Set 5 - Diagnostic Test
Set 5 - Diagnostic Test
Set 5 - Diagnostic Test
1. A student is anxious about an upcoming examination but is able to study intently and does not
become distracted by a roommate’s talking and loud music. What level of anxiety is the student
experiencing?
A. Mild level anxiety
B. Severe level anxiety
C. Panic level anxiety
D. Moderate level anxiety
2. A client comes to the hospital because of intense feelings of unrest, inability to sleep and frequent
episodes of panic. The client tells the Nurse, “I admitted myself because I think I’m going crazy.” The
Nurse should recognize the client’s remark as:
A. Plea for support
B. Reflection of insightfulness
C. Symptom of depression
D. Test of the Nurse’s trustworthiness
3. When teaching a group of clients about antianxiety medications, the Nurse explains that
benzodiazepines affect which brain chemical?
A. Acetylcholine
B. GABA
C. Norepinephrine
D. Serotonin
4. A client is unwilling to go out of the house for fear of doing something crazy in public. Based on this
data, the Nurse determines that the client is experiencing:
A. Agoraphobia
B. Claustrophobia
C. Social phobia
D. Zoophobia
5. Nicole likes her cabinet to be as organized as possible and usually arranging all its contents in
symmetrical positions. She is fixated in which developmental stage?
A. Oral Stage
B. Anal Stage
C. Phallic Stage
D. Genital Stage
6. A client continually walks up and down the hall, touching every other chair. If unable to do this, the
client becomes quite upset. The Nurse should:
A. Keep talking to distract the client from touching the chairs.
B. Let the client continue touching the chairs but wait until fatigue sets in.
C. Allow the behavior to continue but with the client help set the time limits to be imposed
D. Remove all chairs from the hall, relieving the client of the necessity to touch every other one.
7. A client with a fear of air travel is being treated in a mental health clinic using systematic
desensitization. The Nurse would consider the treatment successful if:
A. The client plans a trip requiring air travel.
B. The client takes a short trip in an airplane.
C. The client recognizes the unrealistic nature of the fear of riding on airplanes.
D. The client verbalizes a decreased fear about air travel.
8. The Nurse is assessing a client for symptoms of PTSD. Which among the following symptoms is not
typically seen with this diagnosis?
A. Anger with numbing of other emotions
B. Exaggerated startle response
C. Feels the need to perform rituals
D. Frequent flashbacks and nightmares
9. A client who had panic attack the previous day says to the Nurse, “That was a terrible feeling I had
yesterday. I’m so afraid to talk about it.” The Nurse’s most therapeutic response would be:
A. “It’s best that you try to talk about it.”
B. “OK, we don’t have to talk about it.”
C. “What were you doing yesterday when you first noticed the feeling?”
D. “I understand. That feeling probably won’t come back.”
10. Mrs. Amor, 35 years old, diagnosed with laryngeal cancer stage 4. Which of the Nurse’s statements
is appropriate to facilitate the grieving process?
A. “What came into your mind regarding your condition?”
B. “What do you think you did that made you sick?”
C. “Don’t be sad. At least you still have time to prepare.”
D. “It’s alright. Everything will work out fine.”
11. She verbalized, “I pray that I may be able to live to see my children get married.” What stage of
grieving is she in?
A. Denial
B. Anger
C. Bargaining
D. Acceptance
12. During the grieving process, Mrs. Amor can be assisted by the following nursing interventions
EXCEPT:
A. Allow adaptive denial.
B. Allow client to be withdrawn and wait for patient to talk.
C. Promote maintenance of health.
D. Encourage client to accept support.
13. Mrs. Amor underwent series of chemotherapy and experiencing the physical discomfort. Mrs. Amor’s
husband verbalized to the Nurse, “I feel helpless whenever I see her vomiting and weak after therapy.”
The statement indicates:
A. Manipulation
B. Role Strain
C. Denial
D. Anger
14. The following are the appropriate nursing interventions for Mr. Amor EXCEPT:
A. Encourage caring for one’s own needs.
B. Exploring ways on how he can help the patient.
C. Exploring thoughts and feelings.
D. Support expression of anger in whatever manner.
15. An elderly client verbalized, “I only have a few friends. My daughter lives in another place and
couldn’t care whether I live or die. She doesn’t even know I am hospitalized.” The Nurse recognizes that
the client’s communication is probably a:
A. Call for help to prevent acting on suicidal thoughts
B. Clue to depression that is blocking the motivation to do self-care
C. Manipulative attempt to persuade the Nurse to call the daughter
D. Request for information about community social support groups
16. On the fifth hospital day, the Nurse observes that a depressed client remains lying on the bed when
the clients are called to the dining room for lunch. To encourage the client to eat, the Nurse should:
A. Simply state, “I will accompany you to the dining room”.
B. Bring a tray to the client’s room and leave it without comment.
C. Provide information about the importance of eating to maintain health.
D. Wait for the client to go out from her room.
17. After three weeks while receiving a tricyclic medication, the client states to the Nurse, “I’m really
feeling better, my energy level is up. Did the Nurse aid tell you that I gave her my designer purse?” The
Nurse recognizes that this statement may indicate:
A. An increased risk for suicide
B. A marked improvement in mood
C. An improved socialization
D. A decreased need for continued observation
18. A depressed client is admitted to the hospital after being found bleeding from a self-inflicted
superficial gunshot wound. To assess the client’s high risk for another suicide, the Nurse should:
A. Ask the client why suicide was attempted
B. Determine whether there is a family history of suicide
C. Wait for the client to open the topic.
D. Directly ask client about thoughts of dying.
21. The client becomes violent. Which is not part of the care of a client on restraints?
A. There must be a doctor’s order for the restraints.
B. Apply the restraints firmly.
C. Monitoring the blood pressure.
D. Observe the client’s verbal content and behavior.
22. Which medications may be ordered for a manic patient with delusion of grandeur?
1. Thorazine (Chlorpromazine)
2. Tegretol (Carbamazepine)
3. Rivotril (Clonazepam)
4. Lithium Carbonate
A. 1, 2, 3
B. 1, 3, 4
C. 1, 2, 4
D. 1, 2, 3, 4
23. The client understands the side effects Lithium Carbonate when she expresses:
A. “I should take fiber rich foods.”
B. “I may need to wear long sleeve clothes”
C. “I will limit my fluid intake.”
D. “I’m going to report diarrhea and vomiting”
25. Which of the following best explains the Nurse’s avoidance of a verbally assaultive client?
A. The Nurse attempts to minimize stimulation of the client.
B. The client needs minimal physical care.
C. The Nurse does not understand her own feelings about aggression.
D. The client has the right to express his feelings.
26. Which of the following is an expected outcome in the management of the manic patient?
A. The client expresses her anger rather than acting out.
B. The client verbalizes positive self statements.
C. The client demonstrates clear thinking pattern.
D. The client identifies support system available.
27. When the client is diagnosed to have manic episode, a priority aspect of care is?
A. Reality orientation
B. Suicide assessment and precaution
C. Enhancing self worth
D. Ensuring the need for nutrition and sleep
28. The client comments, “Pinagkakaisahan ako ng mga kamag-anak ko.” The appropriate nursing
diagnosis is:
A. Sensory perceptual disturbance
B. Altered family process
C. Impaired social interaction
D. Disturbed thought process
29. The client who actually hates her family claims that she is being plotted against is utilizing the
defense mechanism:
A. Displacement
B. Denial
C. Projection
D. Reaction Formation
30. During the interview, the client refuses to talk about herself and says, “Nurses kayo from UST? is
manifesting :
A. Resistance
B. Transference
C. Countertransference
D. Violation of boundaries
31. The client says, “Sister ko yun. Trusted ko, tapos dinala ako dito.” In attempting to validate the
client’s experience, the Nurse says?
A. “Tell me what you are experiencing.”
B. “You seem upset.”
C. “Are you saying that you don’t trust your sister anymore?”
D. “How is your relationship with your sister?”
33. A Nurse says to her client, “Our interaction is confidential provided what you tell me is not
detrimental to your safety” is a gauge of the Nurse’s:
A. Trustworthiness
B. Empathy
C. Loyalty
D. Sensitivity
35. The client claims, “I’m not supposed to be here with these patients. I’m not ill.” Which response
shows understanding of the patient’s feeling?
