PSYCHIATRIC AND MENTAL HEALTH NURSING EXAM QUESTIONS WITH ANSWERS, Exams of Psychiatry

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PSYCHIATRIC AND MENTAL HEALTH NURSING EXAM

QUESTIONS WITH ANSWERS

INSTRUCTIONS: Select the correct answer for each of the following questions. Mark only one answer for each item by making the box corresponding to the letter of your choice on the answer sheet provided.

1. Which of the following statements best describes a mentally healthy individual? A. Has ability to make decisions B. Does not exhibit physical and emotional problems C. Has self-acceptance and can meet his own basic needs D. Has absence of anxiety and happy
2. The most important role of the Psychiatric nurse as a member of the team is to: A. carry out medical orders B. meet the needs for the physical well-being of the client C. coordinate the psychological care and management of clients D. keep a constant monitoring of the clients
3. Therapeutic use of self is essential in relating with psychiatric clients. This is BEST demonstrated in: A. sympathizing with the miserable feelings of the patient B. engaging patient in productive activity C. engaging patient in introspective thinking D. suppressing her own feelings toward the patient
4. The superego is the part of the psyche which: A. has sense of punishment B. contains primitive and instinctual drives C. makes use of defense mechanism D. forms adequate solutions to a problem
5. Suppression is best defined as: A. voluntary exclusion from consciousness unpleasant feelings, experiences, and thoughts B. involuntary exclusion from consciousness unpleasant feelings, experiences and thoughts C. channeling unacceptable desires into a socially acceptable behavior D. excessive reasoning or logic to avoid disturbed feelings
6. The unconscious defense mechanism that keeps highly anxious experiences out of conscious awareness is: A. Introjection B. Displacement C. Regression D. Repression
7. A defense mechanism wherein the individual dispels an action is: A. Fantasy B. Undoing C. Symbolism D. Substitution
8. A male college student who wants to become an athlete but fails becomes a well known writer. This is an example of: A. Compensation B. Projection C. Reaction Formation D. Sublimation
9. A third year student does a postmortem care without being disturbed by thought of death. He is using: A. Isolation B. Undoing C. Introjection D. Projection
10. A Biological/Medical approach to patient care utilizes which of the following? A. Milieu Therapy B. Somatic Therapy C. Behavioral Therapy D. Psychotherapy
11. The psychiatric nurse’s role in primary prevention includes the following EXCEPT: A. Providing sex education classes for adolescents B. Educating the public about mental health C. Handling crisis intervention in an outpatient setting D. Stress education and psychosocial support

12. Which of these nursing actions belong to the secondary level of prevention? A. Providing mental health consultation to health care providers B. Providing emergency psychiatric services C. Being politically active in relation to mental illness issues D. Providing mental health education to members of the community
13. The community health nurse was invited by a Principal of an Elementary school and was asked to give a talk to parents. An appropriate topic would be: A. the legal aspects of drug abuse B. disciplining children at home and school C. marital crisis D. problems of out of school youth
14. Trust may develop in the nurse-client relationship when the nurse: A. Avoids limit setting B. Encourages the client to use “testing” behaviors C. Tells the client how he should behave D. Uses consistency in approaching the client
15. In a therapeutic nurse-patient relationship, information about the termination phase is introduced: A. During the orientation phase B. During the working phase C. When the patient can tolerate it D. As the goals of the relationship are reached
16. Which of the following tasks should occur during working phase of the nurse-patient relationship? A. establishes trust and open communication B. assess the patient’s needs and develops plan of care C. promotes development of insight and self-concept D. establishes reality of separation and loss
17. Mrs. Reyes remarked, “I am worried about people visiting- with all the media news about child kidnapping and robberies.” The nurse BEST response would be: A. “Would you rather wish that I don’t come and visit you? You regard me as a stranger?” B. “I get that.” The nurse diverts the attention to talk about non-threatening topics C. “It must be distressing to think and feel the way that you do.” D. “I acknowledge what you are saying. My concern is the health care of your family and information are strictly confidential.”
18. Mrs. Reyes expressed that her socializing with neighbors is limited because her husband thinks she is getting overly friendly with a guy next door. Which of the following would the nurse emphasize as basic? A. Keeping trust in the relationship B. Avoid relating with neighbors to minimize conflict C. Be assertive to express her individuality D. Ignore the husband and just be supportive
19. A client has just begun to discuss important feelings when the time of the interview is up. The next day, when the nurse meets with the client at the agreed upon time, the initial intervention would be to say: A. “Good morning, how are you today?” B. “Yesterday you were talking about some very important feelings. Let’s continue.” C. “What would you like to talk about today?” D. Nothing and wait for the client to introduce a topic.
20. A new staff nurse is on orientation tour with the head nurse. A client approaches her and says, “I don’t belong here. Please try to get me out.” The staff nurse’s best response would be: A. “What would you do if you were out of the hospital?” B. “I am new staff member, and I’m on tour. I’ll come back and talk with you later.” C. “I think you should talk with the head nurse about that.” D. “I can’t do anything about that.”
21. The nurse is in the day room with a group of clients when a client who has been quietly watching TV suddenly jumps up screaming and runs out of the room. The nurse’s priority intervention would be to: A. Turn off the TV, and ask the group what they think about the client’s behavior B. Follow after the client to see what has happened. C. Ignore the incident because these outbreaks are frequent. D. Send another client out of the room to check on the agitated client.

