Commitment. Excellence. Quality. Page 1

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 7

NURSING. MIDWIFERY. CIVIL SERVICE.

CRIMINOLOGY
3rd Floor BSBI Building Bicol University, Legazpi City 4500
TEL. (052) 742- 1590/09175002996
COMPETENCY EVALUATION
PSYCHIATRIC AND MENTAL HEALTH NURSING
Instructions:
1. Choose the best answer and shade the corresponding letter on the answer sheet.
2. Avoid erasures or any form of alteration.
3. Use pencil in shading your answers.
___________________________________________________________________________________________________
Situation: Psychiatric-mental health nursing is a specialized area of nursing practice that uses theories of human behaviour as its scientific framework and
requires the purposeful use of self as its part of expression. It is concerned with promoting optimum health for society. The following questions apply.
1. The initial step for client to attain positive self-concept:
a. self-care c. self-reflection
b. self-awareness d. self-confidence
2. It is the ability to enter the life of another person and perceive his current feelings and their meaning:
a. empathy c. genuineness
b. respect d. sympathy
3. Therapeutic use of self is best described as:
a. the ability to effect change in patient by imposing one’s spiritual values
b. being accurate in the administration of medication
c. the ability to consciously structure nursing intervention and establish relatedness
d. being skilful and artistic in giving treatment
4. In the process of development, the individual strives to maintain, protect and enhance the integrity of self. The nurse understands that this is usually
accomplished through the use of:
a. affective reactions c. ritualistic behaviour
b. withdrawal patterns d. defense mechanisms
5. A man is unable to remember the car accident he was in last week in which his brother was killed. This is an example of what kind of coping
mechanism?
a. denial c. suppression
b. repression d. projection
Situation: The ability to establish therapeutic relationships with clients is one of the most important skills a nurse can develop. The following questions apply.
6. In psychiatric nursing, the most important tool the nurse brings to a helping relationship is:
a. oneself and a desire to help
b. knowledge of psychopathology
c. advanced communication skills
d. years of experience in psychiatric nursing and milieu management
7. A male nurse reminds a client that it is time for group therapy. The client responds by yelling at the nurse, “You are always telling me what to do,
just like my father.” The client’s response is an example of:
a. regression c. reaction formation
b. transference d. countertransference
8. A male nurse is caring for a client. The client states, “You know, I’ve never had a male nurse before.” The nurse’s best reply should be:
a. “Does it bother you to have a male nurse?”
b. “There aren’t many of us; we’re minority.”
c. “How do you feel about having a male nurse?”
d. “You sound upset. I will get a female nurse to care for you.”
9. As depression begins to lift, a client is asked to join a small discussion group that meets every evening on the unit. The client is reluctant to join
because, “I have nothing to talk about.” What is the best response by the nurse?
a. “Maybe tomorrow you will feel more like talking.”
b. “Could you start off by talking about your family?”
c. “A person like you has a great deal to offer the group.”
d. “You feel you will not be accepted unless you have something to say.”
10. A father of a 16 year old student who has just been diagnosed with Hodgkin’s disease tells the nurse that he doesn’t want his child to know the
diagnosis. The nurse best response would be:
a. “It is best if he knows the diagnosis.”
b. “The cure rate for Hodgkin’s disease is high.”
c. “Let’s talk about why you don’t want him to know.”
d. “Would you like someone with Hodgkin’s disease to talk to you?
11. A psychotic client reports to the evening nurse that the day nurse put something suspicious in his water with his medication. The nurse replies,
“You’re worried about your medication?” The nurse’s communication is:
a. an example of presenting reality
b. reinforcing the client’s delusion
c. focusing an emotional content
d. a non therapeutic technique called mind reading
12. During a private conversation, a client with borderline personality disorder asks the nurse to keep his secret and then displays multiple, self-
inflicted, superficial lacerations on the forearms. What is the nurse best response?
a. “That’s it! You’re on suicide precaution.”
b. “I’m going to tell your physician. Do you want to tell me why you did that?”
c. “Tell me what type of instrument you used. I’m concerned about infection.’
d. “The team needs to know when something is important occurs in treatment. I need to tell the others, but let’s talk about it first.”
13. One of the clients verbalizes, “Masama ang pakiramdam ko. Hindi ako nakatulog kagabi.” A therapeutic response of the nurse would be:
a. “Baka ini-istorbo ka na naman ng mga boses.”
b. “Sinabi mo sana sa nars para nabigyan ka ng sedative drug mo.”
c. “Relax lang. Huwag kang masyadong mag-isip ng mga problema mo.”
d. “Maari mo bang sabihin sa akin ang mga naiisip at nararamdaman mo?”
14. Jamby is terminally ill of cancer, looking sad she expressed, “Wala na yata akong pag-asang mabuhay pa.” A nurse best response would be:
a. “Mukhang napakabigat ng dinaramdam ninyo. Andito po ako at pwede tayong mag-usap.”
b. “Huwag po ninyong isipin ang sakit ninyo. Bale wala yon. Andito naman po ako para makausap ninyo.”
c. “Lakasan ninyo ang loob ninyo. Lahat naman po tayo ay doon and patutunguhan.”
d. “Gagaling din po kayo at lalo pang gaganda. Wag po kayong mag-alala.”
15. A 30 year old woman is brought to the local community hospital by a family member because the woman “has been acting strange”. When
assessing the client, which of the following would alert the nurse?
a. “I cry all the time. I am so depressed.”
b. “I would like to end it all with sleeping pills.”