A. “You’re sick and needs to be treated.”
B. “It must be difficult for you to accept your condition.”
C. “Are you thinking that you will not recover?”
D. “You have a fine doctor. You will get well soon.”
36. The client taking Thorazine is noted to be restless and pacing, maybe prescribed the following BUT:
A. Benadryl
B. Akineton
C. Risperdal
D. Artane
37. In the ward, Vivian claims, “I can see devils around me.” indicates disturbance in:
1. Thought
2. Reality Testing
3. Perception
4. Judgment
A. 1, 2
B. 1, 3
C. 2, 3
D. 2, 3, 4
38. Which of the following principles best describes care of a client with personality disorder?
A. The clients are accepted although their behavior may not be.
B. Clients need limits on their behavior.
C. The staff is the one left to care for these clients.
D. The staff may use humor when dealing with these clients.
39. Perla has narcissistic personality disorder tells the Nurse, “I can be a top board executive of
Microsoft.” History revealed that she is a high school graduate. Perla’s statement is a manifestation of:
A. Illusion
B. Self-importance
C. Blatant Lie
D. Magical thinking
40. The most appropriate nursing diagnosis for Perla would be:
A. Social Isolation
B. Self-esteem Disturbance
C. Altered Sensory Perception
D. Risk for Violence
41. Purita was admitted to UST Hospital CC Ward. Upon assessment, the Nurse saw several scars on
both arms. She exhibited labile affect, impulsivity and anger outbursts. The Nurse interprets these
findings as indicative of which personality disorder?
A. Schizotypal
B. Schizoid
C. Paranoid
D. Borderline
42. Another manifestation of Purita’s personality disorder is labeling certain persons as being good or
bad. This behavior refers to:
A. Splitting
B. Secondary gain
C. Resiliency
D. Repression
43. 34 year old Pepito has few close friends. He always feels inferior and lacks self-confidence. He was
diagnosed with avoidant personality disorder. His behavioral manifestations can be related to:
A. Fear of abandonment
B. A need for perfection
C. Fear of rejection
D. Achievement of goals
45. Paquito who has antisocial personality disorder is irritable with angry outbursts. He became verbally
assaultive when his request has been denied. The most therapeutic response of the Nurse is:
A. “You’re very childish Pepito.”
B. “Why are you shouting at me?”
C. “What’s your problem? Tell me.”
D. “I will not talk to you if you continue to curse.”
46. One morning, Paquito approached Nurse Pin and said, “You’re a much better Nurse than Pong.” He
then tells Nurse Pong, “Nurse Pin is saying bad things about you.” This action made by Paquito is an
attempt to:
A. Manipulate the Nurses
B. Create guilt among the staff
C. Gain acceptance
D. Foster understanding
47. Refer to the situation in #46 – Which attitude therapy can the Nurse use in dealing with Paquito’s
behavior?
A. Passive friendliness
B. Active friendliness
C. Matter-of-fact
D. No demand
49. During health teaching, the Nurse should describe Anorexia Nervosa as being characterized by:
A. Excessive fear of becoming fat with near normal body weight
B. Obsession with the weight of others and altered body image
C. Concern about dieting and self-critical body image
D. Intense fear of becoming fat and disturbed body image
50. Bendita, an 18 year old female was diagnosed with anorexia nervosa. Upon assessment, the Nurse
should expect to find which of the following?
A. Amenorrhea, bradycardia and constipation
B. Diarrhea, dry skin and tachycardia
C. Constipation, hypertension and skin rashes
D. Hyperthermia, dysmenorrheal and oliguria
51. Bendita refuses to weigh in before breakfast, stating she just drank 1 glass of water which may
unfairly increase her weight. The best response of the Nurse would be:
A. “You are here to gain weight so that will work in your favor.”
B. “Ok, so don’t drink anymore so I can weigh you later.”
C. “You must weigh in every day at this time. Please step on the scale.”
D. “If you don’t follow my orders, I will call your doctor.”
52. In Bulimia Nervosa, the client typically responds to increased level of anxiety by:
A. Rigid food intake
B. Consuming alcohol
C. Absence of food intake
D. Binging and purging
53. Basha, diagnosed with bulimia, verbalized to the Nurse “I can’t stand myself and the way I look.”
Which of the following statements by the Nurse is most therapeutic?
A. “Tell me more about your feelings.”
B. “Let’s talk about something else.”
C. “Everyone has the same problem like you do.”
D. “Don’t worry; you’ll soon be back in shape.”
54. The Nurse notes that Basha is making positive progress when she:
A. Focuses her attention on foods
B. Spends time alone in her room after meals
C. Identifies healthy ways of coping with anxiety
D. Compares her body built with her best friend
SITUATION: Derek, a Call Center Agent, is a new member of the Alcoholics Anonymous (AA). During
intake interview, he admits that he has been taking a bottle of whiskey after duty.
58. Derek consistently attends to Alcoholics Anonymous (AA) meetings. Which of the following is true
about AA?
