1. Mental health is defined as: D.

Case finding and surveillance in the

A. The ability to distinguish what is real from community
what is not. 6. Situation: In a home visit done by the
B. A state of well-being where a person can nurse, she suspects that the wife and her
realize his own abilities can cope with normal child are victims of abuse. Which of the
stresses of life and work productively. following is the most appropriate for the
C. Is the promotion of mental health, prevention nurse to ask?
of mental disorders, nursing care of patients A. “Are you being threatened or hurt by your
during illness and rehabilitation partner?
D. Absence of mental illness B. “Are you frightened of you partner.”
2. Which of the following describes the role of C. “Is something bothering you?”
a technician? D. “What happens when you and your partner
A. Administers medications to a schizophrenic argue?”
patient. 7. The wife admits that she is a victim of
B. The nurse feeds and bathes a catatonic client abuse and opens up about her persistent
C. Coordinates diverse aspects of care rendered distaste for sex. This sexual disorder is:
to the patient A. Sexual desire disorder
D. Disseminates information about alcohol and B. Sexual arousal disorder
its effects. C. Orgasm disorder
3. Letty says, “Give me ten (10) minutes to D. Sexual Pain Disorder
recall the name of our college professor who 8. What would be the best approach for a wife
failed many students in our anatomy class.” who is still living with her abusive husband?
She is operating on her: A. “Here’s the number of a crisis center that you
A. Subconscious can call for help .”
B. Conscious B. “It’s best to leave your husband.”
C. Unconscious C. “Did you discuss this with your family?”
D. Ego D. “ Why do you allow yourself to be treated this
4. The superego is that part of the psyche way.”
that: 9. Which comment about a 3-year-old child if
A. Uses defensive function for protection. made by the parent may indicate child
B. Is impulsive and without morals. abuse?
C. Determines the circumstances before making A. “Once my child is toilet trained, I can still
decisions. expect her to have some.”
D. The censoring portion of the mind. B. “When I tell my child to do something once, I
5. Primary level of prevention is exemplified don’t expect to have to tell.”
by: C. “My child is expected to try to do things such
A. Helping the client resume self-care. as dress and feed.”
B. Ensuring the safety of a suicidal client in the D. “My three (3)-year-old loves to say NO.”
institution. 10. The primary nursing intervention for a
C. Teaching the client stress management victim of child abuse is:
techniques
A. Assess the scope of the problem B. “I think you’re exaggerating things a little bit.”
B. Analyze the family dynamics C. “Try to forget this feeling and have activities to
C. Ensure the safety of the victim take it off your mind.”
D. Teach the victim coping skills D. “So tell me more about the pain.”
11. Situation: A 30-year-old male employee 16. Situation: A nurse may encounter children
frequently complains of low back pain that with mental disorders. Her knowledge of
leads to frequent absences from work. these various disorders is vital. When
Consultation and tests reveal negative planning school interventions for a child with
results. The client has which somatoform a diagnosis of attention deficit hyperactivity
disorder? disorder, a guide to remember is to:
A. Somatization Disorder A. Provide as much structure as possible for the
B. Hypochondriasis child
C. Conversion Disorder B. Ignore the child’s overactivity.
D. Somatoform Pain Disorder C. Encourage the child to engage in any play
12. Freud explains anxiety as: activity to dissipate energy
A. Strives to gratify the needs for satisfaction and D. Remove the child from the classroom when
security disruptive behavior occurs
B. Conflict between id and superego 17. The child with conduct disorder will likely
C. A hypothalamic-pituitary-adrenal reaction demonstrate:
to stress A. Easy distractibility to external stimuli.
D. A conditioned response to stressors B. Ritualistic behaviors
13. The following are the appropriate nursing C. Preference for inanimate objects.
diagnosis for the client EXCEPT: D. Serious violations of age related norms.
A. Ineffective individual coping 18. Ritalin is the drug of choice for children
B. Alteration in comfort, pain with ADHD. The side effects of the following
C. Altered role performance may be noted:
D. Impaired social interaction A. Increased attention span and concentration
14. The following statements describe B. Increase in appetite
somatoform disorders: C. Sleepiness and lethargy
A. Physical symptoms are explained by organic D. Bradycardia and diarrhea
causes 19. School phobia is usually treated by:
B. It is a voluntary expression of psychological A. Returning the child to the school immediately
conflicts with family support.
