NCLEX Sample Questions for Psychiatric Nursing 2

JUNE 23, 2009 BY CEDRIC 3 COMMENTS

1. Situation : The nurse assigned in the detoxification unit attends to various patients with substance-
related disorders. A 45 years old male revealed that he experienced a marked increase in his intake of
alcohol to achieve the desired effect This indicates:
a. withdrawal
b. tolerance
c. intoxication
d. psychological dependence
2. The client admitted for alcohol detoxification develops increased tremors, irritability, hypertension
and fever. The nurse should be alert for impending:
a. delirium tremens
b. Korsakoff’s syndrome
c. esophageal varices
d. Wernicke’s syndrome
3. The care for the client places priority to which of the following:
a. Monitoring his vital signs every hour
b. Providing a quiet, dim room
c. Encouraging adequate fluids and nutritious foods
d. Administering Librium as ordered
4. Another client is brought to the emergency room by friends who state that he took something an hour
ago. He is actively hallucinating, agitated, with irritated nasal septum.
a. Heroin
b. cocaine
c. LSD
d. marijuana
5. A client is admitted with needle tracts on his arm, stuporous and with pin point pupil will likely be
managed with:
a. Naltrexone (Revia)
b. Narcan (Naloxone)
c. Disulfiram (Antabuse)
d. Methadone (Dolophine)
6. Situation: An old woman was brought for evaluation due to the hospital for evaluation due to
increasing forgetfulness and limitations in daily function. The daughter revealed that the client used
her toothbrush to comb her hair. She is manifesting:
a. apraxia
b. aphasia
c. agnosia
d. amnesia
7. She tearfully tells the nurse “I can’t take it when she accuses me of stealing her things.” Which
response by the nurse will be most therapeutic?
a. ”Don’t take it personally. Your mother does not mean it.”
 b. “Have you tried discussing this with your mother?”
c. “This must be difficult for you and your mother.”
d. “Next time ask your mother where her things were last seen.”
8. The primary nursing intervention in working with a client with moderate stage dementia is ensuring
that the client:
a. receives adequate nutrition and hydration
b. will reminisce to decrease isolation
c. remains in a safe and secure environment
d. independently performs self care
9. She says to the nurse who offers her breakfast, “Oh no, I will wait for my husband. We will eat
together” The therapeutic response by the nurse is:
a. “Your husband is dead. Let me serve you your breakfast.”
b. “I’ve told you several times that he is dead. It’s time to eat.”
c. “You’re going to have to wait a long time.”
d. “What made you say that your husband is alive?
10. Dementia unlike delirium is characterized by:
a. slurred speech
b. insidious onset
c. clouding of consciousness
d. sensory perceptual change
11. Situation: A 17 year old gymnast is admitted to the hospital due to weight loss and dehydration
secondary to starvation. Which of the following nursing diagnoses will be given priority for the client?
a. altered self-image
b. fluid volume deficit
c. altered nutrition less than body requirements
d. altered family process
12. What is the best intervention to teach the client when she feels the need to starve?
a. Allow her to starve to relieve her anxiety
b. Do a short term exercise until the urge passes
c. Approach the nurse and talk out her feelings
d. Call her mother on the phone and tell her how she feels
13. The client with anorexia nervosa is improving if:
a. She eats meals in the dining room.
b. Weight gain
c. She attends ward activities.
d. She has a more realistic self concept.
14. The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is that
bulimic individuals
a. have episodic binge eating and purging
b. have repeated attempts to stabilize their weight
c. have peculiar food handling patterns
d. have threatened self-esteem
15. A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating
habits. The goal for this problem is:
a. Patient will learn problem solving skills
b. Patient will have decreased symptoms of anxiety.
c. Patient will perform self care activities daily.
d. Patient will verbalize how to set limits on others.
16. In the management of bulimic patients, the following nursing interventions will promote a therapeutic
relationship EXCEPT:
a. Establish an atmosphere of trust
b. Discuss their eating behavior.
c. Help patients identify feelings associated with binge-purge behavior
d. Teach patient about bulimia nervosa
17. Situation: A 35 year old male has intense fear of riding an elevator. He claims “ As if I will die inside.”
This has affected his studies The client is suffering from:
a. agoraphobia
b. social phobia
c. Claustrophobia
d. xenophobia
18. Initial intervention for the client should be to:
a. Encourage to verbalize his fears as much as he wants.
b. Assist him to find meaning to his feelings in relation to his past.
c. Establish trust through a consistent approach.
d. Accept her fears without criticizing.
19. The nurse develops a countertransference reaction. This is evidenced by:
a. Revealing personal information to the client
b. Focusing on the feelings of the client.
c. Confronting the client about discrepancies in verbal or non-verbal behavior
d. The client feels angry towards the nurse who resembles his mother.
20. Which is the desired outcome in conducting desensitization:
a. The client verbalize his fears about the situation
b. The client will voluntarily attend group therapy in the social hall.
c. The client will socialize with others willingly
d. The client will be able to overcome his disabling fear.
21. Which of the following should be included in the health teachings among clients receiving Valium:
a. Avoid taking CNS depressant like alcohol.
b. There are no restrictions in activities.
c. Limit fluid intake.
d. Any beverage like coffee may be taken
22. Situation: A 20 year old college student is admitted to the medical ward because of sudden onset of
paralysis of both legs. Extensive examination revealed no physical basis for the complaint. The nurse
plans intervention based on which correct statement about conversion disorder?
a. The symptoms are conscious effort to control anxiety
b. The client will experience high level of anxiety in response to the paralysis.
 c. The conversion symptom has symbolic meaning to the client
d. A confrontational approach will be beneficial for the client.
23. Nina reveals that the boyfriend has been pressuring her to engage in premarital sex. The most
therapeutic response by the nurse is:
a. “I can refer you to a spiritual counselor if you like.”
b. “You shouldn’t allow anyone to pressure you into sex.”
c. “It sounds like this problem is related to your paralysis.”
d. “How do you feel about being pressured into sex by your boyfriend?”
24. Malingering is different from somatoform disorder because the former:
a. Has evidence of an organic basis.
b. It is a deliberate effort to handle upsetting events
c. Gratification from the environment are obtained.
d. Stress is expressed through physical symptoms.
25. Unlike psychophysiologic disorder Linda may be best managed with:
a. medical regimen
b. milieu therapy
c. stress management techniques
d. psychotherapy

