the client should be placed on which position?

a. Affected side
b. Unaffected side
c. Prone position
d. Supine position

5.

The position of a conscious client during suctioning is:

a. Fowlers
b. Supine position
c. Side-lying
d.
Prone

6. Before the nurses shift ended, the water seal bottle is observed to have an intermittent
suctioning. The nurse should do which of the following?
a. Check for an air leak
b. Check for kinks in the tube
c. Inform the physician immediately
d. Make sure that the bottle is at least 2-3 feet below the level of the chest
7. While the chest tube is removed the nurse should instruct the patient to:
a. Exhale deeply
b. Inhale deeply
c. Lie at the abdomen
d. Hyperextend the neck
8.

9.

A client is brought to the ER with complaints of stuffy nose, headache, persistent cough,
fever and post-nasal drip. Pain is complained by the client above the eyebrows. The
diagnosis is sinusitis. Which of the following sinuses is affected?
a. Maxillary
b. Frontal
c. Ethmoid
d. Sphenoid
a.
b.
c.
d.

Which intervention is least likely done for sinutis?

Increase fluid intake
Cold wet packs
Hot wet packs
Rest

10. A client with sinusitis had undergone Caldwell-Luc Surgery. The nurse should instruct the
client to do which of the following after the procedure?
a. Chew on the unaffected side only.
b. The client can wear dentures 5 days after.
c. Sneezing should be avoided for a week after the surgery
d. All of the above
11. A teen ager is diagnosed to have inflamed tonsils (tonsillitis). The patients history reveals
recurrent tonsillitis episodes for about 6 times of the same year. The most appropriate
intervention for the patient is:
a. Promoting rest
b. Increasing fluid intake

c.
d.

Warm saline gargle

Surgery

12. Before a tonsillectomy is performed, which of the following data is very crucial for the nurse
to assess?
a. Degree of pain
b. URTI
c. Drainage on the ears
d. Respiration pattern
13. Mark underwent a tonsillectomy procedure. To promote comfort the following interventions
should be done by the nurse except:
a. Application of ice collar
b. Assist the client to a semi-fowlers position with pillow support
c. Assess for frequent swallowing of the patient
d. Administration of acetaminophen
14. Two days after tonsillectomy, Marks reported that his stool is black. Initially, the nurse
should:
a. Inform the physician
b. Document the findings
c. Obtain stool for analysis
d. Check the clients vital signs
15. Asthma can be caused by extrinsic and intrinsic factors. Presence of these factors triggers
the release of the chemical mediators which does not include:
a. Serotonin
b. Prostaglandin
c. Bradykinin
d. Adrenaline
16. Presence of overdistended and non-functional alveoli is a condition called:
a. Bronchitis
b. Emphysema
c. Empyema
d. Atelectasis
17. A client with COPD is instructed to follow what diet?
a. High carbohydrate, low calorie and high protein diet
b. High protein, high calorie and low carbohydrate diet
c. High carbohydrate, low protein and high calorie diet
d. High protein, high carbohydrate and high caloric diet
18. Nurse Kim is caring for a client with a pneumothorax and who has had a chest tube inserted
notes continuous gentle bubbling in the suction control chamber. What action is appropriate?
a. Do nothing, because this is an expected finding.
b. Immediately clamp the chest tube and notify the physician.
c. Check for an air leak because the bubbling should be intermittent.
d. Increase the suction pressure so that bubbling becomes vigorous.
19. A nurse has assisted a physician with the insertion of a chest tube. The nurse monitors the
adult client and notes fluctuation of the fluid level in the water seal chamber after the tube
is inserted. Based on this assessment, which action would be appropriate?
a. Inform the physician.
b. Continue to monitor the client.
c. Reinforce the occlusive dressing.

d.

Encourage the client to deep-breathe.