C. Expression of conflicts through bodily B. Calmly explaining why attendance in school is
symptoms necessary
D. Management entails a specific medical C. Allowing the child to enter the school before
treatment the other children
15. What would be the best response to the D. Allowing the parent to accompany the child in
client’s repeated complaints of pain: the classroom
A. “I know the feeling is real tests revealed 20. A 10 year old child has very limited
negative results.” vocabulary and interaction skills. She has an
I.Q. of 45. She is diagnosed to have Mental 25. According to Piaget, a 5-year-old is at what
retardation of this classification: stage of development:
A. Profound A. Sensorimotor stage
B. Mild B. Concrete operations
C. Moderate C. Pre-operational
D. Severe D. Formal operation
21. The nurse teaches the parents of a 26. Situation: The nurse assigned to the
mentally retarded child regarding her care. detoxification unit attends to various
The following guidelines may be taught patients with substance-related disorders. A
except: 45 years old male revealed that he
A. Overprotection of the child experienced a marked increase in his intake
B. Patience, routine, and repetition of alcohol to achieve the desired effect This
C. Assisting the parents set realistic goals indicates:
D. Giving reasonable compliments A. Withdrawal
22. The parents express apprehensions on B. Tolerance
their ability to care for their maladaptive C. Intoxication
child. The nurse identifies what nursing D. Psychological dependence
diagnosis: 27. The client admitted for alcohol
A. Hopelessness detoxification develops increased tremors,
B. Altered parenting role irritability, hypertension, and fever. The
C. Altered family process nurse should be alert for impending:
D. Ineffective coping A. Delirium tremens
23. A 5-year-old boy is diagnosed to have B. Korsakoff’s syndrome
autistic disorder. Which of the following C. Esophageal varices
manifestations may be noted in a client with D. Wernicke’s syndrome
autistic disorder? 28. The care for the client places priority on
A. Aargumentativeness, disobedience, angry which of the following:
outburst A. Monitoring his vital signs every hour
B. Intolerance to change, disturbed relatedness, B. Providing a quiet, dim room
stereotypes C. Encouraging adequate fluids and nutritious
C. Distractibility, impulsiveness, and overactivity foods
D. Aggression, truancy, stealing, lying D. Administering Librium as ordered
24. The therapeutic approach in the care of 29. Another client is brought to the
an autistic child includes the following emergency room by friends who state that he
EXCEPT: took something an hour ago. He is actively
A. Engage in diversionary activities when acting hallucinating, agitated, with an
-out irritated nasal septum.
B. Provide an atmosphere of acceptance A. Heroin
C. Provide safety measures B. Cocaine
D. Rearrange the environment to activate the C. LSD
child D. Marijuana
30. A client is admitted with needle tracks on A. “Your husband is dead. Let me serve you your
his arm, stuporous and with pin point pupil breakfast.”
will likely be managed with: B. “I’ve told you several times that he is dead. It’s
A. Naltrexone (Revia) time to eat.”
B. Narcan (Naloxone) C. “You’re going to have to wait a long time.”
C. Disulfiram (Antabuse) D. “What made you say that your husband is
D. Methadone (Dolophine) alive?
31. Situation: An old woman was brought for 35. Dementia, unlike delirium, is
evaluation due to the hospital for evaluation characterized by:
due to increasing forgetfulness and A. Slurred speech
limitations in daily function. The daughter B. Insidious onset
revealed that the client used her toothbrush C. Clouding of consciousness
to comb her hair. She is manifesting: D. Sensory perceptual change
A. Apraxia 36. Situation: A 17-year-old gymnast is
B. Aphasia admitted to the hospital due to weight loss
C. Agnosia and dehydration secondary to starvation.
D. Amnesia Which of the following nursing diagnoses will
32. She tearfully tells the nurse “I can’t take it be given priority for the client?
when she accuses me of stealing her things.” A. Altered self-image
Which response by the nurse will be most B. Fluid volume deficit
therapeutic? C. Altered nutrition less than body requirements
A. ”Don’t take it personally. Your mother does D. Altered family process
not mean it.” 37. What is the best intervention to teach the
B. “Have you tried discussing this with your client when she feels the need to starve?
mother?” A. Allow her to starve to relieve her anxiety
C. “This must be difficult for you and your B. Do a short term exercise until the urge passes
mother.” C. Approach the nurse and talk out her feelings
D. “Next time ask your mother where her things D. Call her mother on the phone and tell her how
were last seen.” she feels
33. The primary nursing intervention in 38. The client with anorexia nervosa is
working with a client with moderate stage improving if:
dementia is ensuring that the client: A. She eats meals in the dining room.
A. Receives adequate nutrition and hydration B. Weight gain
B. Will reminisce to decrease isolation C. She attends ward activities.
C. Remains in a safe and secure environment D. She has a more realistic self-concept.
D. Independently performs self-care 39. The characteristic manifestation that will
34. She says to the nurse who offers her differentiate bulimia nervosa from anorexia
breakfast, “Oh no, I will wait for my husband. nervosa is that bulimic individual
We will eat together” The therapeutic A. Have episodic binge eating and purging
response by the nurse is: B. Have repeated attempts to stabilize their
weight
C. Have peculiar food handling patterns verbal or non-verbal behavior
D. Have threatened self-esteem D. The client feels angry towards the nurse who
40. A nursing diagnosis for bulimia nervosa resembles his mother.
is powerlessness related to feeling not in 45. Which is the desired outcome in
control of eating habits. The goal for this conducting desensitization:
problem is: A. The client verbalize his fears about the
A. Patient will learn problem-solving skills situation
B. Patient will have decreased symptoms of B. The client will voluntarily attend group therapy
anxiety. in the social hall.
C. Patient will perform self-care activities daily. C. The client will socialize with others willingly
D. Patient will verbalize how to set limits on D. The client will be able to overcome his
others. disabling fear.
41. In the management of bulimic patients, 46. Which of the following should be included
the following nursing interventions will in the health teachings among clients
promote a therapeutic relationship EXCEPT: receiving Valium:
A. Establish an atmosphere of trust A. Avoid taking CNS depressant like alcohol.
B. Discuss their eating behavior. B. There are no restrictions in activities.
C. Help patients identify feelings associated with C. Limit fluid intake.
binge-purge behavior D. Any beverage like coffee may be taken
D. Teach patient about bulimia nervosa 47. Situation: A 20-year-old college student is
42. Situation: A 35-year-old male has an admitted to the medical ward because of
intense fear of riding an elevator. He claims “ sudden onset of paralysis of both legs.
As if I will die inside.” This has affected his Extensive examination revealed no physical
studies The client is suffering from: basis for the complaint. The nurse plans
A. Agoraphobia intervention based on which correct
B. Social phobia statement about conversion disorder?
C. Claustrophobia A. The symptoms are conscious effort to control
D. Xenophobia anxiety
43. Initial intervention for the client should B. The client will experience a high level of
be to: anxiety in response to the paralysis.
A. Encourage to verbalize his fears as much as he C. The conversion symptom has symbolic
wants. meaning to the client
B. Assist him to find meaning to his feelings in D. A confrontational approach will be beneficial
relation to his past. for the client.
C. Establish trust through a consistent approach. 48. Nikki reveals that the boyfriend has been
D. Accept her fears without criticizing. pressuring her to engage in premarital sex.
44. The nurse develops a countertransference The most therapeutic response by the nurse
reaction. This is evidenced by: is:
A. Revealing personal information to the client A. “I can refer you to a spiritual counselor if you
B. Focusing on the feelings of the client. like.”
C. Confronting the client about discrepancies in B. “You shouldn’t allow anyone to pressure you
into sex.” 2. The nurse explains to a mental
C. “It sounds like this problem is related to your health care technician that a client’s
paralysis.”
obsessive-compulsive behaviors are
D. “How do you feel about being pressured into
sex by your boyfriend?”
related to an unconscious conflict
49. Malingering is different from somatoform between id impulses and the superego
disorder because the former: (or conscience). On which of the
A. Has evidence of an organic basis. following theories does the nurse base
B. It is a deliberate effort to handle upsetting
this statement?
events
C. Gratification from the environment are
obtained. A. Behavioral theory
D. Stress is expressed through physical B. Cognitive theory
symptoms. C. Interpersonal theory
50. Unlike psychophysiologic disorder Linda D. Psychoanalytic theory
may be best managed with:
A. Medical regimen
3. The nurse observes a client pacing
B. Milieu therapy
C. Stress management techniques in the hall. Which statement by the
D. Psychotherapy nurse may help the client recognize
his anxiety?
Answers and Rationale
A. “I guess you’re worried about
1. Answer: B. A state of well-being where a
something, aren’t you?
person can realize his own abilities can cope
with normal stresses of life and work b. “Can I get you some medication to help
