Psychiatric Nursing Care: Schizophrenia, Eating Disorders, Substance Use, PTSD, Exams of Nursing

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PHYSIOLOGICAL FINAL EXAM REVIEW QUESTIONS

WITH ANSWERS 2024/2025 UPDATES

1. The nurse is admitting a client with a diagnosis of suspected schizophrenia. Which of the following clinical manifestations should the nurse assess as a positive clinical manifestation of schizophrenia? a) Anhedonia and blunted affect b) Hallucinations and delusional thinking c) Lack of motivation d) Abnormal movements of the mouth
2. Which of the following should the nurse include in the plan of care for a client taking an antidepressant drug? a) Encourage the client to drink low-calorie beverages a) Instruct the client to take the drug on an empty stomach b) Inform the client that urinary frequency is an adverse reaction c) Monitor the client for bradycardia prior to administration
3. The nurse should include which of the following adverse reactions to Olanzapine (Zyprexa) in the drug instructions given to a client? Select all that apply: a) Constipation b) Weight loss c) Loss of taste d) Hypotonia (you would have hypertonia) e) Insomnia f) Urinary retention (you would have incontinence)
4. The nurse caring for a client administers sertraline (Zoloft) for which of the following disorders? a. Abnormal movement disorder b. Brief reactive psychosis c. Major depressive disorder d. Schizophrenia
5. A client diagnosed with social phobia asks the nurse about the likelihood of children inheriting this disorder from their parents. Which of the following is the most appropriate response by the nurse? a. “It is only inherited if the child’s father carries the trait.”

b. “There is no research supporting the heritability of social phobia.” c. “The child of a parent with a social phobia has a 25% chance of inheriting it.” d. “The chances of developing social phobia increase about 10% if a parent has the disorder.”

6. Which of the following characteristics should the nurse include when teaching a class on the developmental theory of anxiety? Select all that apply: a) Individuals respond physiologically when anxious b) Anxiety disorder often evolves gradually when anxious temperament and normal childhood fears interact with other predisposing factors c) Excessive reliance on coping responses involving cognitive or behavioral avoidance d) Interpret ambiguous stimuli or situations as threatening e) Biased or distorted cognitive processing leads to an undue reliance on distraction and avoidance as coping mechanisms f) Incompetence with regard to social and emotional regulation and academic skills
7. Which of the following would be the most appropriate statement for the nurse to make to a client found pacing in the hall? a. “The ballgame is on in the dayroom. Perhaps you’d like to watch it.” b. “I noticed you’ve been pacing. Can you tell me how you’re feeling?” c. “I think you’d be much more comfortable in your room.” d. “I can tell something is wrong. What is it?”
8. The nurse caring for a client with a somatic panic disorder includes which of the following manifestations? Select all that apply: a) Fear of dying b) Palpitations c) Sense of impending doom and helplessness d) Sensation of choking e) Takes safety precautions such as being with a “safe” person or avoiding places and situations associated with panic attacks f) Numbness or tingling
9. While assessing a new client, the nurse asks the client about any fears. The client states, “Well, I’ve been afraid to go up and down the basement steps since my hip replacement last fall. I let my children do the laundry.” The nurse should evaluate this response as: a. Manipulative behavior. b. Normal anxiety. c. A phobic reaction. d. Chronic anxiety.

10. The nurse evaluates a client to have which of the following characteristics of severe anxiety? Select all that apply: a) Prompted by the ordinary tensions experienced in daily life b) Produces what is commonly labeled the “fight-or-flight” response c) Becomes aware of some motor tension d) Sensory input begins to disorganize e) Senses are heightened, and individuals are alert, focused, and able to both learn new information and problem solve f) Emotional distress is verbalized
11. A client with agoraphobia tells the nurse in the outpatient clinic, “Now that my medication is working, I don’t think I need to come here for therapy anymore.” The most therapeutic response by the nurse is which of the following? a. “Your medicine will only work if you continue with therapy.” b. “You need to tell the doctor you want to quit c. “You made a commitment to stay in therapy for at least six sessions.” d. “Combining medicine and therapy gives better, more lasting results.”
12. A client diagnosed with obsessive compulsive disorder says to the nurse, “I know the doctor said this was just an anxiety problem, but I think I must really be crazy. I keep thinking that people are mad at me, and then I have to keep telling them I’m sorry.” Which of the following is the most appropriate response by the nurse? a) “Be careful. You might offend someone by using the word ‘crazy.’” b) “Very often, people’s obsessive ideas seem rather bizarre to them.” c) “This is serious. We must let the doctor know.” d) “What makes you think someone is angry with you?”
13. A client approaches the nurse and says, “I don’t know what’s going on, but I have this terrible feeling that something awful is going to happen.” The nurse’s best response is which of the following? a. “Don’t worry, you’re very safe here.” b. “Can you tell me what you think is going to happen?” c. “It sounds like you’re having some anxiety.” d. “Would you like some anxiety medication?”
14. Which of the following assessments would provide the nurse with the most accurate information regarding a low serotonin level in a client with a personality disorder?

