NAME: 1. A newly admitted client is extremely hostile toward a staff member he has just met, without apparent reason.

According to Freudian theory, the nurse should suspect that the client is exhibiting which phenomena? a. b. c. d. 2. Intellectualization Transference Triangulation Splitting 6.

DATE: eliminated, the student continues to express her belief that she has a serious illness. These symptoms are typical of which disorder? a. b. c. Conversional disorder Depersonalization Hypochondriasis Somatization disorder

d.

A nurse is interviewing a client newly admitted to the unit. While stating the list of medications, the client falls asleep. The nurse understands that the client is most likely exhibiting which sleep disorder/ a. b. c. d. Hypersomia Insomnia Narcolepsy Parasomia

During the group therapy, a client listening to another clients description of an abusive incident that occurred during childhood says, I didnt think anyone else felt like I did as a child. The nurse recognizes this statement as a reflection of which curative factor of group therapy, as identified by Yalom? a. b. c. d. Altruism Universality Catharsis Existential factor 7.

Ingestion of which substance in large amounts reduces sleep latency and nocturnal awakening? a. b. c. d. Acetylcholine Dopamine L-tryptophan Serotonin

3.

After telling a nurse to pray for me, a client gives away personal possessions and shows a sudden calmness. The nurse recognizes that this behavior may signal which condition? a. b. c. d. Major depression Panic attack Suicidal ideation Severe anxiety 8.

A client with sleep terror disorder might have autonomic signs of intense anxiety. Which autonomic sign or symptom should the nurse monitor? a. b. c. d. Tachycardia Pupil constriction Cool, clammy skin Decreased muscle tone

4.

Which nursing diagnosis is most appropriate for disorder known as hypochondriasis? a. b. c. d. Risk for injury Anticipatory grieving Risk for situational low self esteem Deficient diversional activity 9.

A client diagnosed with a sleep disorder awakens abruptly with a piercing scream. Which disorder best explains this behavior? a. b. c. d. Hypersommia Nightmare disorder Sleep terror disorder Sleepwalking

5.

A college student frequently visited the health center during the past year with multiple vague complaints of GI symptoms before course examination. Although physical causes have been

10. Which statement made by a client with a pain Page 1

PSYCHIATRIC NURSING Rudy Anthony C. Reyes, RN, RM, MAN

NAME: disorder shows the nurse that the goal of stress management was attained? a. b. c. d. My arms hurts I enjoy being dependent on others I dont really understand why Im here My muscles feel relaxed after that progressive relaxation exercise 11. By which process does a client conceal the true motivations for his thought, actions or feeling? a. b. c. Displacement Rationalization Regression Substitution d. b. c. c. d. Suicide

DATE:

sundown syndrome

15. Which of the nursing action explains why

tricyclic antidepressant medication is given to a client who has severe posttraumatic stress disorder? a. It prevents hyperactivity and purposeless movements It increases the clients ability to concentrate It helps prevent experiencing the trauma again It facilitates the grieving process

d.

16. While caring for a client with posttraumatic stress

disorder, the family notices that loud noises cause a serious anxiety response. Which explanation should the family understand the clients response? a. Environmental triggers can causes the client to become hyperaroused and have exaggerated startle reactions b. c. d. Clients commonly experience extreme fear about normal environmental stimuli After a trauma, the client cant respond to stimuli in an appropriate manner The response indicates that another emotional problems needs investigation 17. Which psychological symptoms should a nurse expect to find in hospitalized client whos the only survivor of a train collision? a. b. c. d. Denial Indifference Perfectionism Trust

12. A 26y/o client is diagnosed with somatoform disorder. When discussing the care plan with the clients wife, the nurse should give which instruction? a. b. Tell your husband that his symptoms are all in his head to force him to deal with reality Tell your husband that his symptoms are an attempt to get attention and that youll be more attentive c. Accept the reality of the symptoms as your husband presents them, and dont dispute them d. Realize that your husband is creating the symptoms on purpose 13. Which statement is typical of a client with social phobia? a. b. c. d. Without people around, I just feel so lost Theres nothing wrong with my behavior I like to be the center of attention I know I cant accept that award for my brother 14. A client suspected of having posttraumatic stress syndrome should assessed for which problem? a. b. Eating disorder Schizophrenia

18. Which symptoms of posttraumatic stress disorder would indicate that hypnosis is an appropriate treatment modality? a. b. Addiction Confabulation Page 2

PSYCHIATRIC NURSING Rudy Anthony C. Reyes, RN, RM, MAN

NAME: c. d. Dissociation Hallucination c. d.