productively. calm you?”
ADVERTISEMENT c. “Have you been pacing for a long
time?”
1. Which nursing intervention is best
d. “I notice that you’re pacing. How are
for facilitating communication with a
you feeling?”
psychiatric client who speaks a foreign
language?
4. A client with obsessive-compulsive
disorder is hospitalized on an
A. Rely on nonverbal communication.
inpatient unit. Which nursing
B. Select symbolic pictures as aids.
response is most therapeutic?
C. Speak in universal phrases.
D. Use the services of an interpreter.
A. Accepting the client’s
obsessive-compulsive behaviors
B. Challenging the client’s D. Teach the client information about the
obsessive-compulsive behaviors long-term physical consequence of
C. Preventing the client’s anorexia.
obsessive-compulsive behaviors
D. Rejecting the client’s 7. A nurse is evaluating therapy with
obsessive-compulsive behaviors the family of a client with anorexia
nervosa. Which of the following would
5. A 45-year-old woman with a history indicate that the therapy was
of depression tells a nurse in her successful?
doctor’s office that she has difficulty
with sexual arousal and is fearful that A. The parents reinforce increased
her husband will have an affair. Which decision making by the client.
of the following factors would the B. The parents clearly verbalize their
nurse identify as least significant in expectations for the client.
contributing to the client’s sexual C. The client verbalizes that family meals
difficulty? are now enjoyable.
D. The client tells her parents about
A. Education and work history feelings of low self-esteem.
B. Medication used
C. Physical health status 8. The nurse is working with a client
D. Quality of spousal relationship with a somatoform disorder. Which
client outcome goal would the nurse
6. Which nursing intervention is most most likely establish in this situation?
appropriate for a client with anorexia
nervosa during initial hospitalization A. The client will recognize signs and
on a behavioral therapy unit? symptoms of physical illness.
B. The client will cope with physical
A. Emphasize the importance of good illness.
nutrition to establish normal weight. C. The client will take prescribed
B. Ignore the client’s mealtime behavior medications.
and focus instead on issues of D. The client will express anxiety verbally
dependence and independence. rather than through physical symptoms.
C. Help establish a plan using privileges
and restrictions based on compliance
with refeeding.
9. Which method would a nurse use to A. Disturbed thought processes
determine a client’s potential risk B. Ineffective coping
for suicide? C. Risk for self-directed violence
D. Impaired social interaction
A. Wait for the client to bring up the
subject of suicide. 12. Which information is the most
B. Observe the client’s behavior for cues essential in the initial teaching session
of suicide ideation. for the family of a young adult
C. Question the client directly about recently diagnosed with
suicidal thoughts. schizophrenia?
D. Question the client about future plans.
A. Symptoms of this disease imbalance in
10. A client with a bipolar disorder the brain.
exhibits manic behavior. The nursing B. Genetic history is an important factor
diagnosis is Disturbed thought related to the development of
processes related to difficulty schizophrenia.
concentrating, secondary to flight of C. Schizophrenia is a serious disease
ideas. Which of the following outcome affecting every aspect of a person’s
criteria would indicate improvement functioning.
in the client? D. The distressing symptoms of this
disorder can respond to treatment with
A. The client verbalizes feelings directly medications.
during treatment.
B. The client verbalizes positive “self” 13. A nurse is working with a client
statement. who has schizophrenia, paranoid type.
C. The client speaks in coherent Which of the following outcomes
sentences. related to the client’s delusional
D. The client reports feelings calmer. perceptions would the nurse
establish?
11. A client tells a nurse. “Everyone
would be better off if I wasn’t alive.” A. The client will demonstrate realistic
Which nursing diagnosis would be interpretation of daily events in the unit.
made based on this statement? B. The client will perform daily hygiene
and grooming without assistance.
C. The client will take prescribed
medications without difficulty. A. Restlessness, short attention span,
D. The client will participate in unit hyperactivity
activities. B. Physical aggressiveness,
low-stress tolerance disregard for the
14. A client with bipolar disorder, rights of others
manic type, exhibits extreme C. Deterioration in social functioning,
excitement, delusional thinking, and excessive anxiety, and worry, bizarre
command hallucinations. Which of the behavior
following is the priority nursing D. Sadness, poor appetite and
diagnosis? sleeplessness, loss of interest in activities