a. Psychosis and hallucinations

b. Delusions and paranoia c. Depression and impulsiveness d. Restlessness and agitation

15. During an initial interview with a client who has a personality disorder, the nurse evaluates which of the following to be present in the client’s personality traits? a. Changes in the personality that have come about because of a stressful event b. Personality traits that are beyond the range found in most people c. Personality traits that have changed with advanced age d. Changes in personality that differ to fit the situation
16. The nurse is caring for a client with schizoid personality disorder. In determining what the plan of care should consist of, which of the following should the nurse consider? The client a. Quickly becomes attached to the group leader. b. Displays behavior lacking social tact or grace in a group. c. Becomes overly emotional in the group setting. d. Attempts to build intimate relationships with other group members.
17. The nurse evaluates a client with schizoid personality disorder to exhibit which of the following behaviors? Select all that apply: a) Irresponsibility with intentional deceit of others b) Grandiosity and a lack of empathy for others c) Peculiar, with exaggerated social anxiety d) Social isolation e) Restricted range of emotion f) Appears indifferent to praise
18. The nurse suspects a narcissistic personality disorder in a client, when which of the following clinical manifestations are present? Select all that apply: a) Grandiosity b) Excessive need for nurturance and emotional support c) Rigid behavior d) Lacks empathy for others e) Arrogant f) Unlawful behavior

19. The nurse is planning the care of a client with borderline personality disorder based on which of the following behaviors? Select all that apply: a) Chronic feelings of emptiness b) Unstable interpersonal relationships c) Suicidal gestures or self-mutilation d) Excessive attention to appearance e) Holding of grudges for long periods of time f) Submissive behaviors
20. The nurse assesses which of the following characteristics to be present in obsessive compulsive personality disorder? Select all that apply: a) Need for admiration b) Perfectionistic c) Indecisiveness d) Hypersensitivity to criticism e) Lacks spontaneity f) Self-centered
21. When planning the care for a client with avoidant personality disorder, the nurse understands that the best intervention is to: a. Allow the client to stay in the room until feeling comfortable with people. b. Avoid acknowledging goals achieved by the client. c. Enable the client to set and drive the goals independent of the nurse. d. Promote self-esteem by praising the client’s success
22. Which of the following descriptions of the dopamine hypothesis should the nurse include when educating another nurse about the causes of schizophrenia? a. The kidneys cause excessive amounts of dopamine in the body that the kidneys do not readily excrete b. There is an excess of dopamine found at the synaptic clefts in the brain c. Too little dopamine in the brain causes hallucinations d. Abnormal levels of dopamine cause structural brain abnormalities
23. Which of the following is the priority nursing intervention in the plan of care for a client with catatonic schizophrenia? a. Introduce the client to the other clients b. Begin obtaining the client’s history c. Give the client the prescribed drugs d. Settle the client in the room

24. The family of a 25-year-old client ask the nurse if any of the family members are at risk to get schizophrenia. The nurse anticipates that which of the following individuals is most likely to also suffer from schizophrenia? a. The younger brother b. The older sister c. The monozygotic twin d. The 50-year-old maternal aunt
25. The nurse administers which of the following prescribed drugs for the purpose of relieving both the positive and negative clinical manifestations of schizophrenia? a. Selective serotonin reuptake inhibitor b. Dopaminergic c. Anxiolytic d. Sedative
26. The nurse is caring for a client with schizophrenia who is experiencing delusions. Which of the following nursing diagnoses would be appropriate? a. Impaired verbal communication b. Ineffective role performance c. Disturbed thought processes d. Disturbed sensory perception
27. Knowing that it is difficult to establish trust with a client experiencing delusions, the nurse who is taking care of a client with delusional disorder should initiate conversation by saying which of the following? a. “What happened to make you come here?” b. “What is bothering you right now?” c. “I’m your nurse; tell me if you need something.” d. “The other clients want to meet you.”
28. A family expresses concern to the nurse when their 96-year-old mother with dementia living in a long-term care facility seems more confused and does not remember the activities of daily living. Which of the following is the most appropriate response? a. “Don’t worry; your mother is safe in the long-term care facility.” b. “You need to remind your mother how to perform her basic needs.” c. “Your mother will get worse as time goes on and the dementia progresses.”

d. “This must be frustrating for you.”