COMMITMENT. EXCELLENCE. QUALITY. Page 1


c. “My boss is always picking on me and it makes me angry.”
d. “Dad has always been so independent. He’s living alone for years since mom died.”
Situation: Therapeutic milieu is designed to meet the emotional and interpersonal needs of clients, help them control problematic behaviour and assist them in
the development of coping skills. The following questions apply.
16. As part of the milieu therapy, the client has the freedom to do which of the following?
a. express feelings in a socially acceptable manner
b. select daily schedule based on personal preferences
c. revise rules according to individual needs
d. vote on policies and procedures of the unit
17. A client with a psychotic disorder refuses to bathe or change her clothes. Which of the following interventions is congruent with the role of the
nurse a mother surrogate?
a. allow the client to make decisions about hygiene
b. assist client to bathe and change clothes
c. encourage family member to talk to client
d. put client in private room to avoid offending others
18. The nurse is preparing an orientation program for a group of new staff members at a community mental health center. As part of the program, the
nurse will be describing the therapeutic milieu. Which of the following would the nurse include? Select all that apply.
1. use of a multidicisplinary treatment team
2. participation of client’s family and support persons
3. use of limit-setting
4. employment of behavioural interventions
5. education of client and family
a. all of the above c. 1, 2 and 3
b. all except 3 d. 2, 4 and 5
Situation: Nurse Penguin has been assigned as co-facilitator for a group of elderly residents in a local nursing home. The group of residents is composed of 8
men aged 70-85; the purpose of the group is to promote social interaction.
19. During the first meeting, Ms. Penguin introduces herself and asks each member to do the same. What information might be useful to the nurse at
this time?
a. the reason for each residents admission to the nursing home
b. socio-cultural history of each resident
c. the usual activity patterns of each resident
d. the interaction pattern in the group
20. When the nurse asked the group what kinds of things would they like to focus on, the only responses she received are comments such as, “You tell
us; the leader” or “Why so we need to come to this group anyway?” this behaviour probably means:
a. the nurse has not explained the purpose of the group clearly enough
b. the residents are anxious (a typical response)
c. the residents are angry about being in the group
d. an interpretation of these comments is not possible after only one meeting
21. Over period of several weeks, Mr. Turoy has monopolized most of the conversation in the group. How might the group facilitator best handle this?
a. take him aside and kindly tell him that the others deserve a chance to talk too
b. ignore the client’s comment and they will occur often
c. tactfully share your perception with the group and wonder aloud why they let it occur
d. transfer the client to another group.
Situation: A group of adult Schizophrenic patients were recommended to undergo social skills training.
22. The following are the objectives of social skills training program, except:
a. explore deep seated intra-psychic conflicts
b. practice skills in relating with people
c. help build self esteem and self confidence
d. develop and practice general coping skills
23. Social skill training is not primarily indicated for psychiatric patients who are:
a. in acute stage of illness
b. having difficulties starting and maintaining interpersonal relationship
c. having chronic episodes of stress and anxiety while interacting with others
d. experiencing recurrence of symptoms in front of particular people or among people in general
24. The focus of group interaction is ‘here and now”. An appropriate topic would be:
a. ways to celebrate Christmas in december
b. how to spend the summer vacation
c. an unforgettable experience as a child
d. how to tell a joke
25. An appropriate technique for the participation to practice how to communicate effectively through:
a. lecture c. role play
b. seminar d. psychodrama
26. Considering that is best to learn by example, it is most practical to:
a. model good social skills throughout the session
b. relate successful past experience