Answers and Rationale of NCLEX Sample Questions for Psychiatric

Nursing 2
JUNE 26, 2009 BY CEDRIC 1 COMMENT

View the NCLEX Sample Questions for Psychiatric Nursing 2

1. Answer: (B) tolerance
tolerance refers to the increase in the amount of the substance to achieve the same effects. A. Withdrawal refers
to the physical signs and symptoms that occur when the addictive substance is reduced or withheld. B.
Intoxication refers to the behavioral changes that occur upon recent ingestion of a substance. D. Psychological
dependence refers to the intake of the substance to prevent the onset of withdrawal symptoms.
2. Answer: (A) delirium tremens
Delirium Tremens is the most extreme central nervous system irritability due to withdrawal from alcohol B. This
refers to an amnestic syndrome associated with chronic alcoholism due to a deficiency in Vit. B C. This is a
complication of liver cirrhosis which may be secondary to alcoholism . D. This is a complication of alcoholism
characterized by irregularities of eye movements and lack of coordination.
3. Answer: (A) Monitoring his vital signs every hour
Pulse and blood pressure are usually elevated during withdrawal, Elevation may indicate impending delirium
tremens B. Client needs quiet, well lighted, consistent and secure environment. Excessive stimulation can
aggravate anxiety and cause illusions and hallucinations. C. Adequate nutrition with sulpplement of Vit. B should
be ensured. D. Sedatives are used to relieve anxiety.
4. Answer: (B) cocaine
The manifestations indicate intoxication with cocaine, a CNS stimulant. A. Intoxication with heroine is manifested
by euphoria then impairment in judgment, attention and the presence of papillary constriction. C. Intoxication with
hallucinogen like LSD is manifested by grandiosity, hallucinations, synesthesia and increase in vital signs D.
Intoxication with Marijuana, a cannabinoid is manifested by sensation of slowed time, conjunctival redness, social
withdrawal, impaired judgment and hallucinations.
5. Answer: (B) Narcan (Naloxone)
Narcan is a narcotic antagonist used to manage the CNS depression due to overdose with heroin. A. This is an
opiate receptor blocker used to relieve the craving for heroine C. Disulfiram is used as a deterrent in the use of
alcohol. D.Methadone is used as a substitute in the withdrawal from heroine
6. Answer: (C) agnosia
This is the inability to recognize objects. A. Apraxia is the inability to execute motor activities despite intact
comprehension. B. Aphasia is the loss of ability to use or understand words. D. Amnesia is loss of memory.
7. Answer: (C) “This must be difficult for you and your mother.”
This reflecting the feeling of the daughter that shows empathy. A and D. Giving advise does not encourage
verbalization. B. This response does not encourage verbalization of feelings.
8. Answer: (C) remains in a safe and secure environment
Safety is a priority consideration as the client’s cognitive ability deteriorates.. A is appropriate interventions
because the client’s cognitive impairment can affect the client’s ability to attend to his nutritional needs, but it is
not the priority B. Patient is allowed to reminisce but it is not the priority. D. The client in the moderate stage of
Alzheimer’s disease will have difficulty in performing activities independently
9. Answer: (A) “Your husband is dead. Let me serve you your breakfast.”
The client should be reoriented to reality and be focused on the here and now.. B. This is not a helpful approach
because of the short term memory of the client. C. This indicates a pompous response. D. The cognitive limitation
of the client makes the client incapable of giving explanation.
10. Answer: (B) insidious onset
Dementia has a gradual onset and progressive deterioration. It causes pronounced memory and cognitive
disturbances. A,C and D are all characteristics of delirium.
11. Answer: (B) fluid volume deficit
Fluid volume deficit is the priority over altered nutrition (A) since the situation indicates that the client is
dehydrated. A and D are psychosocial needs of a client with anorexia nervosa but they are not the priority.
12. Answer: (C) Approach the nurse and talk out her feelings
The client with anorexia nervosa uses starvation as a way of managing anxiety. Talking out feelings with the
nurse is an adaptive coping. A. Starvation should not be encouraged. Physical safety is a priority. Without
adequate nutrition, a life threatening situation exists. B. The client with anorexia nervosa is preoccupied with