DATE: trimester of the pregnancy Lithium causes severe urine retention and increased risk of toxicity Women who take lithium are very likely to have spontaneous abortion 23. Which statement should a nurse explain to a client newly diagnosed with bipolar disorder who doesnt understand why frequent blood work is necessary while hes taking lithium?

19. Which intervention should be given priority for client with generalized anxiety disorder whos working to develop coping skills? a. b. c. d. Determine whether the client has fears or obsessive thinking Monitor the client for overt and covert signs of anxiety Teach the client how to use effective communications skills Assist the client to identify coping mechanism used in the past. b.

a.

Frequent lithium levels will help the primary care provider spot liver and renal damage early Frequent lithium levels will demonstrate whether the client is taking a high enough dosage

20. A nurse is caring for a client with hypomania. In

performing the assessment, which behavior should she expect? a. b. c. A hypomanic client is on the verge of experiencing depression and crisis A hypomanic client is indecisive and vacillating, with a diminished ability to think A hypomanic client is irritable, with an elevated mood and symptoms of mania A hypomanic client is disorganized and tends to exhibit impaired judgment d. c.

Frequent lithium levels will indicate whether the drug passes through the blood-brain barrier Frequent lithium levels are unnecessary if the client takes the drug as ordered.

24. Which factor or condition is the most common cause of amnesia disorders/ a. b. c. d. Delirium Metabolic factors Organic factors Thiamine deficiency related to alcohol abuse

d.

21. Which high risk behavior should the nurse assess

for in client with bipolar who has abruptly stop taking the prescribed medication and experiencing a manic episode? a. b. c. d. Binge eating Relationship avoidance Sudden relocation Thoughtless spending

25. During morning care, a nursing assistant asks the

client with dementia, How was your night?. The client replies, My husband and I went out to dinner and a movie and had a wonderful evening. Which state best describes the clients action? a. b. c. d. Delirium Perseveration Confabulation Showing a sense of humor

22. Which information is important to teach a client with bipolar disorder whos pregnant and taking lithium? a. b. Use of lithium results in serious congenital problems Thyroid problems can occur in the first

26. During conversation with a client, the nurse observes that he shifts from one topic to the3 Page 3

PSYCHIATRIC NURSING Rudy Anthony C. Reyes, RN, RM, MAN

NAME: next on a regular basis. Which term describes this disorder? a. b. c. d. Flight of ideas Concrete thinking Ideas of reference Loose associations b. c. d.

DATE: the dayroom. The client asks if he can play one game of pool first. Whats the most appropriate response by the nurse? a. You can play one quick game. Then you have to clean to your room No, you may not. No, you may not play pool first. The rules were explained to you. Yes, you may play a quick game. But dont tell the other client about this. 32. Which term describes an effect of isolation? a. Delusions Hallucinations Lack of violation Waxy flexibility

27. A nurse notices that a client is mistrustful and

shows hostile behavior. Which type of personality disorder is associated with these characteristics? a. b. c. d. Antisocial Avoidant Borderline Paranoid

b.
c. d.

28. Which behavior is suspected when a client with antisocial personality disorder shows blatant disregard for the law? a. b. c. d. Labeling self as bad Resisting spiritual healing Engaging in criminal behaviors Successful manipulation of the legal system

33. A client on the psychiatric unit is copying and imitating the movements of his primary nurse. During the recovery, he says, I thought the nurse was my mirror. I felt connected only when I saw my nurse. This behavior is known by which term? a. b. c. d. Modeling Echopraxia Ego-syntonicity Ritualism

29. Which characteristic of a client with paranoid personality disorder makes it difficult for the nurse to establish an interpersonal relationship? a. b. c. d. Dysphoria Hypervigilance Indifference Promiscuity

34. Which symptom is usually responsive to

traditional antipsychotic drugs? a. b. c. d. Apathy Delusions Social withdrawal Attention impairment

30. The wife of a client diagnosed with paranoid personality disorder tells the client she wants a divorce. When discussing this situation with the couple, which factor should help the nurse forms a care plan for this couple? a. b. c. d. Denied grief Intense jealousy Exploitation of others Self destructive tendencies

35. A client was hospitalized after his son filed a petition for involuntary hospitalization for safety reasons. The son seeks out the nurse because his father is angry and refuses to talk with him. Hes frustrated and feeling very guilty about his decision. Which response to this client is the most appropriate? Page 4

31. A nurse tells the client with personality disorder that he must clean his room before he can go to PSYCHIATRIC NURSING Rudy Anthony C. Reyes, RN, RM, MAN

NAME: a. b. c. d. Your father is here because he needs help. Hell feel differently about you as he gets better. It sounds like youre feeling guilty about leaving your father here This is stressful time for you, but youll feel better as he gets well.