c. invite a resource person
d. watch movie
Situation: The purpose of psychosocial assessment is to construct a picture of the client’s current emotional state, mental capacity and behavioural function.
The following questions apply.
27. When the nurse is assessing whether or not the client’s ideas are logical and make sense, the nurse is examining which of the following?
a. thought content c. memory
b. thought process d. sensorium
28. To assess the client’s ability to concentrate, the nurse would instruct the client to do which of the following?
a. explain what “a rolling stone gathers no moss” means
b. name the last three presidents
c. repeat the days of the week backward
d. tell what a typical day is like
29. One of the clients was asked, “Have you eaten?” and she answered, “Have you eaten? Have you eaten? Have you eaten?” this phenomenon is
called:
a. echolalia c. dissociation
b. verbigeration d. neologism
Situation: ROB, 30 years old, was admitted to the psychiatric ward because of religious preoccupation, deterioration of self-care and disturbed thoughts. He
believes that he has committed a lot of sins. He is threatened by people reaching out to him. He’s fasting for several days was not sufficient for him to feel
forgiven.
30. A delusion is:
a. psychomotor disturbance c. thought disturbance
b. mood disturbance d. disturbance of perception

COMMITMENT. EXCELLENCE. QUALITY. Page 2


31. The nursing goal for Rob is to:
a. have him see a priest for confession
b. encourage him to pray to atone for his sins
c. help him develop a positive self image
d. socialize him with a group to keep him in touch with reality
32. As Rob talks about his sins that he believes make people look down upon him. It is best to:
a. agree with him and sympathize how sinful he has really been
b. explore the nature of his sins
c. explain that he is depreciating himself too much
d. acknowledge how he feels and focus on reality oriented topics
33. Rob was engaged in horticulture therapy. Which of the following describes the intervention?
a. the therapist brings bongos, tambourine and bells and encourages client participation
b. Tomy, Rob, Karen and Pia play scrabble every night after supper
c. every afternoon, ROB goes in the garden where he works with plants, seeding tree planting and watering them
d. the client finds sketching, relaxing and rewarding
Situation: A nurse was assigned in the psychiatric ward of the hospital where he encountered different cases of schizophrenic clients. The following questions
apply.
34. A client is admitted with chronic undifferentiated and schizophrenia. During the next several days, the client is seen laughing, yelling and talking
about herself. This behaviour is characteristics of:
a. delusion c. illusion
b. looseness of association d. hallucination
35. A client states, “That TV anchor is talking about me.” The nurse recognized this type thought process as:
a. thought broadcasting c. thought insertion
b. delusion of reference d. delusion of persecution
36. The nurse’s assessment of a patient with a diagnosis of catatonic schizophrenia will most likely reveal the following sets of behaviour?
a. aloofness, distrust, suspiciousness and grandiosity
b. regression, giggling, smiling and laughing
c. anxious, bizarre behaviour, depression and elation
d. stupor, hallucination, negativism, automatism
Situation: Nick a 35 year old employee was admitted to the hospital because of behavioral problems at the office. He started to be bossy, claiming that he is
the manager on the unit. On admission he was diagnosed to be having Bipolar disorder, manic phase.
37. Nick's condition is primarily a problem of
a. affect c. thought
b. perceptiond. conscience
38. A therapeutic environment for Nick is:
a. minimal environmental stimuli
b. strict isolation and withering privileges
c. no limitation on his activities
d. well lit and basically colored room
39. During socialization Nick was provoked, became furious, started shouting and making personal demands A therapeutic intervention of the nurse is
a. Take him away from the group until he manages to have control of himself.
b. Restrain him and put him on isolation to protect other patients
c. Prevent him from becoming more furious by giv.ng an extra PRN dose of sedative
d. Respond with. Nick don’t favor anyone. Everybody in the ward is on equal footing

