1. A client limits her social events to only those in which a family member of hers is also present.

The
client is exhibiting behavior typical of which of the following anxiety disorders?
A. Agoraphobia
B. Generalized anxiety disorder
C. Obsessive-compulsive disorder
D. Post-traumatic stress disorder
2. The school nurse is performing routine physical examinations would expect anorexia nervosa in an
adolescent female after collecting which of the following data on her?
A. Bradycardia, hypotension, irregular menses for past 3 months
B. Complaints of constipation, excessive exercising, presence of dry, flaky skin
C. Hoarseness, multiple dental caries, near-normal weight
D. Weight less than 85% of normal, presence of lanugo, amenorrhea for past 3 months
3. A client hospitalized on an eating disorder unit is monitored by the nurse for one hour after eating. The
rationale for this intervention is:
A. To develop a trusting relationship
B. To maintain focus on importance of nutrition
C. To prevent purging behaviors
D. To reinforce behavioral contact
4. Using a cognitive-behavioral therapy, which of the following would be involved in the treatment of a
client with depression?
A. Challenging negative thinking
B. Encouraging analysis of dreams
C. Prescribing antidepressant medications
D. Using ultraviolet light therapy
5. According to the biogenic amine theory, an individual with depression has a deficiency in which of the
following neurotransmitters?
A. Dopamine and thyroxin
B. GABA and acetylcholine
C. Cortisone and epinephrine
D. Serotonin and norepinephrine
6. In clients with cognitive impairment disorder, the phenomenon of increased confusion in the early
evening hours is called:
A. Sundowning
B. Agnosia
C. Aphasia
D. Confabulation
7. The community nurse is speaking to a group of new mothers as past of a primary prevention program.
Which of the following self-care measures would be most helpful as a strategy to decrease occurrence
of mood disorders?
A. Keeping busy, so as not to confront problems
B. Medications with antidepressants
C. Use of crisis intervention services
D. Verbalizing rather than internalizing feelings
8. Which of the following best describes dementia?
A. Memory loss occurring as part of natural consequence of aging
B. Difficulty coping with physical and psychological change
C. Severe cognitive impairment that occurs rapidly
D. Loss of cognitive abilities, impairing ability to perform ADL
9. Which of the following will the nurse use when communicating with a client who has a cognitive
impairment?
A. Complete explanations with multiple details
B. Pictures or gestures instead of words
C. Stimulating words and phrases to capture the client’s attention
D. Short words and simple sentences
10. An elderly client with Alzheimer’s disease becomes agitated and combative when a nurse approaches
to help with morning care. The most appropriate nursing intervention would be:
A. To tell the client firmly that it is time to get dressed
B. To obtain assistance to restrain the client for safety
C. To remain calm and talk quietly to the patient
D. To call the physician and request order for sedation
11. A client is newly admitted to a psychiatric unit because of severe obsessive-compulsive behavior.
Which of the following initial responses would be most therapeutic for the client?
A. The nurse being accepting of the client’s ritualistic behaviors
B. The nurse challenging the client’s need for ritual
C. The nurse expressing concern about the harmfulness of the client’s ritual
D. The nurse limiting the client’s rituals that are excessive
12. A nurse is planning care for a client with post-traumatic stress disorder. Which of the following would
the nurse initially do?
A. Avoid discussion of the traumatic events
B. Encourage the client to verbalize thoughts and feelings about trauma
C. Encourage the client to put the past in proper perspective
D. Instruct the client to use distraction techniques to cope with flashbacks
13. The nurse evaluates the treatment of a client with somatoform disorder as successful if:
A. The client practices self-medication rather than changing health care providers
B. The client recognizes that physical symptoms increase anxiety level
C. The client researches treatment protocols for various illnesses
D. The client verbalizes anxiety directly rather than displacing it
14. When evaluating an imminent suicide risk, which of the following information given by the patient would
be most significant?
A. At least a 2-year history of feeling depressed more days than not
B. Divorced from spouse 6 months ago
C. Feeling loss of energy and appetite
D. Reference to suicide as best solution to identified problems
15. A school nurse is meeting with the school and treatment team professionals about a child who has
been receiving methylphenidate (Ritalin) for 2 months. The meeting is to evaluate the result of the
child’s medication use. While questioning the teacher, which of the following child’s behaviors would
the nurse ask about to determine medication effectiveness?
A. A decrease in repetitive behavior
B. An increase in concentration on tasks
C. A decrease in signs of anxiety
D. An increase in depressed mood
16. Which of the following behavioral assessments in a child is most consistent with the diagnosis of
conduct disorder?
A. Arguing with adults
B. Gross impairment in communication
C. Physical aggression toward others
D. Refusal to separate from caretaker
17. Many people control anxiety by ritualistic behavior. When taking care of these individuals it is important
for the nurse to:
A. Avoid mentioning the ritual
B. Explain the meaning of the ritual
C. Allow them to carry out the ritual
D. Prevent them from carrying out the ritual
18. A person who habitually expresses anxiety through physical symptoms is using:
A. Projection
B. Regression
C. Conversion
D. Hypochondriasis
19. When approaching a client during a period of great overactivity, it is essential to:
A. Use a firm, warm, consistent approach
B. Anticipate and physically control the client’s hyperactivity
C. Allow the client to choose the activities in which to participate
D. Let the client know the staff will not tolerate destructive behavior
20. The activity that would be the least therapeutic for severely depressed clients would be:
A. Specific, simple instructions to be followed
B. Simple, easily completed, short-term projects
C. Monotonous, repetitive projects and activities
D. Allowing the client to plan their own activities
21. What is the usual length of time contracted for crisis counseling?
A. 1 to 2 weeks
B. 6 to 8 weeks
C. 3 to 6 months
D. As long as services are necessary
22. The nurse understands that the personality disorder characterized primarily by mistrust is commonly
classified as:
A. Paranoid personality disorder
B. Antisocial personality disorder
C. Dependent personality disorder
D. Schizotypal personality disorder
23. For most patients with personality disorder, the treatment of choice is usually:
A. group therapy
B. individual psychotherapy
C. self-help support groups
D. inpatient therapy
24. When assessing a patient with personality disorder, the nurse notes ideas of reference and magical
thinking, leading her to suspect which personality disorder:
A. Borderline PD
B. Schizotypal PD
C. Schizoid PD
D. Histrionic PD
25. Which finding would the nurse identify as the most prominent characteristic of borderline PD?
A. Suspiciousness
B. Reckless disregard for others
C. Instability in personal relationships
D. Unlawful behavior
26. A patient with dependent personality disorder reports physical complaints. Which action would be most
appropriate?
A. overlooking the symptoms
B. encouraging her to talk about her symptoms
C. disregarding the symptoms until; emotional issues are explored
D. exploring symptoms in a matter-of-fact way
27. Which characteristic would the nurse most likely identify as common to all personality disorders?
A. Positive self-image
B. Adequate impulse control
C. Appropriate range of emotions
D. Personal relationship problems
28. Neuroleptics are the drugs of choice to relieve symptoms:
A. Psychosis
B. Depression
C. Hyperkinesis
D. Narcotic withdrawal
29. Photosensitization is a side effect associated with the use of:
A. Sertraline (Zoloft)
B. Lithium carbonate (Lithane)
C. Methylphenidate hydrochloride (Ritalin)
D. Chlorpromazine hydrochloride (Thorazine)
30. An extrapyramidal symptom that is a potentially irreversible side effect of antipsychotic drugs is:
A. Torticollis
B. Oculogyric crisis
C. Tardive dyskinesia
D. Pseudoparkinsonism
31. When monoamine oxidase inhibitors (MAOIs) are prescribed, the client should be cautioned against:
A. prolonged, exposure to the sun
B. ingesting wines and aged cheese
C. engaging in active physical exercises
D. the use of medication with an elixir base
32. The major reason for treating severe psychiatric disorders with neuroleptics is to:
A. Decrease neurotic symptoms
B. Decrease psychotic symptoms
C. Prevent destructiveness by the client
D. Improve social skills and poor judgment
33. When caring for a client with a generalized anxiety disorder, the nurse should be aware that one of the
best indicators of the client’s present condition is the client’s:
A. Memory
B. Behavior
C. Judgment
D. Responsiveness
34. The most appropriate way to decrease a client’s anxiety is by:
A. Avoiding unpleasant objects and events
B. Prolonged exposure to fearful situations
C. Acquiring skills with which to face stressful events
D. Introducing an element of pleasure into fearful situations
35. Which of the following interventions should the nurse stress while a client is on lithium therapy?