DATE: behaviors as which disorder? a. b. c. d. Tardive dyskinesia Dystonia Akathasia Akinesia

40. A client with Paranoid schizophrenia tells the nurse that two people talking in the hall are planning to kidnap and kill him. The clients thought pattern reflects which disorder? a. b. c. d. Auditory hallucinations Delusions of grandeur Ideas of reference Echolalia

36. A client diagnosed with schizophrenia has been

taking haloperidol for 1 week when the nurse observed that the clients eyeball is fixated on the ceiling. Which specific condition is the exhibiting? a. b. c. d. Akathisia Neuroleptic malignant syndrome Oculogyric crisis Tardive dyskinisia

41. A female client is talking to a nurse about her binge-purge cycle. Which question should the nurse ask about the cycle? a. b. c. d. Do you know how to stop the binge-purge cycle? Does binge-purge cycle3 help you lose weight? Can the binge-purge cycle take away your anxiety? How often do you go through the bingepurge cycle? 42. A nurse is assessing a client to determine the distress experienced after binge eating. Which symptom is typical after bingeing? a. b. c. d. Ageusia Headache Pain Sore throat

37. A client is admitted to a psychiatric unit for a delusional disorder. He explains to a nurse that he made a contract with God to be the best minister ion earth. Now that he has achieved the goal, most of his friends have stopping him out of envy. On mental status examination, there is little impairment in psychological functioning. Which condition is expected? a. b. c. d. Nonbizarre delusions Fragmentary delusions Regressive behaviors Regressive delusions

38. A nurse is facilitating a group schizophrenia clients when one client says, I like to drive my car, bar, tar, far. This pattern of speech is known as which disorder? a. b. c. d. Clang association Echolalia Neologism Echopraxia

43. Which nursing diagnosis should have the highest priority in the plan of care for the client with an eating disorder? a. b. c. Interrupted family processes Imbalanced nutrition: less than body requirements Disturbed body image Page 5

39. A schizophrenic client, whos receiving

antipsychotic medication paces, fidgets and cant seem to stay still. The nurse recognizes these PSYCHIATRIC NURSING Rudy Anthony C. Reyes, RN, RM, MAN

NAME: d. Ineffective coping

DATE: next week door to her with charges that the wife was in love with him. He wrote love notes and called her on the telephone throughout the night. The client is employed and has no problem in his job. Which disorder is suspected? a. b. c. d. Major depression Paranoid schizophrenia Delusional disorder Bipolar affective disorder

44. Which physiologic complication of anorexia nervosa can quickly become life threatening? a. b. c. d. Cardiac arrhythmias Decreased blood pressure Decreased metabolic rate Altered thyroid functioning

45. Which psychological finding should a nurse expect when assessing a client with anorexia nervosa? a. b. c. d. Avoidant behavior Antisocial behavior Introverted behavior Hypervigilant behavior

50. While talking to client with schizophrenia, a nurse notes the client frequently uses unrecognizable words with no common meaning. Which term describes this? a. b. c. d. Echolalia Clang association Neologism Word salad

46. In planning care for a client with borderline personality disorder, a nurse must be aware that this client is prone to develop which condition? a. b. c. d. Binge eating Memory loss Cult membership Delusional thinking

47. Which defense mechanism is most likely to be seen in a client with borderline personality disorder? a. b. c. d. Compensation Displacement Identification Projection

48. A client with dependent personality disorder has difficulty expressing personal concerns. Which communication technique is best to teach the client? a. b. c. d. Questioning Reflection Silence Touch

49. A 34y/o male client is referred to a mental health clinic by the court. The client harassed a couple PSYCHIATRIC NURSING Rudy Anthony C. Reyes, RN, RM, MAN Page 6