20. The nurse caring for a male client with a chest tube turns the client to the side, and the
chest tube accidentally disconnects. The initial nursing action is to:
a. Call the physician.
b. Place the tube in a bottle of sterile water.
c. Immediately replace the chest tube system.
d. Place the sterile dressing over the disconnection site.
21. Nurse Paul is assisting a physician with the removal of a chest tube. The nurse should
instruct the client to:
a. Exhale slowly.
b. Stay very still.
c. Inhale and exhale quickly.
d. Perform the Valsalva maneuver.
22. While changing the tapes on a tracheostomy tube, the male client coughs and the tube is
dislodged. The initial nursing action is to:
a. Call the physician to reinsert the tube.
b. Grasp the retention sutures to spread the opening.
c. Call the respiratory therapy department to reinsert the tracheotomy.
d. Cover the tracheostomy site with a sterile dressing to prevent infection.
23. A nurse is caring for a male client immediately after removal of the endotracheal tube. The
nurse reports which of the following signs immediately if experienced by the client?
a. Stridor
b. Occasional pink-tinged sputum
c. A few basilar lung crackles on the right
d. Respiratory rate of 24 breaths/min
24. An emergency room nurse is assessing a female client who has sustained a blunt injury to
the chest wall. Which of these signs would indicate the presence of a pneumothorax in this
client?
a. A low respiratory
b. Diminished breathe sounds
c. The presence of a barrel chest
d. A sucking sound at the site of injury
25. A nurse is caring for a male client hospitalized with acute exacerbation of chronic obstructive
pulmonary disease. Which of the following would the nurse expect to note on assessment of
this client?
a. Hypocapnia
b. A hyperinflated chest noted on the chest x-ray
c. Increase oxygen saturation with exercise
d. A widened diaphragm noted on the chest x-ray
Care for Elderly
Dementia (10 questions)
1. The nurse is working with the older clients in a long term care facility. Which of the following
activities perform by the nurse fosters reminiscence among these clients?
a. Having storytelling hours.
b. Setting up pet therapy sessions.

c. Displaying calendars and clocks.

d. Encouraging client participation in pottery class.
2. A 25-year-old man reports losing his sight in both eyes. Hes diagnosed as having conversion
disorder and is admitted to the psychiatric unit. Which nursing intervention would be most
appropriate for this client?
a. Not focusing on his blindness
b. Providing self-care for him
c. Telling him that his blindness isnt real
d. Teaching eye exercises to strengthen his eyes
3. Which statement describes how elderly clients react to medication?
a. At increased risk for adverse reactions
b. Tolerate medication better because theyre less active
c. Metabolize medications quickly
d. All of the above

4. A client who developed delirium following surgery asks if having delirium is the beginning of
Alzheimer disease. The nurse explains the differences between delirium and dementia.
Which of the following statements by the client requires further teaching?
a. In dementia there are quick changes in the levels of consciousness, too.
b. If I have dementia I will slowly get worse.
c. I might have developed permanent brain damage.
d. So I developed delirium because I had surgery.
5. A client is diagnosed with vascular dementia. Which of the following explanations will assist
the family to understand the cause of this type of dementia?
a.
b.
c.
d.

Strands of protein are tangled together.

Acetylcholine production is decreased.
Blood vessels in the brain are bleeding.
Fragments mix with molecules to make plaques in the brain.

6. An 80-year-old client who lives with her daughter tells the nurse, No one lets me eat with
them. I have to hide my food under the bed. The nurse plans a family meeting to discuss:
a.
b.
c.
d.

Current living arrangement.

Cultural values of the family.
Adequate nutrition for the family.
Family eating patterns

7. A client with dementia has a disturbed sleep pattern. Which of the following interventions
should the nurse utilize for the client?
a. Awaken the client when napping.
b. Give sleep medication.

c. Promote mild exercise

d. Encourage TV watching during the day.
8. The nurse is working with families of clients with Alzheimer disease. One of the members
says, I feel so sad because my loved one is lost. The nurse can best facilitate group
discussion on this issue by saying:
a.
b.
c.
d.

How have others in the family dealt with these feelings?

You will not feel sad as soon as you can accept his illness.
Are you experiencing anger about this?
Grieving for a lost relationship is a normal behavior.

9. A client with dementia fell in the hallway. The initial nursing action is to:
a.
b.
c.
d.

Call the family.

Assign the nurses aide to stay with the client.
Place a blanket on the client.
Assess the client.
Elder Abuse (9 questions)

10. Primary prevention of elder mistreatment is a healthcare goal. The nurse recognizes that
one of the risk factors often present in elder mistreatment situations is:
a.
b.
c.
d.

Home care dependency.

Elder abandonment.
Elder dependency.
Caregiver independence.

11. A home care nurse found an elderly client with multiple bruises on both arms and the trunk.
After the client denied the spouse was responsible, the rationale the nurse used for reporting
the suspicion of abuse was:
a.
b.
c.
d.

The nurse wanted to be identified as the one who was the case finder.
Reporting suspected abuse is an ethical responsibility of the nurse.
The nurse was concerned about being sued.
The client was too afraid to report the spouse.

12. When a nurse determines with a high degree of confidence that an elderly homebound client
has been mistreated, an appropriate intervention would be:
a.
b.
c.
d.

Arranging for police surveillance of the home.

Suggesting that the family hire a new caregiver.
Waiting until a social services agency completes an investigation before developing a plan.
Consulting with the physician about admission to the hospital for a thorough assessment of
the client.