33. A female client has just received the diagnosis of Hypochondriasis. This client continually focuses on GI problems and constantly rings for a nurse to meet her every demand. The best nursing approach is to: A. Ignore the demands because the nurse knows it is not necessary to respond B. Assign various staff members to work with the client so no staff member will become negative C. Anticipate the client’s demands and spend time with her even though she does not demand it D. Provide for the client’s basic needs, but do not respond to every demand, which reinforces secondary gains
34. Persons with Personality disorders tend to be manipulative. In planning the care of a person with this diagnosis, the nurse would: A. Allow manipulation so as to not raise the client’s anxiety B. Appeal to the client’s sense of loyalty in adhering to rules of the community C. Know that when the client’s manipulation are not successful, anxiety will increase D. Establish a nurse-client relationship to decrease the client’s manipulations
35. A male client in the Psychiatric unit becomes upset and breaks a chair when a visitor does not show up. The first nursing intervention should be to: A. Stay with the client during the stressful time B. Ask direct questions about the client’s behavior C. Set limits and restrict the client’s behavior D. Plan with the client for how can he better handle the situation
36. The nurse has been interviewing a client who has not been able to discuss any feelings. 5 minutes before the time is over, the client begins to talk about important feelings. The intervention is to: A. Go over the agreed upon time, as the client is finally able to discuss his feelings with him B. Tell the client that it is time to end the session now, but another nurse will discuss his feelings with him C. Set an extra meeting time a little later to discuss these feelings D. End just as agreed, but tell the client that these are very important feelings and he can continue tomorrow
37. The psychodynamics of depression is: A. lax super-ego B. weak super-ego C. internalized hostility feelings D. id dominance
38. In working with a depressed client, the nurse should understand that depression is most directly related to a person’s: A. Experiencing poor interpersonal relationships with others B. Having experienced a sense of loss C. Remembering his traumatic childhood D. Stage in life
39. A 45 yr. old female client has been in the hospital for 3 days with a diagnosis of depression. During this time, she has not put on a clean dress, washed her hair, or participated in any of the unit activities. The next day, the nurse observes that she is wearing a clean dress and has combed her hair. The appropriate statement to the client is: A. “Oh, I’m so pleased that you finally put on a clean dress.” B. “Something is different about you today. What is it?” C. “That’s good. You have on a clean dress and have combed your hair.” D. “I see that you have on a clean dress and have combed your hair.”
40. Which of these drugs is likely given for depression? A. Haloperidol (Serenace) B. Diazepam (Valium) C. Imipramine (Tofranil) D. Fluphenazine (Prolixin)
41. Which of the following must be considered while planning activities for the depressed patient? A. activities which require exertion of energy B. challenging activities to foster self expression C. reading materials to divert his thoughts D. variety of unstructured activities
42. The BEST Attitude therapy that a nurse utilize for a depressed client is: A. Active Friendliness B. Matter of Fact C. Kind Firmness D. Passive Friendliness
43. When encouraged to join an activity, a depressed client on the psychiatric unit refuses and says, “What’s the use?” The approach by the nurse that would be most effective is to: A. Sit down beside her and ask her how she is feeling B. Tell her it is time for the activity, help her out of the chair, and go with her to the activity C. Convince her how helpful it will be to engage in the activity D. Tell her that this is a self-defeating attitude and it will only make her feel worse