40. When talking with the client who is in acute manic phase with flight of ideas, the nurse primarily needs to:
a. speak loudly and rapidly to keep client’s attention, as the client is easily distracted
b. focus on the feelings conveyed rather than the thoughts expressed.
c. encourage the client to complete one thought at a time
d. allow the client to talk freely
Situation: Suicide is always a consideration for clients with depression. The nurse should be able to recognize manifestations of suicidal behaviour in order to
plan appropriate nursing interventions and prevent unnecessary deaths or injury from suicide.
41. Suicide precaution should be strictly observed when the client exhibits which of the following manifestations?
a. a client feels weak and tired c. the client has sudden cheerfulness
b. the client expresses hostile feelings d. the client is agitated
42. A female client confides to the nurse that she has been thinking about suicide. The nurse recognizes that the client:
a. wishes to frighten the nurse
b. wants attention from the staff
c. feels safe and can share her feeling with the nurse
d. is fearful of her own impulses and is seeking protection from them
43. A female client has been hospitalized for 3 weeks while receiving TCA medication for severe depression. One day, the client states to the nurse,
“I’m really feeling better, my energy level is up. Did the nurse aide tell you that I gave her my designer purse?” the nurse recognizes that this
statement may indicate:
a. an increased risk for suicide
b. an improved socialization level
c. an marked improvement in mood
d. a decreased need for continued observation
Situation: Anxiety is a vague feeling of dread or apprehension. It is an unavoidable life circumstance that serves as a response of the body to internal and
external stressors. Nurses must be ready to provide nursing care for clients suffering from anxiety and anxiety disorders.
44. A client’s severe anxiety and panic is often considered to be “contagious”. When the nurse identifies that personal feelings of anxiety are
increasing, the nurse should:
a. refocus the conversation on some pleasant topics
b. say to the client, “Calm down, you are making me anxious too.”
c. say, “I have to leave for awhile. I’ll send someone in and I’ll be back later.”
d. remain quiet so that personal feelings of anxiety do not become apparent to the client
45. When speaking with the client who has just experienced a panic attack, the nurse can best address the client’s concerns most therapeutically by
stating:
a. “I would have been upset too.”
b. “Episodes like this can be upsetting, but they do end.”
c. “You are concerned that this might happen again.”
d. “You’re family was concerned that you were having a heart attack.”
46. A client with a general anxiety disorder says to the nurse, “What can I do to prevent over-responding to stress in the future?” What is the nurse’s
best response?
a. “Hone your problem solving skills.”
b. “Improve your time management skills.”
c. “Ignore situations that you cannot change.”
d. “Develop a wide variety of coping strategies.”