13. Which of the following situations could be the source of an ethical dilemma for the nurse
with respect to elder mistreatment?
a. The elderly person decides to return to the abusive setting.
b. The family sues the nurse for reporting abuse.

c. The elderly person is not competent to make decisions.

d. The elderly person was seriously injured due to physical abuse.
14. An elderly person reports all of the following experiences to the nurse. Which of the reported
experiences is the most likely indicator of exploitation of the elderly person?
a.
b.
c.
d.

Family members rarely visit.

The client is being threatened with admission to a nursing home.
There isnt any money available to make a weekly donation at church.
The client is forced to attend family events the individual doesnt want to attend.

15. The nurse suspects that a home health aide who comes into the home every day to provide
basic hygiene care is abusing an elderly client. What is the best way to gather more
information about the situation to confirm suspicions of abuse?
a.
b.
c.
d.

Request a social services agency do an investigation.

Confront the caregiver about suspicions.
Ask the family what they think.
Interview the client in private.

16. What data would help support a nursing diagnosis of elder mistreatment in the domestic
setting?
a. Client states unhappiness with living arrangements and lack of privacy in a small home with
young children present.
b. Client has a flat affect.
c. Caregiver will bathe the client only once a week.
d. An adult daughter, who is the primary caregiver, says that it is difficult to care for her elderly
parent.
17. Mistreatment that occurs in nursing homes and is directed toward the elderly often is due to:
a.
b.
c.
d.

Nurses who feel their talent is not being used appropriately in a nursing home setting.
Inability to use restraints with physically challenging residents.
Low wages and heavy workloads of the nursing assistants
Staffs lack of interest in the elderly as individuals.

18. Which of the following observations is indicative of physical mistreatment?

a.
b.
c.
d.

Withdrawing from soft touch

Dislocated shoulder
Agitation
Downcast eyes
Parkinsons disease (4 questions)

19. Which among the following are not the cardinal signs of Parkinsons disease?
a.
b.
c.
d.

Bradykinesia
Tremor
Anhedonia
Postural instability

20. Parkinsons Disease is associated with:

a.
b.
c.
d.

Increase level of Dopamine

Decrease level of Dopamine
Destruction of Myelin
Autoimmune disease

21. Which is not true regarding Levodopa?

a.
b.
c.
d.

Mainstay treatment of Parkinsons disease

Converter into dopamine in basal ganglia
It is an antidepressant
May lead to neuroleptic malignant syndrome

22. The nurse is planning the care for a client diagnosed with Parkinsons disease. Which would
be:
a therapeutic goal of treatment for the disease process?
a. The client will experience periods of akinesia throughout the day.
b. The client will take the prescribed medications correctly.
c. The client will be able to enjoy a family outing with the spouse.
d. The client will be able to carry out activities of daily living.
Alzheimers disease (3 questions)

23. Which is not true regarding Alzheimers disease?

a.
b.
c.
d.

It is a progressive, reversible, degenerative neurologic disease

Can occur as young as 40
Enzyme active in producing Acetylcholine is decreased
Involve neurofibrillary tangles.

24. Which of the following statements made by the primary caregiver of a patient with
Alzheimers disease indicates that more teaching is required?
a.
b.
c.
d.

Eventually I may need someone to help me care for her in our home.
She will lose her most recent memories first.
The medications that are available are only modestly effective.
When she beats this disease we can go on that trip weve always talked about.

25. The nurse is caring for a 75 year old widow admitted to the psychiatric hospital by her
daughter who became concerned when her mother began to talk in a confused manner
about her husband who has been dead for 7 years. In the hospital, especially at night, the
client wanders in the other clients rooms looking for her husband. What is the most
appropriate action for the nurse to take when this woman wanders in the rooms of the other
clients?
a.
b.
c.
d.

Lock the door to her room.

Tell her to stay in her room except for meals.
Take her by the hand and guide her back to her room.
Tell her that she will be restrained if she continues to wander.

Pharmacology
Drugs used to treat Respiratory disorders (10 questions)
1. The congestion associated with the common colds and allergic rhinitis is caused by:
a.
b.
c.
d.

Diphenhydramine
Histamine
Collagen
Bacterial toxins

2. In the presence of contact allergens, histamine results in:

a.
b.
c.
d.