A. Anxiety 17. The nurse understands that if a

B. Impaired social interaction client continues to be dependent on
C. Disturbed sensory-perceptual heroin throughout her pregnancy, her
alteration (auditory) baby will be at high risk for:
D. Risk for other-directed violence
A. Mental retardation.
15. A client who abuses alcohol and B. Heroin dependence.
cocaine tells a nurse that he only uses C. Addiction in adulthood.
substances because of his stressful D. Psychological disturbances.
marriage and difficult job. Which
defense mechanisms is this client 18. The emergency department nurse
using? is assigned to provide care for a victim
of a sexual assault. When following
A. Displacement legal and agency guidelines, which
B. Projection intervention is most important?
C. Rationalization
D. Sublimation A. Determine the assailant’s identity.
B. Preserve the client’s privacy.
16. An 11-year-old child diagnosed C. Identify the extent of an injury.
with conduct disorder is admitted to D. Ensure an unbroken chain of evidence.
the psychiatric unit for treatment.
Which of the following behaviors 19. Which factor is least important in
would the nurse assess? the decision regarding whether a
victim of family violence can safely 22. Which neurotransmitter has been
remain in the home? implicated in the development of
Alzheimer’s disease?
A. The availability of appropriate
community shelters A. Acetylcholine
B. The non-abusing caretaker’s ability to B. Dopamine
intervene on the client’s behalf C. Epinephrine
C. The client’s possible response to D. Serotonin
relocation
D. The family’s socioeconomic status 23. Which factors are the most
essential for the nurse to assess when
20. The nurse would expect a client providing crisis intervention foer a
with early Alzheimer’s disease to have client?
problems with:
A. The client’s communication and coping
A. Balancing a checkbook. skills
B. Self-care measures. B. The client’s anxiety level and ability to
C. Relating to family members. express feelings
D. Remembering his own name C. The client’s perception of the triggering
event and availability of situational
21. Which nursing intervention is most supports
appropriate for a client with D. The client’s use of reality testing and
Alzheimer’s disease who has frequent level of depression
episodes emotional lability?
24. The nurse considers a client’s
A. Attempt humor to alter the client response to crisis intervention
mood. successful if the client:
B. Explore reasons for the client’s altered
mood. A. Changes coping skills and behavioral
C. Reduce environmental stimuli to patterns.
redirect the client’s attention. B. Develops insight into reasons why the
D. Use logic to point out reality aspects. crisis occurred.
C. Learns to relate better to others.
D. Returns to his previous level of
functioning.
25. Two nurses are co-leading group 28. When providing family therapy,
therapy for seven clients in the the nurse analyzes the functioning of
psychiatric unit. The leaders observe healthy family systems. Which
that the group members are anxious situations would not
and look to the leaders for answers. increase stress on a healthy family
Which phase of development is this system?
group in?
A. An adolescent’s going away to college
A. Conflict resolution phase B. The birth of a child
B. Initiation phase C. The death of a grandparent
C. Working phase D. Parental disagreement
D. Termination phase
29. A client taking the monoamine
26. Group members have worked very oxidase inhibitor (MAOI)
hard, and the nurse reminds them antidepressant isocarboxazid
that termination is approaching. (Marplan) is instructed by the nurse to
Termination is considered successful if avoid which foods and beverages?
group members:
A. Aged cheese and red wine
A. Decide to continue. B. Milk and green, leafy vegetables
B. Elevate group progress C. Carbonated beverages and tomato
C. Focus on positive experience products
D. Stop attending prior to termination. D. Lean red meats and fruit juices