COMMITMENT. EXCELLENCE. QUALITY. Page 3


47. The nurse understands that compulsive symptoms such as using paper towels to open doors develop because the clients are:
a. unconsciously controlling unacceptable impulses or feelings
b. consciously using this method to punish themselves
c. listening to voices that tell them the doorknobs are unclean
d. fulfilling a need to punish others by carrying out an annoying procedure
48. A college student was at the airport waiting for his flight home when a terrorist bomb exploded nearby, killing several people. He developed
selective psychogenic amnesia and was admitted to the hospital for treatment. He is cooperative, however he remembers nothing regarding his
experience and when questioned becomes very anxious. What is the best nursing intervention?
a. plan a trip with the client to the airport to jar his memory
b. help the client develop coping skills to deal with his anxiety
c. be firm with the client and insist he tries to remember
d. tell the client it is alright to be anxious and we’ll talk another time
49. The situation in which individuals have excessive worry or belief that they are suffering from a physical illness despite lack of medical evidence is
known as:
a. psychogenic pain c. hypochondriasis
b. psychogenic fugue d. coversion disorder
50. The term “la belle indifference” can be described as:
a. longstanding feeling of inferiority
b. situation that threaten self-esteem
c. marked lack of subjective distress toward symptoms
d. partially expressed forbidden impulses
51. A disorder where an individual may manifest a personality that is opposite to a previous identity?
a. psychogenic amnesia c. la belle indifference
b. somatoform disorder d. psychogenic fugue
52. Management of client with Somatoform disorders include the following except:
a. use of matter of fact attitude
b. help develop insight into his condition
c. help use effective coping skills that reduces stress and anxiety
d. ignore somatic complaints
53. The desired outcome for the nursing care of client with hypochondriasis is:
a. nurse will respond in an authoritative manner when the client complains of pain
b. client will seek 2nd opinion from health care providers
c. client will state the relationship between life events and physical symptoms
d. nurse will reinforce physical symptoms experience by the client
54. The nurse working with a client with dissociative disorder understands that his disorders is likely to begin as a:
a. gradual loss of memory c. effects of drug abuse
b. means to avoid responsibilities d. protective defense against anxiety
Situation: Tatang and Penguin are in their late 40’s, have been married for 20 years and at the peak of their careers. Suddenly, Penguin discovered that her
husband was falling in love with another woman. Shaken by these situations, she started to have problems in sleeping and could not function well at work and
at the risk of losing her job. Tatang asked for forgiveness and regret very much the hurt his wife was going through and suffered guilt feelings.
55. All but one is characteristics of crisis:
a. a hazardous or threatening event occurs
b. it has growth promoting potential
c. usual problem solving methods and coping mechanisms produce a solution
d. anxiety or depression continues to increase
56. The nurse employs which of the following interventions during crisis management?
a. problem solving c. role-playing
b. behaviour modification d. nurse-patient relationship
57. Assessment data of the nurse include all of the following except:
a. coping mechanisms c. perception of the event
b. situational support d. repressed problems
58. The duration of crisis usually last several days and usually:
a. 2-4 weeks c. 1-2 months
b. 1-2 weeks d. 4-6weeks
Situation: Gibo, a supervisor in a computer store and has intensive drive for achievement. He has difficulty in relating with his co-workers being highly-
critical and sarcastic. He was diagnosed with paranoid personality disorder.
59. The appropriate initial nursing intervention for the client:
a. reward him for acceptable behavior
b. establish trusting relationship with him
c. decrease environmental stimuli
d. help him to assume responsibility for himself
60. Which of the following is an effective attitude in caring for the client who has personality disorder?
a. firmness in setting limits to his behavior
b. consistency in dealing with him
c. friendliness to show him you care
d. patience in listening to his talks
61. After being informed with his discharge plan, the client starts to show anxiety. Which of the following is an effective nursing intervention?
a. involve his family in planning for the discharge
b. encourage him to express his feelings and concern about leaving the institution
c. tell him that he will be discharge only if he is ready
d. help him identify significant others to lessen his anxiety
Situation: Personality disorders are diagnosed when personality traits become inflexible and maladaptive and significantly interfere with how a person
functions in society or cause the person emotional distress. The following questions apply.
62. A client with anti-social personality disorder smokes where it is prohibited and does not follow other unit or hospital rules. The client gets others to
do the laundry and other personal chores, splits staff and will only work with certain nurses. The primary focus of this client’s care plan should be:
a. consistency in enforcing unit rules and hospital policy
b. isolating the client to decrease contact with easily manipulated clients
c. engaging in power struggles with the client to decrease the incidence of manipulative behavior
d. using behaviour modification to decrease the amount of negative behaviour by using negative reinforcement
63. Your client states, “I work for the government and I am so important in my office that other worker will not able to work without me.” This is
characteristic of:
a. histrionic personality disorder c. narcissistic personality disorder
b. antisocial personality disorder d. multiple personality disorder
64. A client is diagnosed as borderline personality disorder. An important characteristics displayed in this client is an inability to incorporate all good or
all bad. This is known as:
a. denial c. sublimation
b. splitting d. regression