losing weight due to disturbed body image. Limits should be set on attempts to lose more weight. D. The client
may have a domineering mother which causes the client to feel ambivalent. The client will not discuss her feelings
with her mother.
13. Answer: (B) Weight gain
Weight gain is the best indication of the client’s improvement. The goal is for the client to gain 1-2 pounds per
week. (A)The client may purge after eating. (C) Attending an activity does not indicate improvement in nutritional
state. (D) Body image is a factor in anorexia nervosa but it is not an indicator for improvement.
14. Answer: (A) have episodic binge eating and purging
Bulimia is characterized by binge eating which is characterized by taking in a large amount of food over a short
period of time. B and C are characteristics of a client with anorexia nervosa D. Low esteem is noted in both eating
disorders
15. Answer: (A) Patient will learn problem solving skills
if the client learns problem solving skills she will gain a sense of control over her life. (B) Anxiety is caused by
powerlessness. (C) Performing self care activities will not decrease ones powerlessness (D) Setting limits to
control imposed by others is a necessary skill but problem solving skill is the priority.
16. Answer: (B) Discuss their eating behavior.
The client is often ashamed of her eating behavior. Discussion should focus on feelings. A,C and D promote a
therapeutic relationship
17. Answer: (C) Claustrophobia
Claustrophobia is fear of closed space. A. Agoraphobia is fear of open space or being a situation where escape is
difficult. B. Social phobia is fear of performing in the presence of others in a way that will be humiliating or
embarrassing. D. Xenophobia is fear of strangers.
18. Answer: (D) Accept her fears without criticizing.
The client cannot control her fears although the client knows its silly and can joke about it. A. Allow expression of
the client’s fears but he should focus on other productive activities as well. B and C. These are not the initial
interventions.
19. Answer: (A) Revealing personal information to the client
A. Countertransference is an emotional reaction of the nurse on the client based on her unconscious needs and
conflicts. B and C. These are therapeutic approaches. D. This is transference reaction where a client has an
emotional reaction towards the nurse based on her past.
20. Answer: (D) The client will be able to overcome his disabling fear.
The client will overcome his disabling fear by gradual exposure to the feared object. A,B and C are not the
desired outcome of desensitization.
21. Answer: (A) Avoid taking CNS depressant like alcohol.
Valium is a CNS depressant. Taking it with other CNS depressants like alcohol; potentiates its effect. B. The
client should be taught to avoid activities that require alertness. C. Valium causes dry mouth so the client must
increase her fluid intake. D. Stimulants must not be taken by the client because it can decrease the effect of
Valium.
22. Answer: (C) The conversion symptom has symbolic meaning to the client
the client uses body symptoms to relieve anxiety. A. The condition occurs unconsciously. B. The client is not
distressed by the lost or altered body function. D. The client should not be confronted by the underlying cause of
his condition because this can aggravate the client’s anxiety.
23. Answer: (D) “How do you feel about being pressured into sex by your boyfriend?”
Focusing on expression of feelings is therapeutic. The central force of the client’s condition is anxiety. A. This is
not therapeutic because the nurse passes the responsibility to the counselor. B. Giving advice is not therapeutic.
C. This is not therapeutic because it confronts the underlying cause.
24. Answer: (B) It is a deliberate effort to handle upsetting events
Malingering is a conscious simulation of an illness while somatoform disorder occurs unconscious. A. Both
disorders do not have an organic or structural basis. C. Both have primary gains. D. This is a characteristic of
somatoform disorder.
25. Answer: (C) stress management techniques
Stree management techniques is the best management of somatoform disorder because the disorder is related to
 stress and it does not have a medical basis. A. This disorder is not supported by organic pathology so no medical
regimen is required. B and D. Milieu therapy and psychotherapy may be used a therapeutic modalities but these
are not the best.