27. The nurse is teaching a group of 30. Prior to

clients about the mood-stabilizing administering chlorpromazine (Thoraz
medications lithium carbonate. Which ine) to an agitated client, the nurse
medications should she instruct the should:
clients to avoid because of the
increased risk of lithium toxicity? A. Assess skin color and sclera
B. Assess the radial pulse
A. Antacids C. Take the client’s blood pressure
B. Antibiotics D. Ask the client to void
C. Diuretics
D. Hypoglycemic agents
31. The nurse understands that 34. The nurse correctly teaches a
electroconvulsive therapy is primarily client taking the Benzodiazepine
used in psychiatric care for the Oxazepam (Serax) to avoid excessive
treatment of: intake of:

A. Anxiety disorders. A. Cheese

B. Depression. B. Coffee
C. Mania. C. Sugar
D. Schizophrenia. D. Shellfish

32. A client taking the MAOI 35. The nurse provides a referral to
phenelzine (Nardil) tells the nurse that Alcoholics Anonymous to a client who
he routinely takes all of the describes a 20-year history of alcohol
medications listed below. Which abuse. The primary function of this
medication would cause the nurse to group is to:
express concern and therefore initiate
further teaching? A. Encourage the use of a 12-step
program.
A. Acetaminophen (Tylenol) B. Help members maintain sobriety.
B. Diphenhydramine (Benadryl) C. Provide fellowship among members.
C. Furosemide (Lasix) D. Teach positive coping mechanisms.
D. Isosorbide dinitrate (Isordil)
36. Which client outcome is most
33. The nurse is administering a appropriately achieved in a
psychotropic drug to an elderly client community approach setting in
who has a history of benign prostatic psychiatric nursing?
hypertrophy. It is most important for
the nurse to teach this client to: A. The client performs activities of daily
living and learns about crafts.
A. Add fiber to his diet. B. The client is able to prevent aggressive
B. Exercise on a regular basis. behavior and monitors his use of
C. Report incomplete bladder emptying medications.
D. Take the prescribed dose at bedtime. C. The client demonstrates self-reliance
and social adaptation.
D. The client experience experiences
anxiety relief and learns about his A. Confabulation
symptoms. B. Delirium
C. Orientation
37. A client with panic disorder D. Perseveration
experiences an acute attack while the
nurse is completing an admission 40. Which of the following will the
assessment. List the following nurse use when communicating with a
interventions according to their level client who has a cognitive
of priority. impairment?