COMMITMENT. EXCELLENCE. QUALITY. Page 4


65. An appropriate short term-goal for a client with borderline personality disorder, as mutually agreed upon by client and nurse would be for the client
to:
a. discuss feelings of self-destruction with the nurse rather than to act out impulses
b. state ability to use problem solving as a means to deal with life problems
c. control of impulses through use of PRN medications
d. identify the process of splitting before acting out the behavior
Situation: Symptoms of alcohol withdrawal usually begin 4 to 12 hours after cessation or marked reduction of alcohol intake. The following questions apply.
66. Which of the following signs is most characteristic of alcohol withdrawal?
a. decrease blood pressure c. persistent hallucination
b. hypersomnia d. tremors
67. The nurse is caring for a client who has been diagnosed with delirium. Which statement about delirium is true?
a. it is characterized by an acute onset and lasts about 1 month
b. it is characterized by slowly evolving onset and lasts about 1 week
c. it is characterized by slowly evolving onset and lasts about 1 month
d. it is characterized by an cute onset and last for hours to a number of days
68. The client with alcohol withdrawal delirium has disorientation and threatening hallucinations. At this time, what other clinical finding would the
nurse find in this client?
a. increased alertness c. agitation
b. seizure activity d. cerebellar ataxia
Situation: Janine, 17 years old admitted for rapid loss of weight associated with Anorexia Nervosa
69. The nurse in her assessment would note which of the following signs and symptoms?
a. bradycardia, hypotension c. tachycardia and hypertension
b. palpitation and hypertension d. nausea and vomiting
70. The most important nursing diagnosis important to include in her plan of care:
a. impaired gas exchange
b. sensory perceptual alteration
c. decreased fluid volume
d. altered nutrition less than body requirement
71. After lunch, client was observed to purge in the bathroom. What would be the appropriate nursing intervention?
a. observe the client for 24 hours for any incidence of purging
b. tell the client that she would be forced to eat the food served for her soon after purging
c. tell the client that she would be given extra food
d. client should be observed 2 hours after meal
72. Which of the following is most important goal for the client?
a. be able to cope with stress and conflict
b. develop more realistic body image
c. be able to identify and express her feelings and concern
d. be able to identify significant others
73. A female client has gone from 110 lbs to 90 lbs, and she has stopped menstruating. Based on this information, the nursing diagnosis would be
alteration in nutrition: less than body requirements related to:
a. excessive exercise program c. loss of 15 % body weight
b. self-induced vomiting d. abuse of laxatives
Situation: Gloria, 60 years old, is admitted to the hospital with symptoms of increasing forgetfulness, irritability, decreasing concentration and feelings that
the others are out to get her. The medical diagnosis is AD.
74. In view of the medical diagnosis, which of the following pieces of information would be most helpful to obtain for immediate nursing care?
a. family history concerning other members with similar disorders
b. her previous occupation, hobbies and diversion activities
c. her past medical history
d. major stressor in her life
75. Memory loss for recent event is the most common symptom during the early stages of AD. Of the following actions which one will probably not
help?
a. answer questions repeatedly as needed using short, simple sentences
b. place a large calendar next to the client’s bed
c. place the client’s name in large letters outside of the door to her room
d. tell the client she is getting increasingly forgetful
76. The client has difficulty remembering where her room is on the unit. Which of the following would best help her to alleviate this problem?
a. paint the door to her room with light blue color
b. assign her a buddy who will help her when she gets lost
c. put her picture and her name in large letters on the door on the door to her room
d. assign her a room next to the nurse’s station so the staff can assist her as necessary
77. The client food intake is only marginally adequate, in part because of her inability to sit at the table and concentrate for the length of time necessary
to eat the meal. Which approach would be most likely to ensure a nutritionally adequate intake?
a. order a full liquid diet that will take her less time to eat
b. feed the client
c. order 6 small, nutritionally balanced meals
d. offer small amounts of food whenever she appears ready to eat
78. During a visit, the husband of the client spoke to the nurse. He tearfully told her that his son and daughter are urging him to place the client in a
nursing home. Which of the following is the best response?
a. “Your wife will recover soon. Just give her time.”
b. “Our social service department has list of the best nursing homes in the area that you may want to consider.”
c. “When you are finished visiting your wife, come up to the nursing station. I’ll find a quiet place where we can talk.”
d. “I’m sure you will be able to take care of your wife at home without that much difficulty.”
Situation: The community health nurse encounters special children in the community.
79. The nurse teaches parents about children beginning concepts of right and wrong by emphasizing child rearing attitude and practices during:
a. school age c. infancy period
b. pre-school d. latency period
80. It is best for the parents to teach healthy interpersonal relationship to their children by:
a. modelling to their children
b. encouraging their children to attend secondary school
c. encouraging their children at home to behave properly
d. teaching their children good manners and right conduct
81. A 3 1/2 –year old child begins screaming and kicking when a laboratory technician comes to draw blood. The nurse recognizes this reaction is
primarily as a result of the child’s:
a. fear of loss of control c. fear of intrusive procedures
b. inability to localize pain d. past experience with the procedure
82. Mental retardation is:
a. a delay in normal growth and development caused by inadequate environment