29. A 77-year-old client expresses concern to a nurse in a walk-in psychiatric clinic of “going crazy or of having Alzheimer’s disease” because of feelings of being overwhelmed and sad all of the time, and misplacing things. Which of the following is the priority for the nurse to include in this client’s plan of care? a. Assist the client to develop areas of strength in coping b. Make a psychosocial assessment c. Explore the available supports for the client d. Assure the client and dispel the idea of
30. The nurse is caring for an older adult with situational depression following the death of a spouse. What is the most important outcome for the nurse to plan for? a. The client will discuss the spouse and the meaning of the loss b. The client will not cry c. The client will speak of the spouse only positively d. The client will avoid talking about the
31. An older client in a nursing facility suddenly becomes confused, paranoid, and verbally abusive to the staff. Which of the following is the priority nursing action? a. Ask the family members if they had a recent disagreement with the client b. Assess the vital signs and obtain a urine specimen c. Reorient the client to person, place, and time d. Ask whether the client is hearing voices
32. The nurse is teaching a class on eating disorders to a group of nurses. Which of the following should the nurse include in the class? a. Eating disorders affect females and males equally b. There is an increased incidence of depression in clients with eating disorders c. There is no mother–daughter connection in eating disorders d. There is a 20% chance of dysthymia in clients with eating disorders
33. The nurse should monitor a client with an eating disorder for which of the following complications? Select all that apply: a) Hypertension b) Dysmenorrhea c) Parotid swelling d) Delayed gastric emptying e) Bradycardia f) Dysthymia

34. The nurse is planning the care of a client with muscle weakness, constipation, a serum potassium of 3.0 mEq/L, and a pulse of 65 bpm. What clinical manifestation should take priority in this client’s plan of care? a. Muscle weakness b. Serum potassium 3.0 mEq/L c. Pulse of 65 bpm d. Constipation
35. The nurse assesses a client for which of the following findings in a client suspected of having bulimia? Select all that apply: a) Laxative abuse b) Amenorrhea c) Lanugo d) Dental erosion from repeated vomiting e) Chemical dependency or stealing behaviors f) Perfectionistic tendency
36. The nurse is caring for a 25-year-old client with an eating disorder who is in the hospital. The physician ordered periodic laboratory tests to monitor the client’s medical status. Which of the following serum laboratory test results is abnormal and should prompt the nurse to notify the physician? a. Calcium of 9.2 mg/dl b. Magnesium of 1.8 mEq/L c. Potassium of 3.0 mEq/L d. Sodium of 128 mEq/L
37. The nurse should include which of the following interventions in the plan of care for a client with a binge-eating disorder? Select all that apply: a) Encourage the client to keep a food diary and a feelings diary b) Encourage the client to gain ½ pound a week c) Instruct the client to avoid fasting d) Instruct the client that high-calorie foods are to be avoided e) Encourage the client to plan for structured meals f) Instruct the client on well-balanced nutrition
38. The nurse is signing a hospitalized client with bulimia back in after a day pass at home. Which of the following should be the nurse’s priority action? a) Ask the client about any special activities while out on pass b) Obtain a detailed menu of what was eaten

c) Search the client’s belonging for laxatives or diuretics d) Question the client about any binge–purge behavior at home

39. The nurse is collecting a health history from a 25-year-old client suspected of having an eating disorder. Which of the following questions is a priority question for the nurse to ask the client? a. “Is your father away from home much of the time due to his job?” b. “Do any siblings have issues with food?” c. “Does your mother have an eating disorder?” d. “Do you have a friend who has a body image problem?”
40. Which of the following statements would provide the nurse with the most accurate information regarding how successful the treatment has been for a client with a longstanding history of bulimia? a. “I take my medicine when I have an urge to binge.” b. “I try to do other things when I feel I want to eat.” c. “I have learned to eat a variety of foods.” d. “I no longer feel the need to see my therapist.”
41. Which of the following nursing interventions is a priority when planning nursing care for the client experiencing alcohol withdrawal? a. Teach techniques to reduce anxiety b. Administer a benzodiazepine c. Encourage fluid intake d. Provide a diet low in fat
42. Which of the following orders should the nurse question when planning the nursing care for a client beginning to experience alcohol withdrawal? a. Eliminate caffeine from the diet b. Assess vital signs every 2 to 4 hours c. Nothing by mouth d. Teach relaxation techniques
43. The nurse should monitor which of the following for a client experiencing alcohol withdrawal? Select all that apply: a) Hypertension b) Tinnitus