A. Remain with the client. A. Complete explanations with multiple

B. Encourage physical activity. details
C. Encourage low, deep breathing. B. Picture or gestures instead of words
D. Reduce external stimuli. C. Stimulating words and phrases to
E. Teach coping measures. capture the client’s attention
D. Short words and simple sentences
38. The doctor has prescribed
haloperidol (Haldol) 2.5 mg. I.M. for an 41. A 75-year-old client has dementia
agitated client. The medication is of the Alzheimer’s type and
labeled haloperidol 10 mg/2 ml. The confabulates. The nurse understands
nurse prepares the correct dose by that this client:
drawing up how many milliliters in the
syringe? A. Denies confusion by being jovial.
B. Pretends to be someone else.
A. 0.3 C. Rationalizes various behaviors.
B. 0.4 D. Fills in memory gaps with fantasy.
C. 0.5
D. 0.6 42. An elderly client with Alzheimer’s
disease becomes agitated and
39. The nurse enters the room of a combative when a nurse approaches
client with a cognitive impairment to help with morning care. The most
disorder and asks what day of the appropriate nursing intervention in
week it is: what the date, month, and this situation would be to:
year are; and where the client is. The
nurse is attempting to assess:
A. Tell the client family that it is time to the child’s frequent fighting in school
get dressed. and truancy. Which of the following
B. Obtain assistance to restrain the client data would be a priority to the nurse
for safety. doing the initial family assessment?
C. Remain calm and talk quietly to the
client. A. The child’s performance in school
D. Call the doctor and request an order B. Family education and work history
for sedation. C. The family’s perception of the current
problem
43. In clients with a cognitive D. The teacher’s attempt to solve the
impairment disorder, the problem
phenomenon of increased confusion
in the early evening hours is called: 46. The parents of a young man with
schizophrenia express feelings of
A. Aphasia responsibility and guilt for their son’s
B. Agnosia problems. How can the nurse best
C. Sundowning educate the family?
D. Confabulation
A. Acknowledge the parent’s
44. Which of the following outcome responsibility.
criteria is appropriate for the client B. Explain the biological nature of
with dementia? schizophrenia.
C. Refer the family to a support group
A. The client will return to an adequate D. Teach the parents various ways they
level of self-functioning. must change.
B. The client will learn new coping
mechanisms to handle anxiety. 47. The nurse collecting family
C. The client will seek out resources in assessment data asks. “Who is in your
the community for support. family and where do they live?” which
D. The client will follow an establishing of the following is the nurse
schedule for activities of daily living. attempting o identify?

45. The school guidance counselor A. Boundaries

refers a family with an 8-year-old child B. Ethnicity
to the mental health clinic because of
C. Relationships 50. A 16-year-old girl
D. Triangles has returned home following
hospitalization for treatment of
48. According to the family systems anorexia nervosa. The parents tell
theory, which of the following best the family nurse performing a home
describes the process of visit that their child has always done
differentiation? everything to please them and they
cannot understand her current
A. Cooperative action among members of stubbornness about eating. The nurse
the family analyzes the family situation and
B. Development of autonomy within the determines it is characteristic of
family which relationship style?
C. Incongruent messages wherein the
recipient is a victim A. Differentiation
D. Maintenance of system continuity or B. Disengagement
equilibrium C. Enmeshment
D. Scapegoating
49. The nurse is interacting with a
family consisting of a mother, a Answers and Rationale
father, and a hospitalized adolescent
who has a diagnosis of alcohol abuse.
The nurse analyzes the situation and 1. Answer: D. Use the services of an
agrees with the adolescent’s view interpreter.
about family rules. Which intervention
is most appropriate? ADVERTISEMENT