Local itching
Rhinitis
Infection
Pain

3. When the nurse teaches the client about antihistamines, the teaching should include which
of the following actions of these medications?
a. Blocking the release of histamine
b. Antagonizing histamine action at the H1 receptors
c. Interfering with epinephrine release

d. Interrupting histamine action at the H2 skin receptors

4. Because the effect of antihistamines have on respiratory tract secretions, they should be
used with caution in clients with:
a. Allergic rhinitis
b. Influenza
c. Asthma
d. Pruritus
5. Clients taking decongestants should be taught to monitor which of the following?
a.
b.
c.
d.

Urine PH
Pulse
Temperature
Blood pressure

6. To administer nasal spray, the client should be taught to:

a.
b.
c.
d.

Keep the container and head in an upright position

Lie with head at the edge of the bed
Lie with head extending over the edge of supporting surface
Not shake the inhaler prior to use.

7. Expectorants act by:

a.
b.
c.
d.

Decreasing the viscosity of sputum

Decreasing the frequency of involuntary coughing
Blocking the histamine receptor in the alveoli
Increasing the viscosity of endobronchial secretions

8. Guafenesin is classified as an:

a.
b.
c.
d.

Antitussive
Antihistamine
Expectorant
Iodine compound

9. A client with a frequent non productive cough that interrupts his sleep is prescribe
diphenhydramine HCl for its approved action as an:
a.
b.
c.
d.

Anti histamine
Expectorant
Antitussive
Narcotic agonist

10. Expectorants and antitussives in syrup form should be administered:

a.
b.
c.
d.

With glass of water

With food
On an empty stomach
Last if other medication are being taken

Drugs used to treat cardiovascular disorders (10 questions)

11. Drugs that increase the force of myocardial contractions have what type of effect?
a.
b.
c.
d.

Positive inotropic
Negative inotropic
Positive chronotropic
Negative chronotropic

12. Drugs that decrease the heart rate by decreasing the rate of impulse formation at the SA
node are:
a.
b.
c.
d.

Positive inotropic
Negative inotropic
Positive chronotropic
Negative chronotropic

13. Digoxin is classified as:

a.
b.
c.
d.

Hypokalemic
Cardiac glycoside
Coronary artery vasodilator
Positive chronotropic

14. Cardiac hypertrophy and sodium and fluid retention are characteristics of what condition
treated with digoxin?
a.
b.
c.
d.

Ventricular fibrillation
Atrial fibrillation
Heart failure
Hypokalemia

15. The primary cause of ischemic heart disease is:

a.
b.
c.
d.

Peripheral artery constriction

Coronary artery disease
Myocardial myopathy
Cardiac neoplasm

16. Cardiac ischemia results in pain referred to as:

a.
b.
c.
d.

Angina pectoris
Raynauds disease
Peripheral artery disease
Intermittent claudication

17. Nitroglycerin is classifies as:

a.
b.
c.
d.

Peripheral Vasodilator
Diuretic
Antihypertensive
Diuretic antihypertensive coronary vasodilator

18. When teaching a client how to store his or her nitroglycerin tablets, the nurse should include
which of the following lessons?
a.
b.
c.
d.

The container should be stored in the warmest room in the house

Sublingual nitroglycerin should be taken with meals
The client should obtain fresh supply of nitroglycerin every 6 months
Nitroglycerin should be stopped at the first sign of Angina

19. Clients taking nitroglycerin should be advised to sit or lie down before taking this medication
because it can cause:
a.
b.
c.
d.

Hypotension
Headache
Hypertension
Flushed feeling

20. A client receiving peripheral vasodilators should be assessed for effectiveness of the
treatment by routine monitoring of:
a.
b.
c.
d.

Pulse
Temperature
Blood pressure
Pulse oximetry
Drugs used to treat Gastrointestinal Disorders (5 questions)

21. The client is prescribed omeprazole and the nurse understands that this agent is an:
a.
b.
c.
d.

Antihistamine
Gastric stimulant
Proton pump inhibitor
H2 receptor antagonist

22. A client is taking Milk of Magnesia regularly for heartburn. The nurse should monitor this
client for which of the following adverse effect of this therapy?
a.
b.
c.
d.

Constipation
Diarrhea
Infection
Arthritis

23. Antacids:
a. Increase gastric acidity

b. Neutralize cholecystokinin
c. Prevent overproduction of gastric acid
d. Stimualate bicarbonate secretion from the cells in the gastric gland
24. The nurse understands that all of the following are H2 receptor antagonist except:
a.
b.
c.
d.

Lansoprazole
Ranitidine
Famotidine
Nizatidine

25. Histamine H2 receptor antagonists:

a.
b.
c.
d.

Neutralize gastic acid secretions

Compete with histamine for binding sites on the parietal cells
Block histamine release form the gastric cells
Neutralize the proton pump in the gastric mucosa