COMMITMENT. EXCELLENCE. QUALITY. Page 5


b. a lack of sensory abilities development
c. a condition of sub average intellectual functioning that originates during the developmental period and is associated with
impairment in adaptive behavior
d. a severe lag in neuromascular development and motor abilities
Situation: Manny, aged 7 was diagnosed having Attention Deficit Hyperactivity Behavior
83. The client parents express apprehension on their ability to care for him. The nurse identifies this appropriate diagnosis:
a. hopelessness c. self-esteem disturbance
b. altered parenting role d. impaired adjustment
84. Which of the following drugs is usually ordered for child with ADHD?
a. Methylphenidate c. Diazepam
b. Chlorpromazine d. Imipramine
85. The client is most likely to exhibit which of the following?
a. destructiveness, somatic complaints and physical aggressiveness
b. poor concentration, decreased attention span and impulsiveness
c. distractibility, assertiveness and somatic complaints
d. distractibility, restlessness and decreased attention span
86. In the client’s nursing care plan, the nurse identified this nursing diagnosis: ineffective Individual Coping based on one of the following behaviours:
a. constantly tell lies
b. initiates fights with his classmates
c. inability to verbalize his feelings
d. easily distracted by extraneous stimuli
Situation: Noynoy, six years old sitting in the corner of the room rocking back and forth and spinning his toy occasionally. He was diagnosed to have Autism.
87. The client manifests one of the following behaviour?
a. often shifts from one activity to another
b. may indulge in repetitive play with fingers and hands
c. talk excessively
d. has difficulty playing quietly
88. Autism among children is associated with one of the ff:
a. disturbed body image
b. sibling rivalry among children
c. dysfunctional family environment
d. disturbed mother-child relationship
89. Milieu management for autistic children would include which one of the ff?
a. developing an environment that provides physical and emotional safety
b. assisting the child in activities of daily living
c. providing recreational activities
d. providing child with stimulant activity
Situation: Psychopharmacologic agents are mainstay treatment for clients suffering from wide range of mental and psychiatric disorders. As a beginning
nurse, you must know the action, side effects and contraindications of most commonly used drugs to ensure safety of clients and achieve the maximum effect
of the drugs.
90. Dopamine receptor agonist such as Bromocriptine (Parlodel) relieves muscle rigidity caused by antipsychotic medication by:
a. blocking the dopamine receptors in the CNS
b. blocking the Ach in the CNS
c. activating norepinephrine in the CNS
d. activating dopamine receptors in the CNS
91. Most antipsychotic medications exert which of the following effects on the central nervous system?
a. stimulate the CNS by blocking post-synaptic dopamine, norepinephrine and serotonin receptors
b. sedate the CNS by stimulating serotonin at the synaptic cleft