c) Pupil constriction d) Tachycardia e) Sedation f) Startles easily

44. The priority nursing intervention in caring for a client experiencing flashbacks from hallucinogenic intoxication is which of the following? a. Assisting the client with reduction of anxiety b. Exploring with the client relapse triggers c. Providing intrapersonal skills training d. Teaching the client the medical consequences of hallucinogen abuse
45. Which of the following does a coworker notice in a fellow nurse suspected of being an impaired nurse? Select all that apply: a) The narcotic count is wrong when checked b) Heightened ability to concentrate c) Promptly reports to work d) Inability to concentrate e) Client reports a decrease in pain after receiving a pain medication f) Alcohol breath
46. The nurse monitors for which of the following assessment findings in hallucinogen intoxication? Select all of the following: a) Cardiac arrhythmias b) Labile affect c) Nervousness d) Floating feeling e) Anorexia f) Diuresis
47. The nurse documents which of the following clinical manifestations to be present in a client who is experiencing cannabis intoxication? Select all that apply: a) Anorexia b) Dry mouth c) Euphoria d) Bradycardia e) Sensation of slowed time f) Drowsiness

48. A client admitted for cannabis intoxication asks the nurse what the average time in days is for urine drug screens to be positive for cannabis after the last use. The appropriate response by the nurse is how many days? 30 days
49. The nurse is caring for a client who is experiencing cocaine intoxication. Which would indicate to the nurse that the client’s condition is deteriorating? Select all that apply: a) Dyskinesias b) Chest pain c) Decreased urine output d) Hypertension e) Anxiety f) Tachycardia
50. The nurse is caring for a client admitted with cocaine intoxication who has a fever and is experiencing chest pain, palpitations, and increased blood pressure and pulse. The nursing priority action is to do which of the following? a. Establish a patent airway b. Perform a cranial nerve exam c. Provide comfort measures d. Instruct client about medical complications
51. The nurse is preparing to teach a class to a group of new graduate nurses on substance use disorders. Which of the following should the nurse include in the class? a) A client with substance dependence must take the same drug to relieve withdrawal symptoms b) Substance abuse is both a physical and psychological disorder c) A client with substance dependence who is motivated to do so can overcome the addiction by stopping use of the substance d) A substance must be abused over a long period of time before an addiction develops
52. The nurse should monitor a client who is suspected of having abused dextroamphetamine (Dexedrine) for which of the following? Select all that apply: a) Constipation b) Increased urine output c) Chest pain d) Pupil dilation

e) Tachycardia f) Increased muscular endurance

53. The nurse assesses which of the following in a client with a blood alcohol concentration level of 0.10? Select all that apply: a) Impaired balance and movement b) Slight impaired judgment c) Inability to make rational decisions d) Impaired reaction time e) Impaired sense of control f) Loss of consciousness
54. The nurse assesses which of the following clients to be at the highest risk of developing post-traumatic stress disorder? a. A client who recently moved to a new city b. A client who witnessed a fatal shooting c. A client with a family history of depression
55. A client reports experiencing nightmares and constant worry about the weather since a tornado destroyed the client’s house 1 year ago. The nurse assesses that this client is experiencing a. Delusions. b. Panic attacks. c. Flashbacks. d. Hallucinations.
56. The nurse assesses a client of rape-trauma syndrome for which of the following expressed style features? Select all that apply: a) Flashbacks b) Nightmares c) Crying d) Restlessness e) Mood swings f) Laughing
57. When planning the care of a client who is experiencing post-traumatic stress disorder, the nurse identifies which of the following as an appropriate goal? The client will report: a. Spending less time on ritualistic behavior. b. A decrease in flashbacks and nightmares. c. Having more energy.

d. A decrease in hearing voices.

58. A client tearfully reports having been sexually attacked by a spouse during an argument. The nurse evaluates this situation as: a. An emotional reaction but not a rape, because the couple is married and has had sexual relations. b. The right of the partner to expect sex because they are married. c. A rape because sex against one’s will is rape. d. A reaction to the couple’s argument that will most likely not happen again.
59. The client who has been raped tells the nurse, “I am not pressing charges and I’m afraid of seeing my attacker because we live in the same town.” Which of the following should the nurse include in the plan of care for this client? a. Assess the client’s safety and develop a safety plan b. Encourage the client to change jobs to avoid future encounters with the perpetrator c. Instruct the client not to worry about safety because perpetrators don’t attack twice d. Support the client’s desire to move to a new town and assume a new identity
60. A client currently taking fluoxetine (Prozac) to decrease clinical manifestations of posttraumatic stress disorder asks the nurse if continuing to take dietary supplements such as St John’s Wort is acceptable. The most appropriate response by the nurse is which of the following? a. “If it makes you feel better, continue to take the dietary supplements.” b. “Dietary supplements may interact negatively with your prescribed drugs; check with your care provider.” c. “Make sure you take the dietary supplements at a different time.” d. “Dietary supplements are harmless and won’t make any difference in how you feel.”