A. It is a therapy group that caters to spouses, relatives and friends of alcoholics
B. A self-help group led by members who admits they were powerless over alcohol
C. A self-help group by health professionals who achieved sobriety from alcohol
D. The group that modifies behavior to stay tobacco free
59. Prolonged use of alcohol may result to Wernicke’s Korsakoff syndrome characterized by severe
memory loss and confabulation. The primary cause of this is:
A. Atrophy of the brain
B. Imbalance of primary neurochemicals
C. Deficiency of B-complex vitamin
D. Deterioration of frontal lobe
60. As part of the detoxification process, Disulfiram therapy is initiated to cause an aversion to alcohol.
This works by:
A. Allowing metabolism of alcohol in the body
B. Interfering with the breakdown of alcohol
C. Reducing the craving for alcohol
D. Achieving total abstinence from alcohol
61. The following are important instructions to Derek during Disulfiram therapy EXCEPT:
A. Use of OTC drugs like cough syrups is not allowed
B. May take wine and beer in few occasions
C. Abstain self from alcohol
D. Refrain use of mouthwash
SITUATION: Agua and Oxenada are two new patients admitted for Heroine and Cocaine withdrawal.
62. Agua is admitted for heroine abuse. The Nurse knows that early withdrawal from heroine includes:
A. Fatigue, increase appetite, agitation, insomnia
B. Tremors, restlessness, diaphoresis, palpitation
C. Watery eyes, sneezing, yawning, goose bumps
D. Euphoria, increase thirst, dry mouth, eye irritation
63. Which of the following drugs will the Nurse prepare for Agua to lessen effects of heroine withdrawal?
A. Chlordiazepoxide (Librium)
B. Methadone (Dolophine)
C. Naltrexone (Revia)
D. Acamprosate (Campral)
64. Which of the following conditions are expected with cocaine abuse?
1. Formication
2. Confabulation
3. Rebound Dysphoria
4. Synesthesia
A. 1, 2
B. 3, 4
C. 1, 3
D. 2, 4
65. Which of the following nursing intervention should the Nurse prioritize for Oxenada during cocaine
withdrawal?
A. Providing adequate nutrition
B. Provision for safety
C. Fluid replacement therapy
D. Reduction of anxiety
66. A new patient in the unit is being managed for Marijuana use. The harmful effects of this drug
include:
1. Weakening of heart contractions
2. Immunosuppression
3. Bronchitis
4. Nasal septum perforation
A. 1, 2
B. 3, 4
C. 1, 2, 3
D. 2, 3, 4
SITUATION: Brando, 45 y/o laborer has sexual fantasies to children who are far younger than his own
age. He was also put to jail twice for assaulting and molesting a 10y/o child in their neighborhood.
70. Chona, 29, married but separated, is diagnosed with sexual disorder. For a while, she was keeping it
to herself till her family come to her support. Which nursing interventions are useful when caring for Rona:
1. Informing her of the treatment regimen
2. Treating her with empathy doesn’t threaten the Nurse’s sexuality
3. Accept Rona’s sexual inadequacy
4. Not to say anything that would make rona feels ashamed
A. 1, 2
B. 3, 4
C. 1, 2, 3
D. 1, 3, 4
71. Nanay Anching, 86, is an Alzheimer’s and DM patient. She can’t stay in one place and loves to talk
about her “old, happy days” when she was a beautiful lady part time studying at FEU and working as
peanut vendor near Clover Theater. In her case, she has a good recall of events that probably happened:
A. An hour ago
B. 20 years ago
C. 6 months ago
D. 5 years ago
72. As her Nurse, she often forgets your name. The best that you do is:
A. Recommend that you be relieved from her
B. Provide her with your picture with name in it
C. Be patient in presenting reality
D. Ignore when she calls you by other name
73. To promote safety when walking around, Nanay Anching should have the following:
1. A bracelet with her name, address and phone number
2. An identification card
3. Always have a companion
4. Provide right directions through maps
A. 1, 2, 3
B. 1, 3, 4
C. 1, 2, 4
D. 1,2, 3, 4
75. The most appropriate indoor game for Nanay Anching is:
A. Drawing
B. Bingo
C. Message relay
D. Stop dance
76. Nanay Anching’s talks were centered on her roles as “labandera ng mga Hapon” and being wife to
an American soldier who left her after the war. Nurse Justin’s most appropriate nursing action is:
A. Ask Nanay Anching to tell about her old pictures.
B. Tell her to narrate her most recent activities prior to confinement to hospital a month ago.
C. Ask her about her present medications.
D. Convince Nanay Anching to watch TV talk shows instead.
78. Many cognitive impaired patients don’t want to eat, won’t eat, and sometimes can’t eat. The Nurse
should consider the following BUT:
A. Serve smaller meals several times per day.
B. Serve his favorite food, provide them as well.
C. Finger foods for those who can’t stay on the table.
D. Spicy food to the maximum
79. Nanay Anching has impaired ability to recognize familiar objects. We call it:
A. Agnosia
B. Aphasia
C. Amnesia
D. Apraxia
82. Michael, 6 years old, was observed with poor eye contact, repeating other people’s words and doing
hand flapping frequently. Based on Michael’s behavior, he is manifesting:
A. Hyperactivity
B. Mental retardation
C. Autism
D. Depression
84. Which of the following nursing action may provide a trusting relationship with Michael?
A. Reinforce positive behavior through praise and rewards
B. Provide structured environment
C. Convey acceptance through touch
D. Explain the rules and routines
85. Roy, 8 years old, has an IQ of 45. Which of the following is appropriately expected from Roy?
A. Some motor and speech development
B. Can be trained in basic health habits
C. May learn to travel alone in a familiar
D. Can learn skills up to grade 6
87. Enya, 6 years old was observed by her mother for the past 3 months since the start of school as
refusing to go to school and having nightmare of being “separated” from her mother. These are
indications of :
A. Conduct disorder
B. Mental retardation
C. Separation anxiety
D. Autism
88. The following are the choice of treatment for a child diagnosed with ADHD EXCEPT:
A. Methylphenidate (Ritalin)
B. Behavior therapy
C. Amphetamine (Adderall)
D. Parent training
90. Which is a prioritized nursing intervention for a hyperactive and impulsive child?
A. Stop a potentially harmful behavior
B. Providing positive feedback on expected behavior
C. Communicating simple and direct instructions
D. Teaching parents effective behavior management
91. When a child is described to be argumentative to adults, easily angered and disobeys his parents
and teachers may be suspected to be:
A. Conduct disorder
B. Oppositional defiant disorder
C. Separation anxiety
D. Antisocial personality
92. Daisy was sexually abused by his father’s friend. While being interviewed, she appears anxious and
cries a lot. The most therapeutic response of the Nurse would be:
A. “I know something horrifying happened to you.”
B. “What do you intend to do with your dad’s friend?”
C. “Daisy, you’re upset. Calm yourself first. I can’t understand you.”
D. “Can you tell me about the incident?”
93. Nurse Kakay can lower the level of anxiety of Daisy by:
A. Recommending best coping mechanism
B. Teach her about sexuality
C. Allow her to express feelings
D. Assess her family history
94. Which of the following rights of rape victims must be addressed immediately during ER procedures?
A. Presence of a legal counsel
B. Referral to long-term counseling
C. Medical release to return to work
D. Privacy, confidentiality and resource information
95. Hilda, 36, mother of 3 children, married, consulted at the OPD, claiming she was hit by her husband.
Nurse Rhoffa’s priority nursing intervention is:
A. Instruct Hilda to file a case against her husband
B. Refer her to a psychiatrist
C. Make referrals to other community resources
D. Provide information about spouse abuse
96. Why do women victims of partner abuse stay as long as they do?
1. Believes that the abuse is her fault
2. Belief that partner is sick and needs her help
3. For readiness for court processes
4. Fear of losing custody of children
A. 1, 2, 3
B. 1, 2, 4
C. 1, 3, 4
D. 2, 3, 4
97. Hilda says, “I am still going to stay with my husband.” The Nurse’s most appropriate response is:
A. “If I were you, I’ll leave him at once.”
B. “I can give you a very good lawyer if you want.”
C. “Let’s develop a safety plan for violence.”
D. “Might as well go and talk to a psychologist.”
98. Rona, 5 years old is rushed to the ER as an abuse victim. Her mom is working in a 24/7 restaurant
from 6AM to 6PM. Care of Rona is left to a neighbor with 2 preschoolers. These are common signs of
tortures (within 24 hours):
1. Teeth, head and genital injuries
2. Bone fractures, scars and bruises
3. Damaged family relationships
4. Pains on body parts when touched
A. 1, 2, 3
B. 1, 2, 4
C. 1, 3, 4
D. 2, 3, 4
99. To better help Rona, Nurse Bernie highly recommends this activity which is:
A. Music therapy
B. Remotivation Therapy
C. Dance Therapy
D. Play Therapy
100. What is the priority nursing intervention for a child or elder victim of abuse?
A. Analyze family situations
B. Assess the scope of the abuse
C. Teach appropriate coping skills
D. Implement measures to ensure victim’s safety