44. A 60 yr. old male client has been admitted to the psychiatric unit, the symptoms ranging from fatigue, an inability to complete everyday tasks, to refusal care to care for him and preferring to sleep all day. One of the first interventions should be aimed to: A. developing a good nursing care plan B. Talking to his wife for cues to help him C. Encouraging him to join activities on the unit D. Developing a structured routine for him to follow
45. When a depressed client becomes more active and there is evidence that her mood has lifted, an appropriate goal to add to the nursing care plan is to: A. Encourage her to go home for the weekend B. Move her to a room with three other clients C. Monitor her whereabouts D. Begin to explore the reasons she became depressed
46. The nurse is assigned to a client who is potentially suicidal. Of the following nursing objectives, which one is the most important? A. Observe the client closely at all times B. Recognize a continued desire to commit suicide C. Involve the client in activities with others to mobilize him D. Provide a safe environment to protect the client
47. When assessing a client for possible suicide, an important clue would be if the client: A. is hostile and sarcastic to the staff B. identifies with problems expressed by other clients C. seems satisfied and detached D. begins to talk about leaving the hospital
48. The defense mechanism utilized by manic patients to cover up depression is: A. Reaction-Formation B. Compensation C. Displacement D. Denial
49. A client with the diagnosis of manic episode is pacing around the unit trying to organize the games with the clients. An appropriate nursing intervention is to: A. have the client play table tennis B. suggest video exercises with the other clients C. Take the clients outside for walk D. Do nothing, as organizing a game is considered therapeutic
50. A client ahs the diagnosis of manic episode. Her disruptive behavior on the unit has been increasingly annoying to the other clients. One intervention by the nurse might be to: A. tell the client she is annoying others and confine her to her room B. ignore the client’s behavior, realizing it is consistent with her illness C. set limits on the client’s behavior and be consistent in approach D. make a rigid, structured plan that the client will have to follow
51. While working with an alcoholic client, the most important approach by the nurse would be to: A. maintain a nonjudgmental attitude toward the client B. establish strict guidelines of behavior C. explicitly outline expectations of the client D. set up a working nurse-client relationship
52. A client is admitted with a diagnosis of delirium tremens. He is exhibiting marked tremors, hallucinations, tachycardia, and is perspiring profusely. The nurse anticipates an order of: A. Start an IV with Vitamin B complex supplement B. Administer valium IM C. Control the environment with a quiet, single room, side-rails up, and soft lights D. Get baseline VS
53. A client has the diagnosis of Cognitive disorder, Alzheimer’s disease. The client is constantly making up stories that are untrue. This characteristic of the disease is called: A. Senility B. Confabulation C. Lability D. Memory loss
54. A client in a long-term care facility has the diagnosis of Dementia, Alzheimer’s disease. His care plan should include the goal of assisting him to participate in activities that provide him a chance to: A. interact with other clients B. compete with others C. succeed at something D. get a sense of continuity