A. Weigh self once a month
B. Restrict fluid intake to prevent edema
C. Do not restrict sodium intake
D. Avoid eating cheese and bananas, and drinking wine
36. The psychiatrist orders chlorpromazine (Thorazine) IM. The nurse should handle the medication
carefully to prevent:
A. skin discoloration
B. skin irritation
C. headache
D. dizziness
37. Which of the following interventions should be included in a care planning concerning Chlorpromazine
(Thorazine) therapy?
A. supervise ambulation
B. take a hot bath to reduce agitation
C. restrict fluid intake to prevent edema
D. discontinue drug if sedation occurs
38. When should the client expect to see improvement of depression while on imipramine (Tofranil)?
A. 1 – 2 days
B. 1 week
C. Several weeks
D. Immediately after first dose
39. Which foods/beverages should be avoided while taking phenelzine (Nardil)?
A. Cheese
B. Apples
C. Fish
D. Cereal
40. The nurse recognizes that obsessive-compulsive rituals are an attempt to:
A. Increase self – esteem
B. Control others
C. Express anxiety
D. Avoid severe anxiety
41. The psychiatrist orders lorazepam (Ativan) 1 mg orally TID. While the patient is taking this medication,
the nurse should remind him to:
A. Avoid caffeine
B. Avoid aged cheese
C. Stay out of the sun
D. Maintain an adequate salt intake
42. The mother of a 2-month old baby is concerned that she may be spoiling her baby by picking her up
when she cries. Which of the following would be the nurse’s best response?
A. “Let her cry for a while before picking her up, so you don’t spoil her.”
B. “Babies need to be held and cuddled; you won’t spoil her this way.”
C. “Crying at this age means the baby is hungry; give her a feeding bottle.”
D. “If you leave her alone she will learn how to cry herself to sleep.”
43. Which of the following best describes preschool sexual identification?
A. Identification with same-sex parent; attachment to opposite-sex parent
B. Identification with opposite-sex parent; attachment to same-sex parent
C. Identification and attachment to same-sex parent
D. Identification and attachment to opposite-sex parent
44. The superego is that part of the psyche that:
A. Contains the instinctive drives
B. Is the source of creative energy
C. Operates on the pleasure principle and demands immediate gratification
D. Develops from internalizing the concepts of parents and significant others
45. A client is scheduled for surgery and the nurse assesses a severe level of preoperative anxiety. Which
of the following nursing actions is the priority?
A. Asking the client about her perceptions and concerns about the surgery
B. Informing the surgeon about the client’s level of anxiety
C. Requesting family members to come and stay with the client
D. Teaching the client facts about upcoming preoperative and postoperative care
46. Schizophrenic hallucinations are most commonly:
A. Tactile
B. Visual
C. Auditory
D. Olfactory
47. The nurse’s role in crisis therapy should be:
A. Nondirective and passive
B. Firm and confrontational
C. Active and directive
D. Calm and non-expressive
48. The basis for a therapeutic nurse-patient relationship begins with the nurse’s:
A. Sincere desire to help others
B. Acceptance of others
C. Self-awareness and understanding
D. Sound knowledge of psychiatric nursing
49. Helping a patient find an alternative to her home which has been destroyed by fire, is an example of
what prevention strategy:
A. Primary
B. Secondary
C. Tertiary
D. Any of these
50. Health education, communication, and information dissemination are examples of activities under:
A. Health promotion
B. Rehabilitation
C. Case finding
D. Prompt treatment
51. Prevention of mental illness is best achieved by:
A. Helping individuals use established successful coping mechanisms
B. Assisting individuals deal with physical problems
C. Helping individuals deal with physical problems
D. Assisting individuals deal with family problems
52. Karen, 19 years old college student belongs to what stage of psychosexual development?
A. Anal
B. Phallic
C. Latency
D. Genital
53. A child who belongs to the phallic stage in Freud’s theory, must develop which of the following
developmental tasks according to Erickson?
A. Trust
B. Autonomy
C. Initiative
D. Industry
54. Which of the following is expected when a person is in crisis?
A. Able to adjust in a week
B. Becomes submissive and passive
C. Takes the lead in problem solving
D. Assists the nurse in decision making
55. The nurse is aware that the two major types of precipitating factors in anxiety are:
A. Fear and conflict
B. Conflicts and repressions of feelings
C. Threats to one’s biologic integrity and to self-esteem
D. Poor health and poor financial condition
56. When working with a person who is anxious, what is the overall goal of nursing intervention?
A. Minimize anxiety
B. Develop the person’s awareness of anxiety
C. Protect the person from anxiety
D. Develop the person’s capacity to tolerate mild anxiety
57. The most appropriate way to decrease a client’s anxiety is by:
A. Avoiding unpleasant objects and events
B. Prolonged exposure to fearful situations
C. Acquiring skills with which to face stressful events
D. Introducing an element of pleasure into fearful situations
58. A client with a diagnosis of schizophrenia, paranoid type, is admitted to an acute-care psychiatric unit.
In anticipation of the client’s needs, what nursing diagnosis would be given the highest priority?
A. Altered thought process
B. Social isolation
C. Impaired verbal communication
D. Risk for violence directed at self or at others
59. While working with a client who is having delusions, what nursing interventions would be most helpful?
A. Avoid challenging the content of the client’s delusion
B. Promise the client that antipsychotic meds will improve thought process
C. Challenge the content of the client’s delusion
D. Seclude the client in his room to decrease stimulation
60. A male client with schizophrenia is having negative symptoms associated with his illness. Which of the
following is classified as a negative symptom?
A. Abnormal thoughts
B. Ideas of reference
C. Blunted affect
D. Hallucinations
61. While working with a client who is withdrawn and disconnected, which of the following is an appropriate
short-term goal?
A. The client will attend one-group meeting accompanied by a staff member within a week
B. The client will voluntarily lead the unit community meeting by discharge from the hospital
C. The client will be more connected to the unit in 3 days
D. The client will attend many of the unit group meetings by discharge from the hospital
62. A client presents in the intake assessment office of the mental health clinic with mutism and wax-like
flexibility of the extremities. What type of schizophrenia is characteristic of these findings?
A. Disorganized type
B. Undifferentiated type
C. Residual type
D. Catatonic type
63. A client with a diagnosis of schizophrenia is speaking in a group by putting rhyming words that have no
meanings together. This speech pattern is known as:
A. Echopraxia
B. Echolalia
C. Clang associations
D. Neologisms
64. A male client with a diagnosis of schizophrenia tells you that his roommate is putting thoughts in his
mind against his will. This is an example of:
A. Thought blocking
B. Thought broadcasting
C. Thought insertion
D. Thought control
65. When caring for a patient with schizophrenia, which nursing intervention would be least effective?
A. Exploring the content of his hallucinations
B. Asking the patient to clarify his neologisms
C. Rewarding the patient for positive behavior
D. Performing all activities for the client so his needs are met.
66. The nurse is caring for a client who experiences false sensory perceptions with no basis in reality.
These perceptions are known as:
A. delusions.
B. hallucinations.
C. loose associations
D. neologisms.
67. The nurse is caring for a client who is suicidal. When accompanying the client to the bathroom, the
nurse should:
A. give him privacy in the bathroom.
B. allow him to shave.
C. open the window and allow him to get some fresh air.
D. observe him
68. The nurse is developing a care plan for a client with anorexia nervosa. Which action should the nurse
include in the plan?
A. Restrict visits with the family until the client begins to eat.
B. Provide privacy during meals.
C. Set up a strict eating plan for the client.
D. Encourage the client to exercise, which will reduce her anxiety.
69. A client whose husband recently left her is admitted to the hospital with severe depression. The nurse
suspects that the client is at risk for suicide. Which of the following questions would be most
appropriate and helpful for the nurse to ask during an assessment for suicide risk?
A. "Are you sure you want to kill yourself?"
B. "I know if my husband left me, I'd want to kill myself. Is that what you think?"
C. "How do you think you would kill yourself?"
D. "Why don't you just look at the positives in your life?"
70. The nurse is caring for a client experiencing an anxiety attack. Appropriate nursing interventions
include:
A. turning on the lights and opening the windows so that the client doesn't feel crowded.
B. leaving the client alone.
C. staying with the client and speaking in short sentences.
D. turning on stereo music.
71. The nurse is teaching a new group of mental health aides. The nurse should teach the aides that
setting limits is most important for:
A. a depressed client.
B. a manic client.
C. a suicidal client.
D. an anxious client.
72. A client is admitted with a diagnosis of delusions of grandeur. This diagnosis reflects a belief that one
is:
A. highly important or famous.
B. being persecuted.
C. connected to events unrelated to oneself.
D. responsible for the evil in the world.
73. The nurse is caring for a client, a Vietnam veteran, who exhibits signs and symptoms of posttraumatic
stress disorder. Signs and symptoms of posttraumatic stress disorder include:.
A. hyper alertness and sleep disturbances.
B. memory loss of traumatic event and somatic distress.
C. feelings of hostility and violent behavior.
D. sudden behavioral changes and anorexia.
74. The nurse is caring for a client with manic depression. The care plan for a client in a manic state would
include:
A. offering high-calorie meals and strongly encouraging the client to finish all food.
B. insisting that the client remain active throughout the day so that he’ll sleep at night.
C. allowing the client to exhibit hyperactive, demanding, manipulative behavior without setting limits.
D. listening attentively with a neutral attitude and avoiding power struggles.
75. A 22-year-old client is diagnosed with dependent personality disorder. Which behavior is most likely
evidence of ineffective individual coping?
A. Inability to make choices and decisions without advice
B. Showing interest only in solitary activities
C. Avoiding developing relationships
D. Recurrent self-destructive behavior with history of depression
76. A client is admitted with a diagnosis of schizotypal personality disorder. Which signs would this client
exhibit during social situations?
A. Aggressive behavior
B. Paranoid thoughts
C. Emotional affect
D. Independence needs
77. The nurse is caring for a client in an acute manic state. What's the most effective nursing action for this
client?
A. Assigning him to group activities
B. Reducing his stimulation
C. Assisting him with self-care
D. Helping him express his feelings
78. The nurse is assessing a client for lifestyle factors that might affect normal coping. Which factor would
the nurse most likely consider?
A. Inadequate diet
B. Divorce
C. Job promotion
D. Adopting a child
79. A client with bipolar disorder is being treated with lithium for the first time. The nurse should observe the
client for which common adverse effect of lithium?
A. Sexual dysfunction
B. Constipation
C. Polyuria
D. Seizures
80. A client is admitted for an overdose of amphetamines. When assessing this client, the nurse should
expect to see:
A. tension and irritability.
B. slow pulse.
C. hypotension.
D. constipation.
81. During a shift report, the nurse learns that she'll be providing care for a client who is vulnerable to panic
attack. Treatment for panic attacks includes behavioral therapy, supportive psychotherapy, and
medication such as:
A. barbiturates.
B. antianxiety drugs.
C. depressants.
D. amphetamines.
82. A client comes to the emergency department while experiencing a panic attack. The nurse can best
respond to a client having a panic attack by:
A. staying with the client until the attack subsides.
B. telling the client everything is under control.
C. telling the client to lie down and rest.
D. talking continually to the client by explaining what's happening.
83. A 24-year-old client is experiencing an acute schizophrenic episode. He has vivid hallucinations that
are making him agitated. The nurse's best response at this time would be to:
A. take the client's vital signs.
B. explore the content of the hallucinations.
C. tell him his fear is unrealistic.
D. engage the client in reality-oriented activities.
84. A client with paranoid type schizophrenia becomes angry and tells the nurse to leave him alone. The
nurse should:
A. tell him that she'll leave for now but will return soon.
B. ask him if it's okay if she sits quietly with him.
C. ask him why he wants to be left alone.
D. tell him that she won't let anything happen to him.
85. A client begins taking haloperidol (Haldol). After a few days, he experiences severe tonic contractures
of muscles in the neck, mouth, and tongue. The nurse should recognize this as:
A. psychotic symptoms.
B. parkinsonism.
C. akathisia.
 D. dystonia.
86. The nurse must administer a medication to reverse or prevent Parkinson-type symptoms in a client
receiving an antipsychotic. The medication the client will likely receive is:
A. benztropine (Cogentin).
B. diphenhydramine (Benadryl).
C. propranolol (Inderal).
D. haloperidol (Haldol).
87. The nurse is providing care for a female client with a history of schizophrenia who is experiencing
hallucinations. The physician orders 200 mg of haloperidol (Haldol) orally or I.M. every 4 hours as
needed. What's the nurse's best action?
A. Administer the haloperidol orally if the client agrees to take it.
B. Call the physician to clarify whether the haloperidol should be given orally or I.M.
C. Call the physician to clarify the order because the dosage is too high.
D. Withhold haloperidol because it may worsen hallucinations.
88. The nurse is providing care to a client with catatonic type of schizophrenia who exhibits extreme
negativism. To help the client meet his basic needs, the nurse should:.
A. ask the client which activity he would prefer to do first.
B. negotiate a time when the client will perform activities.
C. tell the client specifically and concisely what needs to be done.
D. prepare the client ahead of time for the activity.
89. Which information is most important for the nurse to include in a teaching plan for a schizophrenic client
taking clozapine (Clozaril)?
A. Monthly blood tests will be necessary.
B. Report a sore throat or fever to the physician immediately.
C. Blood pressure must be monitored for hypertension.
D. Stop the medication when symptoms subside.
90. A client with manic episodes is taking lithium. Which electrolyte level should the nurse check before
administering this medication?
A. Calcium
B. Sodium
C. Chloride
D. Potassium
91. A client is admitted to the inpatient unit of the mental health center with a diagnosis of paranoid
schizophrenia. He's shouting that the government of France is trying to assassinate him. Which of the
following responses is most appropriate?
A. "I think you're wrong. France is a friendly country and an ally of the United States. Their government
wouldn't try to kill you."
B. "I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel
frightened by this."
C. "You're wrong. Nobody is trying to kill you."
D. "A foreign government is trying to kill you? Please tell me more about it."
92. A client has been receiving chlorpromazine (Thorazine), an antipsychotic, to treat his psychosis. Which
finding should alert the nurse that the client is experiencing pseudoparkinsonism?
A. Restlessness, difficulty sitting still, pacing
B. Involuntary rolling of the eyes
C. Tremors, shuffling gait, masklike face
D. Extremity and neck spasms, facial grimacing, jerky movements
93. A 54-year-old female was found unconscious on the floor of her bathroom with self-inflicted wrist
lacerations. An ambulance was called and the client was taken to the emergency department. When
she was stable, the client was transferred to the inpatient psychiatric unit for observation and treatment
with antidepressants. Now that the client is feeling better, which nursing intervention is most
appropriate?
A. Observing for extrapyramidal symptoms
B. Beginning a therapeutic relationship
C. Canceling any no-suicide contracts
D. Continuing suicide precautions
94. A 26-year-old male reports losing his sight in both eyes. He's diagnosed as having a conversion
disorder and is admitted to the psychiatric unit. Which nursing intervention would be most appropriate
for this client?
A. Not focusing on his blindness
B. Providing self-care for him
C. Telling him that his blindness isn't real
D. Teaching eye exercises to strengthen his eyes
95. A client has a diagnosis of borderline personality disorder. She has attached herself to one nurse and
refuses to speak with other staff members. She tells the nurse that the other nurses are mean, withhold
her medication, and mistreat her. The staff is discussing this problem at their weekly conference. Which
intervention would be most appropriate for the nursing staff to implement?
A. Provide an unstructured environment for the client.
B. Rotate the nurses who are assigned to the client.
C. Ignore the client's behaviors.
D. Bend unit rules to meet the client's needs.
96. A client is being admitted to the substance abuse unit for alcohol detoxification. As part of the intake
interview, the nurse asks him when he had his last alcoholic drink. He says that he had his last drink 6
hours before admission. Based on this response, the nurse should expect early withdrawal symptoms
to:
A. not occur at all because the time period for their occurrence has passed.
B. begin anytime within the next 1 to 2 days.
C. begin within 2 to 7 days.
D. begin after 7 days.
97. The nurse in the substance abuse unit is trying to encourage a client to attend Alcoholics Anonymous
(AA) meetings. When the client asks the nurse what he must do to become a member, the nurse
should respond:
A. You must first stop drinking.
B. Your physician must refer you to this program.
C. Admit you're powerless over alcohol and that you need help.
D. You must bring along a friend who will support you.
98. The nurse is assessing a 15-year-old female who is being admitted for treatment of anorexia nervosa.
Which clinical manifestation is the nurse most likely to find?
A. Tachycardia
B. Warm, flushed extremities
C. Parotid gland tenderness
D. Coarse hair growth
99. The nurse is assessing an adult's developmental stage. The nurse should consider:.
A. height and weight.
B. blood pressure.
C. previous problem-solving strategies.