c. depress the CNS by blocking the post-synaptic transmission of dopamine, serotonin and norepinephrine
d. depress the CNS by stimulating the release of Ach
92. The nurse is teaching a client taking a MAOI about foods with tyramine that he should avoid. Which of the following statements indicates that the
client needs further teaching?
a. “I’m so glad I can have pizza as long as I don’t order pepperoni.”
b. “I will be able to eat cottage cheese without worrying.”
c. “I will have to avoid drinking non-alcoholic beer.”
d. “I can eat green beans on this diet.”
93. The signs of lithium toxicity include which of the following?
a. sedation, fever, restlessness
b. psychomotor agitation, insomnia, increased thirst
c. elevated WBC, sweating, confusion
d. severe vomiting, diarrhea, weakness
94. Which of the following is a concern for children taking stimulants for ADHD for several years?
a. dependence on drugs c. growth suppression
b. hypersomnia d. weight gain
95. The nurse is caring for a client with schizophrenia who is taking Haloperidol. The client complains of restlessness, can’t sit still and has muscle
stiffness. Of the following prn medications, which would the nurse administer?
a. haloperidol, 5mg PO c. propanolol, 20mg PO
b. benztropine, 2 mg PO d. trazodone, 50mg PO
96. A client is admitted to the local psychiatric facility with bipolar disorder in the manic phase. The physician decided to start the client on lithium
carbonate (Lithonate) therapy. One week after this therapy started, the nurse notes that the client’s serum lithium is 1 mEq/L. What should the nurse
do?
a. call the physician immediately to report laboratory results
b. observe the client closely for signs and symptoms of lithium toxicity
c. withhold the next dose and repeat the laboratory test
d. continue to administer the medication as ordered
97. A client with manic episodes is taking lithium. Which electrolyte level should the nurse check before administering this medication?
a. calcium c. chloride
b. sodium d. potassium
98. A client has been receiving chlorpromazine, an antipsychotic, to treat his psychosis. Which findings should alert the nurse that the client is
experiencing psuedoparkinsonism?
a. restlessness, difficulty sitting still and pacing
b. involuntary rolling of the eyes
c. tremors, shuffling gait and masklike facies
d. extremity and neck spasm, facial grimacing and jerky movements
99. You are assigned at the mental ward in Imind Medical Center. Your client is about to undergo electroconvulsive therapy. Which of the following
indications is the primary use of ECT?
a. severe agitation

COMMITMENT. EXCELLENCE. QUALITY. Page 6


b. antisocial behavior
c. non-compliance with treatment
d. major depression with psychotic features
100. Nursing interventions prior to ECT should include:
a. providing an opportunity for the client to asks questions and express concerns about ECT
b. telling the client that it is not helpful to concentrate on the therapy
c. reassuring the client that ECT is no worse than having a venipuncture
d. telling the client that she will recover completely as a result of ECT

COMMITMENT. EXCELLENCE. QUALITY. Page 7

You might also like