D. Akathisia

66. A client with the diagnosis of Schizophrenia has orders for Clozapine (Leopnex). The nurse will evaluate the drug’s effect as positive if the: A. Client develops Leukopenia B. Psychotic symptoms such as hearing voices are reduced C. Monthly liver function studies changes moderately D. Client’s energy level and involvement in activities goes up
67. A client with a diagnosis of Paranoid Personality disorder refuses to take his medication and is accusing the nurse of trying to kill him. The nurse’s best strategy would be to tell him that: A. “It is not poison and you must take the medication.” B. “I will give you an injection if necessary.” C. “You may decide if you want to take the medication by mouth or injection, but you must take it.” D. “It’s all right if you don’t take the medication right now.”
68. A newly admitted client to the psychiatric unit will receive ECT. ECT is considered most effective in treating: A. Young clients with depressive reactions B. Elderly clients with depressive reactions C. Any age client with Schizophrenia D. Young clients with paranoid reactions
69. The treatment in Crisis intervention centers is specifically intended to help clients: A. Return to prior levels of functioning B. Understand the dynamics underlying symptoms C. Make long range plans for the future D. Accept their illness
70. A client comes to the emergency room with complaints of headache and vomiting. Upon interview, the client says she is taking the drug Marplan. The nurse would continue the assessment by first asking: A. The dose of Marplan she is taking B. If she recently had flu symptoms C. What foods she has been eating D. What other medication she is taking
71. A client is to take Lithium regularly after she is discharged from the hospital. The most important information to impart to the client and his family is that the client should: A. Have an adequate intake of sodium B. Limit his fluid intake C. Have a limited intake of sodium D. Not eat foods that have a high tyramine content
72. A hospitalized male adolescent flirts with and is sexually provocative toward a female nurse. The nurse can respond MOST therapeutically by doing which of the following? A. Telling him she is married and too old for him B. Introducing him to female clients his own age C. Encouraging him to watch TV in his room D. Ignoring his flirtatious and provocative behaviors
73. The pedophile’s choice of a sex object is primary based on: A. difficulty relating with adults B. feelings of tenderness towards children C. fears of incestuous impulses D. preferred for a passive sexual role
74. The attitude therapy that is best to be used for Carlo who is aggressive is: A. Kind Firmness B. No Demand C. Active Friendliness D. Passive Friendliness
75. Jim would count pencils in a mug over and over with the thought that stopping could result in something bad happening. These are many things Jim seems he has to do to keep himself from feeling: A. Confused B. Suspicious C. Excited D. Anxious
76. He has to change clothes 20 times before work, chew each bite he eats 24 times and go up and down the stairs 4-5 times before it feels right. He is demonstrating; A. ideas of reference B. denial and projection C. obsession and compulsion

D. rationalization and over reaction

77. The objective of nursing care for Jim is to develop or increase feelings of: A. self-mastery B. self-worth C. self-actualization D. self-determination
78. All of these are therapeutic interventions for Jim EXCEPT: A. impose limits every time the behavior becomes repetitive B. establish a routine for him C. assign task that can be done repetitively D. facilitate self-expression
79. Jim is aware of his behavior, yet realizes that it is very disturbing to him. This is a pattern of: A. personality disorder B. psychosis C. neurosis D. habitual disorder
80. An appropriate nursing diagnosis for Jim is: A. Altered Thought Process B. Ineffective Individual Coping C. Impaired Adjustment D. Self-care deficit
81. Which of the following items will the nurse NOT allow to be brought inside a psychiatric unit? A. Pocket book B. box of cake C. bottle of coke D. wallet
82. Situational crisis are usually resolved in a time period of: A. 1-4 days B. 2-4 weeks C. 1-2 months D. 2-6 months
83. According to crisis theory, the minimal long-term goal in crisis intervention is: A. relief of acute symptoms B. relief of panic level anxiety C. restoration of the functioning level D. reorganization and reordering of the personality
84. The most critical factor for the nurse to determine during crisis intervention is the client’s: A. developmental history B. available situational supports C. underlying unconscious conflict D. willingness to restructure personality
85. Which of the following statements about Family Violence is Tue? A. It affects every socio-economic level B. It is caused by drug and alcohol abuse C. It predominantly occurs in lower socioeconomic levels D. It rarely occurs during pregnancy
86. Secondary level of prevention of domestic violence involves: A. educational programs that enhance family function B. early detection and treatment of interpersonal violence C. psychotherapy for the abuser D. family therapy
87. You are working in the emergency department conducting an interview with a victim of spousal abuse. Which step should you take first? A. contact the appropriate legal services B. ensure privacy for interviewing the victim away from the abuser C. establish rapport with the victim and the abuser D. request the presence of the security personnel
88. The following are characteristic of abuse in the family, EXCEPT A. victims have little capacity to defend themselves B. victims may feel emotionally if not physically trapped

A. Somatization disorder B. Conversion disorder C. Hypochondriasis D. Phobia