D. pulse rate.
100. Which of the following factors would have the most influence on the outcome of a crisis
situation?
A. Age
B. Previous coping skills
C. Self-esteem
D. Perception of the problem
101. The nurse is caring for an elderly client in a long-term care facility. The client has a history of
attempted suicide. The nurse observes the client giving away personal belongings and has heard the
client express feelings of hopelessness to 3 other residents. Which intervention should the nurse
perform first?
A. Setting aside time to listen to the client
B. Removing items that the client could use in a suicide attempt
C. Communicating a nonjudgmental attitude
D. Referring the client to a mental health professional
102. The nurse is caring for an adolescent female who reports amenorrhea, weight loss, and
depression. Which additional assessment finding would suggest that the woman has an eating
disorder?
A. Wearing tight-fitting clothing
B. Increased blood pressure
C. Oily skin
D. Excessive and ritualized exercise
103. A high school student is referred to the school nurse for suspected substance abuse. Following
the nurse's assessment and interventions, what would be the most desirable outcome?
A. The student discusses conflicts over drug use.
B. The student accepts a referral to a substance abuse counselor.
C. The student agrees to inform his parents of the problem.
D. The student reports increased comfort with making choices.
104. The nurse is using drawing, puppetry, and other forms of play therapy while treating a terminally
ill, school-age child. The purpose of these techniques is to help the child:
A. internalize his feelings about death and dying.
B. accept responsibility for his situation.
C. express feelings that he can't articulate.
D. have a good time while he's in the hospital.
105. The nurse is working with a client who abuses alcohol. Which of the following facts should the
nurse communicate to the client?
A. Abstinence is the basis for successful treatment.
B. Attendance at Alcoholics Anonymous (AA) meetings every day will cure alcoholism.
C. For treatment to be successful, family members must participate.
D. An occasional social drink is acceptable behavior for the alcoholic.
106. A client exhibits the following defining characteristics: denial of problems that are evident to
others, expressions of shame or guilt, perceptions of self as being unable to deal with events, and
projection of blame or responsibility for problems onto others. How would a nurse diagnose this client?
A. Anxiety
B. Chronic low self-esteem
C. Ineffective denial
D. Ineffective individual coping
107. The nurse is caring for a client with bulimia. Strict management of dietary intake is necessary.
Which intervention is also important?
A. Fill out the client's menu and make sure she eats at least half of what's on her tray.
B. Let the client eat her meals in private then engage her in social activities for at least 2 hours after
each meal.
C. Let the client choose her own food. If she eats everything she orders, then stay with her for 1 hour
after each meal.
D. Let the client eat food brought in by the family if she chooses, but keep a strict calorie count.
108. A 15-year-old client is brought to the clinic by her mother. Her mother expresses concern about
her daughter's weight loss and constant dieting. The nurse conducts a health history interview. Which
of the following comments indicates that the client may be suffering from anorexia nervosa?
A. "I like the way I look. I just need to keep my weight down because I'm a cheerleader."
B. "I don't like the food my mother cooks. I eat plenty of fast food when I'm out with my friends."
C. "I just can't seem to get down to the weight I want to be. I'm so fat compared to other girls."
D. "I do diet around my periods, otherwise I just get so bloated."
109. Which psychological or personality factors are most likely to predispose an individual to
medication abuse?
A. Low self-esteem and unresolved rage
B. Desire to inflict pain upon oneself
C. Obsessive-compulsive disorder
D. Codependency
110. A client chronically complains of being unappreciated and misunderstood by others. She's
argumentative and sullen. She always blames others for her failure to complete work assignments. She
expresses feelings of envy toward people she perceives as more fortunate. She voices exaggerated
 complaints of personal misfortune. The client most likely suffers from which of the following personality
disorders?
A. Dependent personality
B. Passive-aggressive personality
C. Avoidant personality disorder
D. Obsessive-compulsive disorder
111. A client diagnosed with depression tells the nurse, "I won't allow myself to cry because it upsets
the whole family when I cry." This is an example of:
A. manipulation.
B. insight.
C. rationalization.
D. repression.
112. A client diagnosed with major depression has started taking amitriptyline (Elavil), a tricyclic
antidepressant. What's a common adverse effect of this drug?
A. Weight loss
B. Dry mouth
C. Increased blood pressure
D. Muscle spasms
113. A client has received treatment for depression for 3 weeks. Which behavior suggests that the
client is recovering from depression?
A. The client talks about the difficulties of returning to college after discharge.
B. The client spends most of the day sitting alone in the corner of the room.
C. The client wears a hospital gown instead of street clothes.
D. The client shows no emotion when visitors leave.
114. A client in the manic phase of bipolar disorder constantly belittles other clients and demands
special favors from the nurses. Which nursing intervention would be most appropriate for this client?
A. Ask other clients and staff members to ignore the client's behavior.
B. Set limits with consequences for belittling or demanding behavior.
C. Offer the client an antianxiety drug when belittling or demanding behavior occurs.
D. Offer the client a variety of stimulating activities to distract him from belittling or making demands of
others.
115. The nurse is caring for a client with hypochondriasis. Which behavior would the nurse most
likely encounter?
A. Ready acceptance of the physician's explanation that all medical and laboratory tests are normal
B. Expression of fear of dying after being diagnosed with advanced breast cancer
C. Expression of fear of colorectal cancer following 3 days of constipation
D. Lack of concern about having a serious disease
116. The nurse is caring for a client who has been diagnosed with hypochondriasis. The client
attributes his cough to tuberculosis. A chest X-ray and skin test are negative for tuberculosis. The client
begins to complain about the sudden onset of chest pain. How should the nurse react initially?
A. Let the client know the nurse understands his fears of serious illness.
B. Encourage the client to discuss his fear of having a serious illness.
C. Report the complaint of chest pain to the physician.
D. Determine if the illness is fulfilling a psychological need for the client.
117. The nurse is talking with a client who recently attempted suicide. The client asks her not to tell
anyone one about their conversation. How should the nurse respond?
A. I'll need to share information with the rest of your health care team if it’s important to your care.
B. I promise I won't tell anyone about the information you share with me today.
C. I promise I won't tell anyone about the information you share with me today unless you give me
permission to do so.
D. Please don't tell me anything that you wouldn't want others on your health care team to know.
118. The nurse is administering atropine sulfate to a client about to undergo electroconvulsive
therapy. Which assessment indicates that the medication is effective?
A. Client's heart rate is 48 beats/minute.
B. Client states that his mouth is dry.
C. Client appears calm and relaxed.
 D. Client falls asleep.
119. The nurse is documenting a care plan for a client who has undergone electroconvulsive therapy.
Which intervention should the nurse include?
A. Monitoring the client's vital signs every hour for 4 hours
B. Placing the client in Trendelenburg's position
C. Encouraging early ambulation
D. Reorienting the client to time and place
120. The nurse is caring for a client in the manic phase of bipolar disorder who is ready for discharge
from the psychiatric unit. As the nurse begins to terminate the nurse-client relationship, which client
response is most appropriate?
A. Expressing feelings of anxiety
B. Displaying anger, shouting, and banging the table.
C. Withdrawing from the nurse in silence
D. Rationalizing the termination, saying that everything comes to an end
121. A client with a borderline personality disorder has been playing one staff member against
another. In formulating a care plan for this client, the nursing staff should include which intervention?
A. Assigning the same staff members to work with the client
B. Avoiding setting limits
C. Rotating staff members who work with the client
D. Avoiding interaction with the client until splitting behaviors stop
122. The nurse is planning care for a client admitted to the psychiatric unit with a diagnosis of
paranoid schizophrenia. Which nursing diagnosis should receive the highest priority?
A. Risk for self- or other-directed violence
B. Imbalanced nutrition
C. Ineffective coping
D. Impaired verbal communication
123. The nurse is teaching a psychiatric client about her prescribed drugs, chlorpromazine and
benztropine. Why is benztropine administered?
A. reduce psychotic symptoms
B. reduce extrapyramidal symptoms
C. control nausea and vomiting
D. relieve anxiety