Filconnect Nursing Board Exam Review Questions with Rationale

Situation : The nurse assigned in the detoxification unit attends to various patients with substance-related disorders.
Filconnect Review Question
1. A 45 years old male revealed that he experienced a marked increase in his intake of alcohol to achieve the desired
effect This indicates:
A. withdrawal
B. tolerance
C. intoxication
D. psychological dependence
Answer: (B) Explanation: tolerance refers to the increase in the amount of the substance to achieve the same
effects. A. Withdrawal refers to the physical signs and symptoms that occur when the addictive substance is reduced
or withheld. B. Intoxication refers to the behavioral changes that occur upon recent ingestion of a substance. D.
Psychological dependence refers to the intake of the substance to prevent the onset of withdrawal symptoms.
Filconnect Review Question
2. The client admitted for alcohol detoxification develops increased tremors, irritability, hypertension and fever. The
nurse should be alert for impending:
A. delirium tremens
B. Korsakoff’s syndrome
C. esophageal varices
D. Wernicke’s syndrome
Answer: (A) Explanation: Delirium Tremens is the most extreme central nervous system irritability due to withdrawal
from alcohol B. This refers to an amnestic syndrome associated with chronic alcoholism due to a deficiency in Vit. B
C. This is a complication of liver cirrhosis which may be secondary to alcoholism . D. This is a complication of
alcoholism characterized by irregularities of eye movements and lack of coordination.
Filconnect Review Question
3. The care for the client places priority to which of the following:
A. Monitoring his vital signs every hour
B. Providing a quiet, dim room
C. Encouraging adequate fluids and nutritious foods
D. Administering Librium as ordered
Answer: (A) Explanation: Pulse and blood pressure are usually elevated during withdrawal, Elevation may indicate
impending delirium tremens B. Client needs quiet, well lighted, consistent and secure environment. Excessive
stimulation can aggravate anxiety and cause illusions and hallucinations. C. Adequate nutrition with sulpplement of
Vit. B should be ensured. D. Sedatives are used to relieve anxiety.
Filconnect Review Question
4. Another client is brought to the emergency room by friends who state that he took something an hour ago. He is
actively hallucinating, agitated, with irritated nasal septum.
A. Heroin
B. cocaine
C. LSD
D. marijuana
Answer: (B) Explanation: The manifestations indicate intoxication with cocaine, a CNS stimulant. A. Intoxication with
heroine is manifested by euphoria then impairment in judgment, attention and the presence of papillary constriction.
C. Intoxication with hallucinogen like LSD is manifested by grandiosity, hallucinations, synesthesia and increase in
vital signs D. Intoxication with Marijuana, a cannabinoid is manifested by sensation of slowed time, conjunctival
redness, social withdrawal, impaired judgment and hallucinations.
Filconnect Review Question
5. A client is admitted with needle tracts on his arm, stuporous and with pin point pupil will likely be managed with:
A. Naltrexone (Revia)
B. Narcan (Naloxone)
C. Disulfiram (Antabuse)
D. Methadone (Dolophine)
Answer: (B) Explanation: Narcan is a narcotic antagonist used to manage the CNS depression due to overdose with
heroin. A. This is an opiate receptor blocker used to relieve the craving for heroine C. Disulfiram is used as a
deterrent in the use of alcohol. D. Methadone is used as a substitute in the withdrawal from heroine