70. The nurse is leading group therapy with psychiatric clients. During the working phase, what should the
nurse do?
A. Explain the purposes and goals of the group.
B. Offer advice to help resolve conflicts.
C. Encourage group cohesiveness.
D. Encourage a discussion of feelings of loss regarding termination of the group.

71. A client is admitted to the substance abuse unit for alcohol detoxification. Which of the following
medications is the nurse most likely to administer to reduce the symptoms of alcohol withdrawal?
a. Naloxone (Narcan) B. Haloperidol (Haldol)
C. Magnesium sulfate D. Chlordiazepoxide (Librium)
72. The client tells the nurse he was involved in a car accident while he was intoxicated. What would be the
most therapeutic response from the nurse?
A. Why didn't you get someone else to drive you?
B. Tell me how you feel about the accident.
C. You should know better than to drink and drive.
D. I recommend that you attend an Alcoholics Anonymous meeting.
73. A client suffers from depression after the accidental death of her daughter. After a suicide attempt, the
client is admitted to the psychiatric unit. During the admission interview, the client tells the nurse that she no
longer wants to die. The nurse should:
a. suggest that the client no longer requires close observation.
b. place the client in a private room, away from the nurses' station, so that she has privacy to work through the
stages of the grieving process.
c. inspect the client's personal belongings for potentially dangerous objects.
d. avoid any further discussion of suicide, unless the client brings up the topic.
74. The nurse is caring for a client diagnosed with panic disorder. The client begins to hyperventilate. How
should the nurse respond initially?
A. Stay with the client during the panic attack.
B. Shout for help and obtain assistance.
C. Teach the client relaxation exercises.
D. Help the client explore the reason for the anxiety.

75. The nurse is caring for a client with panic disorder who has difficulty sleeping. Which nursing intervention
would best help the client achieve healthy long-term sleeping habits?
A. Administering sleeping pills
B. Encouraging the use of relaxation exercises
C. Suggesting he talk with other clients until he feels ready to sleep
D. Telling him to play ping-pong in the day room
76. A teenager was driving a car that slipped off an icy road, killing two of his friends. He repeatedly tells the
nurse that he should be dead instead of his friends. The client's behavior is an example of:.
A. survivor's guilt. B. denial.
C. anticipatory grief. D. repression.
77. The nurse is caring for a client with schizophrenia. Which of the following outcomes is least desirable?
a. The client spends more time by himself.
b. The client doesn't engage in delusional thinking.
c. The client doesn't harm himself or others.
d. The client demonstrates the ability to meet his own self-care needs.
78. The nurse is caring for a client with schizophrenia who experiences auditory hallucinations. The client
appears to be listening to someone who isn't visible. He gestures, shouts angrily, and stops shouting in mid-
sentence. Which nursing
intervention is the most appropriate?
a. Approach the client and touch him to get his attention.
b. Encourage the client to go to his room where he'll experience fewer distractions.
c. Acknowledge that the client is hearing voices, but make it clear that the nurse doesn't hear these voices.
d. Ask the client to describe what the voices are saying.

79. A client with schizophrenia who receives fluphenazine (Prolixin) develops pseudoparkinsonism and
akinesia. What drug would the nurse administer to minimize extrapyramidal symptoms?.
A. Benztropine (Cogentin) B. Dantrolene (Dantrium)
C. Clonazepam (Klonopin) D. Diazepam (Valium)

80. The nurse is caring for a client being treated for alcoholism. Before initiating therapy with disulfiram
(Antabuse), the nurse teaches the client that he must read labels carefully on which of the following products?
A. Carbonated beverages B. Aftershave lotion
C. Toothpaste D. Cheese

81. Which statement about somatoform pain disorder is accurate?

a. The pain is intentionally fabricated by the client in order to receive attention.
b. The pain is real to the client, even though there may not be an organic etiology for the pain.
c. The pain is less than would be expected from what the client identifies as the underlying disorder.
d. The pain is what would be expected from what the client identifies as the underlying disorder.
82. The nurse is caring for a client diagnosed with antisocial personality disorder. The client has a history of
fighting, cruelty to animals, and stealing. Which of the following traits would the nurse be most likely to uncover
during assessment?.
A. History of gainful employment
B. Frequent expression of guilt regarding antisocial behavior
C. Demonstrated ability to maintain close, stable relationships
D. A low tolerance for frustration
83. The nurse is caring for a client with antisocial personality disorder. Which of the following statements is
most appropriate for the nurse to make when explaining unit rules and expectations to the client?
a. "I and other members of the health care team would like you to attend group therapy each day."
b. "You'll find your condition will improve much faster if you attend group therapy each day."
c. "You'll be expected to attend group therapy each day."
d. "Please try to attend group therapy each day."

84. A 58-year-old client on a mental health unit has lost control, despite having been properly medicated, and
is threatening to harm himself and others. He has been placed in four-point restraints. Which nursing measure
should be taken next?
a. Release one restraint every 15 minutes.
b. Have a staff member stay with the client at all times.
c. Leave the client alone to reduce his sensory stimulation and allow him to regain control.
d. Restrict fluids until the restraint period is over.

85. Which nursing assessment has priority while a client's extremities are restrained?
A. Measuring urine output B. Checking circulation in extremities
C. Assessing pupillary responses D. Noting respiratory pattern

86. A psychiatric client who was voluntarily admitted now wishes to be discharged from the hospital, against
medical advice. What's the most important assessment the nurse should make of the client?.
A. Ability to care for himself B. Degree of danger to self and others
C. Level of psychosis D. Intended compliance with aftercare

87. The nurse should determine that restraints are no longer needed when the client:
A. falls asleep. B. ceases verbalizing threats.
C. is calm verbally and nonverbally. D. expresses being okay.

87. A client on an inpatient psychiatric unit at a community mental health center is pacing up and down the
hallway. The client has a history of aggression. Which response by the nurse would be best when approaching
the client?.
A. "If you can't relax, you could go to your room."
B. "Would you like your antianxiety medication now?"
C. "You're pacing. What's going on?"
D. "Let's go play a game of pool."

88. A 37-year-old male with a history of schizophrenia is having auditory hallucinations. The physician orders
200 mg of haloperidol (Haldol) orally or I.M. every 4 hours as needed. What's the nurse's best action?
a. Administer the haloperidol orally if the client agrees to take it.
b. Call the physician to clarify whether the haloperidol should be given orally or I.M.
c. Call the physician to clarify the order because the dosage is too high.
d. Withhold haloperidol because it may cause hallucinations.

89. An inpatient psychiatric client suddenly becomes loud and visibly anxious. What's the best action for the
nurse to take?.
A. Summon help and escort the client to his room.
B. Face the client squarely and say, "You must be quiet."
C. Say, "Calm down; you're safe here."
D. Say, "Let's go talk in your room."

90. A voluntary client on an inpatient psychiatric unit has a history of auditory hallucinations and self-
aggression. The nurse is talking with the client when the client suddenly jumps up and says, to no one in
particular, "Get away from me." What's the nurse's best response?
A. Escort the client to his room. B. Say, "I won't let them harm you."
C. Sit quietly until the client becomes calm. D. Ask, "Who are you talking to?"
91. A 35-year-old voluntary client suddenly begins yelling, throws a chair, and exhibits extreme agitation.
Which of the following would be most important for the nurse to consider when planning an intervention?.
A. Because the client is a voluntary admission, restraints can't be used.
B. The family must be called for permission to restrain the client.
C. Restraint should be used as a last resort.
D. Restraint can't be initiated until the physician is called.
92. Before forcing a client to take a medication, the nurse should give priority to:
a. the client's danger to self or others.
B. what the "voices" are saying to the client.
C. whether the client's admission was voluntary.
D. the client's insight into the illness.
93. A client was admitted to the hospital 2 days ago for disrupting a town meeting, shouting religious delusions,
and fighting with police. The client now refuses to take prescribed haloperidol (Haldol), saying, "I don't want it."
Which response by the nurse would be best?.
A. "It will help you feel better."
B. "You must take it or get an injection."
C. "What are you afraid of?" D. "You sound concerned."

94. A client has been prescribed 75 mg of amitriptyline (Elavil) at bedtime and 15 mg of phenelzine (Nardil)
three times per day. Which nursing action takes priority?
A. Teaching the client about the adverse effects
B. Calling the physician and questioning the order
C. Instituting dietary restrictions
D. Taking baseline vital signs

95. A client on an inpatient psychiatric unit has been taking a tricyclic antidepressant without satisfactory
results, so the physician changes to a monoamine oxidase (MAO) inhibitor. In evaluating the physician's order,
the nurse must first be sure:
a. adequate time has elapsed between discontinuing the first medication and beginning the second.
b. the MAO inhibitor is begun at the same dosage as the tricyclic antidepressant.
c. the client isn't suicidal.
d. the client isn't allergic to cheese.

96. A client reports no improvement in mood since beginning a regimen of 15 mg of tranylcypromine (Parnate)
twice per day 1 week ago. Which of the following is the best nursing action?
a. Say to the client, "The medication may need up to 4 weeks to take effect."
b. Say to the client, "You should feel the effects any day now."
c. Consult with the physician about a dosage adjustment.
d. Consult with the physician about a change of medication.

97. A client who has been hospitalized with depression is about to be dischargedwith a prescription of
phenelzine (Nardil). In planning for discharge, the nurse should have a teaching plan that emphasizes:
A. getting adequate rest. B. avoiding smoking.
C. avoiding red wine. D. taking the drug with food or milk.

98. The physician prescribes a monoamine oxidase (MAO) inhibitor for a client. Which of the following nursing
diagnostic categories would be most appropriate to focus on during client teaching?.
A. Risk for injury B. Disturbed thought processes
C. Deficient fluid volume D. Disturbed sleep pattern

99. A nurse is teaching clients in an outpatient clinic about monoamine oxidase (MAO) inhibitors. The nurse
would best evaluate the clients' understanding of how their medications work by noting:.
A. food selections. B. fluid intake.
C. potential for self-harm. D. level of anxiety.
100. A hospitalized client taking 30 mg of tranylcypromine (Parnate) twice per day complains of a stiff neck and
headache. Which action would be best for the
nurse to take?.
A. Note the complaints as usual adverse effects.
B. Withhold the next dose of medication.
C. Administer an analgesic, as needed and as prescribed.
D. Help the client relax.

101. A client avoids leaving home to shop for groceries or complete other errands. At times the client feels
"crazy" because of her fear. The client seeks out her neighbor, a nurse, for help. The nurse's assessment is
phobic reaction. Which of the following statements about a phobia is true?
a. The condition is a persistent, intrusive image that seems senseless to the person.
b. It's important not to force the person to face the phobic object or situation.
c. The phobic condition can be cured by hypnosis.
d. It's necessary to agree with the client's assessment that the phobia is silly.

102. A 76-year-old widowed mother of six is admitted to a long-term care facility with a diagnosis of organic
mental disorder. Which of the following approaches would be most helpful for the nurse in meeting the client's
needs?.
A. Make sure the client completes tasks that she begins.
B. Maintain a gentle approach that doesn't set limits.
C. Give the client alternative choices in making decisions.
D. Simplify the environment as much as possible.

103. Which of the following snacks would be best for a client with anorexia nervosa who requires a high-
protein, high-calorie diet?
A. Chicken soup and crackers B. Doughnut and orange juice
C. Egg salad and peanuts D. Cashews and strawberries

104. What's the most appropriate nursing diagnosis for a client exhibiting obsessive-compulsive behavior?
A. Ineffective coping
B. Imbalanced nutrition: Less than body requirements
C. Imbalanced nutrition: More than body requirements
D. Interrupted family processes

105. A 28-year-old accountant is admitted to the neurologic unit after a sudden onset of blindness the day
before an important project is due for her boss. After preliminary evaluation and testing yields no positive
findings, the physician's initial reaction is that the client may be demonstrating which defense mechanism?
A. Repression B. Transference
C. Reaction formation D. Conversion

106. A client with bipolar disorder, manic phase, who usually dresses conservatively, appears at breakfast with
brightly colored cheeks, wearing a miniskirt, sheer blouse, and designer boots. Which of the following actions
should the nurse take to deal with the client's attire?
a. Redirect the client to her room and help her put on her more customary clothing.
b. Allow her the freedom to wear what she prefers for now.
c. Remind the client of the dress code and the consequences of violation.
d. Tell the client what to wear and advise her that she has lost the privilege of choosing her wardrobe.

107. What's the most effective intervention for handling a client with an antisocial personality?
A. Reason with the client. B. Set limits with the client.
C. Ignore the client. D. Agree with the client.

108. A client on the nursing unit, charged with child abuse, doesn't speak to the staff when approached. Which
response by the nurse would be best?
A. "If you need me, I'll be in the nurses' station."
B. "You need to come to grips with what has happened."
C. "Not speaking to the staff won't help your situation."
D. "Admission to a psychiatric unit can be very difficult."

109. After refusing to eat for 4 days, a 17-year-old college freshman is referred to the inpatient eating disorders
unit of a general hospital. Her affect is flat, her eyes downcast, and her long blonde hair dull and limp. Her
clothes hang loosely on her body, and she appears sullen and frightened. Her weight on admission is 89 lb
(40.4 kg); her normal weight is 114 lb (52 kg). Which of the following assessments would best enable the nurse
to develop a specific nursing diagnosis?.
A. Family history, including genograms
B. Psychiatric history, including all hospital admissions
C. Cardiac and respiratory history
D. Weight loss history and general condition of skin, hair, and nails

110. A client is admitted for a suspected eating disorder. Which of the following statements would indicate that
the client may be suffering from anorexia nervosa?
A. "I've gained 3 pounds in the last month."
B. "I eat loads of spinach and yellow vegetables each day."
C. "I'm a perfectionist, and I work hard to get A's."
D. "I binge frequently in the morning and feel fat."

111. Which of the following nursing interventions would be included in the care of a client with anorexia
nervosa as therapy progresses?
A. Let the client eat alone to avoid embarrassment.
B. Weigh the client once a week in the same clothing.
C. Monitor the client for self-destructive tendencies.
D. Praise the client for "looking better," and remind the client that she isn't "too fat."

112. A client with a personality disorder exhibits manipulative behavior. Care planning for this client should
include:
A. freedom to do as the client chooses when behavior improves.
B. limitations per unit rules without restrictions for broken rules.
C. reasonable expectations with varying limits.
D. verbal reinforcement when the client functions within established limits.

113. A 40-year-old woman is brought to the hospital by her husband, who states that she has refused to eat or
get out of bed for 2 days. The woman says that she's tired all the time and doesn't feel up to going to work. Her
admitting diagnosis is major depression. Which question would be most appropriate for the admitting nurse to
ask?
A. "What has been troubling you?"
B. "Why do you dislike yourself?"
C. "How do you feel about your life?"
D. "What can we do to help?"

114. A 24-year-old secretary is transferred to your psychiatric unit. Her husband says that she has been
overeating and that she vomits soon after she eats. Her weight stays about the same, at 96 lb (44 kg). In
planning care for the client, the nurse should anticipate which medical diagnosis?
A. Anorexia nervosa B. Bulimia
C. Klein-Levin syndrome D. Dysthymia

115. For a client with bulimia, which assessment is least important in the care plan?.
A. Observe the client after eating for 1 hour. B. Note the client's intake.
C. Note changes in appetite. D. Note changes in respiratory rate.

116. A client with personality disorder gets along poorly with the immediate family. The client's manipulative
behavior most likely shows a failure to develop:.
A. intimate relationships. B. trust.
C. industry. D. feelings of guilt.

117. A 32-year-old client is admitted to the unit. She states, "I'm a well-known, wealthy designer," and begins
to order the nurses to prepare her bath while she orders her tray and telephones her colleagues. Her husband
states that she's too busy to eat and sleep and is losing weight. Her admitting diagnosis is bipolar disorder,
manic phase. For which of the following events should the nurse plan?.
A. Erratic and unpredictable behavior if challenged
B. Boredom and the need for minute-to-minute activities
C. Rapid mood changes from elation to depression
D. One-to-one treatment to occupy the client's time

118. A 32-year-old lawyer is admitted to the neurologic unit with a sudden onset of blindness the night before
an important case is scheduled to go to trial. Tests reveal no physical findings. Which of the following is the
best assessment of the client's anxiety?
a. It's diffuse and free floating. b. It's consciously experienced.
c. It's localized and relieved by the blindness.
d. It's projected onto the environment.

119. A 50-year-old client has been admitted for psychological testing after having been charged with physical
abuse of a 7-year-old child. The client refuses to cometo the day room, saying, "I don't want people to stare at
me." Which response by the nurse is best?
A. "That's okay for now if that's what you want."
B. "It will be easier for you if you face people as soon as possible."
C. "The staff are the only people who know why you were admitted."
D. "You're very hard on yourself."

120. A 26-year-old office manager is hospitalized after developing acute leg pain.
Diagnostic tests reveal no organic cause. What's the best long-term goal to include in this client's care plan?.
A. Develop insight into the client's psyche.
B. Accelerate the client's developmental tasks.
C. Restore the client's previous adaptive behaviors.
D. Eliminate responsibility for the client's behavior.

121. A 16-year-old student has been admitted to your psychiatric unit after fainting in physical education class.
She has a diagnosis of anorexia nervosa, weighs 88 lb (40 kg), and is 5 (1.6 m) tall. She has been weighing
herself several times per day at home and has lost 30 lb (13.5 kg) in the past 3 months. Which nursing
diagnosis would be most appropriate for the client?.
A. Disturbed thought processes B. Impaired adjustment
C. Imbalanced nutrition: Less than body requirements
D. Ineffective sexuality patterns

122. A client with antisocial personality disorder refuses to take a shower for 3 days. Which response by the
nurse is best?.
A. "It's policy here for all clients to bathe daily."
B. "It's time for your shower. I'll help you with it."
C. "Don't worry about your shower until tomorrow."
D. "Do you want people to make fun of you?"

123. A client with major depression states, "Everything is my fault, and I'd be better off dead." What's the
priority nursing intervention?
A. Assess the seriousness of the client's comment.
B. Notify the psychiatrist of the client's verbalization.
C. Assign staff members to a suicide watch.
D. Engage the client in a no-suicide contract.
124. An abused child is scheduled to be on the unit for 3 to 4 weeks. Which of the following assignments would
be best for the child?
a. Assign a different primary nurse to the child each day.
b. Assign the primary nurse who is transferring next week to another unit.
c. Assign the same primary nurse to the child each day of the hospital stay.
d. Assign a new primary nurse every 3 days.

125. A 38-year-old client is hospitalized with obsessive-compulsive disorder. On admission, she becomes
nervous and asks to go to the bathroom to brush her teeth. Her husband says that she brushes her teeth at
least 25 times per day. The nurse notes that the client's gums are inflamed and bleeding. What's the best
nursing intervention?
A. Have her stop brushing her teeth until the gums heal.
B. Allow her to continue her routine of daily brushing.
C. Monitor her dental care and set limits on the amount of daily brushing.
D. Brush her teeth for her.

126. A client with a diagnosis of organic mental disorder becomes verbally and physically abusive when the
nurse enters the client's room to assist with daily care. Which of the following interventions should the nurse
engage in first?
a. Check orders for physical and chemical restraints.
b. Set firm limits verbally.
c. Give clear directions while gently securing the client's arms from hitting the nurse.
d. Leave the room and let the angry, hostile behavior work itself out.

127. A 2-year-old client is hospitalized with a fractured left arm, a concussion, and multiple bruises. The client
appears quite withdrawn. The bruises appear to have occurred at different times, with some new and some
nearly healed. Emergency department staff report suspected child abuse to the authorities. During an
assessment, the nurse would expect which behavior in the child?.
A. Quiet and passive about pain B. Crying and sensitive to pain
C. Happy to see new people D. Having good eye contact with the parents

128. A bulimic client admitted to the psychiatric unit suddenly shouts, "I want to leave right now. I'm not crazy
and don't belong here." Which response should the nurse make?.
A. "You can't go home until we cure your eating problems."
B. "You seem upset; I'll stay with you."
C. "Don't worry. You'll feel better tomorrow."
D. "Let's talk about something more pleasant."

129. A 22-year-old client has been diagnosed with antisocial personality disorder. She has been having
problems since age 15, when she ran away from home. She has had two broken marriages, has been unable
to keep a job for more than 2
months, and has had difficulties with the law because she has abused drugs and passed bad checks. Although
the client has made all the telephone calls she is allowed for the day, she asks the nurse, "Can't I just make
one more phone call?"
Which response by the nurse would be best?
a. "Okay, but don't talk too long."
b. "Okay, if you promise to obey the rules the rest of the day."
c. "No, you can't. The rules apply equally to everyone, and you are asking to break them."
d. "No, you can't. Go watch television."

130. A client with anorexia nervosa who is on bed rest stares at her dinner tray. She has made little effort to
eat. Which statement by the nurse would be most therapeutic?
a. "You should be ashamed of yourself. There are starving people who would love that food."
b. "Hurry up with your tray. I have several more clients to see."
c. "Don't worry. You can eat more tomorrow."
d. "I'll stay with you while you eat and help you fill out tomorrow's menu."
131. A client is hospitalized after experiencing sudden-onset paralysis. Diagnostic tests reveal no positive
physical findings. What's a likely cause?.
A. Demonstrated organic pathology B. Intense feelings of worthlessness
C. A primary and conscious need for attention
D. An involuntary attempt to solve a conflict

132. A 19-year-old male just arrived on the psychiatric unit from the emergency department. His medical
diagnosis is personality disorder, and he exhibits manipulative behavior. As the nurse reviews the unit rules
with him, the client asks, "Can I go to the snack shop just one time, and then I'll answer whatever you want?"
What's the nurse's best response?.
A. "Okay, but hurry up. I need to finish your assessment."
B. "Okay, but only for 5 minutes." C. "No, you can't go."
D. "No, you can't go. The rules here are for everyone."

133. A client with major depression begins to improve and participates in treatment programs on the unit. The
nurse should recognize that the client is ready for discharge when the client:.
A. asks the staff for advice about how to handle the future.
B. speaks to the employer about a return date to work.
C. identifies personal weaknesses and plans to work on them.
D. discusses plans to return home and continue outpatient treatment.

134. Which of the following concepts about anorexia nervosa should the nurse consider in understanding a
client's cry for help?
a.Focus on anorexia as an effort to gain status and resolve conflict
b. Rejection of food as a way to obtain love and care from parents
c. Use of eating behavior to resolve conscious sexual needs
d. Avoidance of eating as a response to voices that threaten the client

135. A noticeably withdrawn 14-year-old female client is being treated on the unit for anorexia nervosa. Which
nursing assessments should be made daily?
A. Edema of the legs B. Pulse and blood pressure elevation
C. Frequent binging and purging D. Level of depression and anxiety

136. A 76-year-old client is admitted to a long-term care facility with a diagnosis of organic mental disorder.
The client has been wearing the same dirty, torn undergarments for several days. The nurse contacts family
members to bring in clean clothing. Which of the following interventions would best prevent further regression
in the client's personal hygiene habits?.
A. Encourage the client to perform as much self-care as possible.
B. Make the client assume responsibility for physical care.
C. Assign a staff member to take over the client's physical care.
D. Accept the client's desire to go without bathing and to wear dirty clothing.

137. A 37-year-old man with a history of schizophrenia is having hallucinations. He shouts to the nurse, "You're
stepping on spiders! Move aside. Don't you see them?" Which response by the nurse is best?
a. "No, I don't. Quit talking foolishly."
b. "Yes, I see them, and they sure are big ones."
c. "No, I don't see them, but I believe that you do see them."
d. "Let's go to the recreation room."

138. Teaching for a client taking antipsychotic medication should include which of the following instructions?
A. Take the medication with antacid to prevent upset stomach.
B. Get fresh air and plenty of sunshine.
C. If a dose is missed, take two the next time.
D. Avoid abrupt withdrawal of the medication.
139. A client on an inpatient psychiatric unit at a community mental health center is pacing the hallway and
appears agitated. When the nurse approaches him, he says loudly, "Leave me alone." What's the nurse's best
approach?
A. Say "Okay" and walk away.
B. Summon help in case the client becomes aggressive.
C. Say nothing and pace with the client.
D. Say "You sound upset. I'd like to help."

140. A 23-year-old married homemaker has been on the psychiatric unit for 2 days. She has a history of
bipolar disorder and came to the hospital in the manic phase. She stopped taking her medication (lithium
carbonate [Eskalith]) 2 weeks ago. Which of the following findings is the nurse least likely to see?
A. Flight of ideas B. Delusions of grandeur
C. Increased appetite D. Restlessness