● 1. A client is struggling to explore

A. The nurse should align with the and solve a problem. Which
nursing statement would
adolescent, who is the family scapegoat.
verbalize the implication of the
B. The nurse should encourage the
client’s actions?
parents to adopt more realistic rules.
C. The nurse should encourage the ● A. “You seem to be motivated to
adolescent to comply with parental rules. change your behavior.”
D. The nurse should remain objective and B. “How will these changes affect
encourage mutual negotiation of issues. your family relationships?”
C. “Why don’t you make a list of the
behaviors you need to change.”
 D. “The team recommends that you with clients diagnosed with
make only one behavioral change psychiatric disorders. Which
at a time.” statement by the instructor best
provides information about this
● 2. The nurse asks a newly aspect of therapeutic
admitted client, “What can we do communication?
to help you?” What is the
purpose of this therapeutic ● A. “Touch carries a different
communication technique? meaning for different individuals.”
B. “Touch is often used when
● A. To reframe the client’s thoughts deescalating volatile client
about mental health treatment situations.”
B. To put the client at ease C. “Touch is used to convey interest
C. To explore a subject, idea, and warmth.”
experience, or relationship D. “Touch is best combined with
D. To communicate that the nurse empathy when dealing with
is listening to the conversation anxious clients.”

● 3. A student nurse tells the ● 5. Which nursing statement is a

instructor, “I’m concerned that good example of the therapeutic
when a client asks me for advice communication technique of
I won’t have a good solution.” focusing?
Which should be the nursing
instructor‘s best response? ● A. “Describe one of the best things
that happened to you this week.”
● A. “It’s scary to feel put on the spot B. “I’m having a difficult time
by a client. Nurses don’t always understanding what you mean.”
have the answer.” C. “Your counseling session is in 30
B. “Remember, clients, not nurses, minutes. I’ll stay with you until
are responsible for their own then.”
choices and decisions.” D. “You mentioned your
C. “Just keep the client’s best relationship with your father. Let’s
interests in mind and do the best discuss that further.”
that you can.”
D. “Set a goal to continue to work ● 6. After fasting from 10 p.m. the
on this aspect of your practice.” previous evening, a client finds
out that the blood test has been
● 4. A student nurse is learning canceled. The client swears at
about the appropriate use the nurse and states, “You are
of touch when communicating
 incompetent!” Which is the can change with time.”
nurse’s best response? C. “You’ve been feeling sad and
alone for some time now?”
● A. “Do you believe that I was the D. “It is great that you have come in
cause of your blood test being for help.”
canceled?”
B. “I see that you are upset, but I ● 9. Which nursing response is an
feel uncomfortable when you example of the nontherapeutic
swear at me.” communication block of
C. “Have you ever thought about requesting an explanation?
ways to express anger
appropriately?” ● A. “Can you tell me why you said
D. “I’ll give you some space. Let me that?”
know if you need anything.” B. “Keep your chin up. I’ll explain
the procedure to you.”
● 7. During a nurse-client C. “There is always an explanation
interaction, which nursing for both good and bad behaviors.”
statement may belittle the D. “Are you not understanding the
client’s feelings and concerns? explanation I provided?”

● A. “Don’t worry. Everything will be ● 10. A client states, “You won’t

alright.” believe what my husband said to
B. “You appear uptight.” me during visiting hours. He has
C. “I notice you have bitten your no right treating me that way.”
nails to the quick.” Which nursing response would
D. “You are jumping to best assess the situation that
conclusions.” occurred?

● 8. A client on an in-patient ● A. “Does your husband treat you

psychiatric unit tells the nurse, “I like this very often?”
should have died because I am B. “What do you think is your role in
totally worthless.” In order to this relationship?”
encourage the client to continue C. “Why do you think he behaved
talking about feelings, which like that?”
should be the nurse’s initial D. “Describe what happened during
response? your time with your husband.”

● A. “How would your family feel if ● 11. Which therapeutic

you died?” communication technique
B. “You feel worthless now, but that should the nurse use when
 communicating with a client the nurse employed and what
who is experiencing auditory defense mechanism is the client
hallucinations? unconsciously demonstrating?

● A. “My sister has the same ● A. Making observations and the

diagnosis as you and she also hear defense mechanism of suppression
voices.” B. Verbalizing the implied and the
B. “I understand that the voices defense mechanism of denial
seem real to you, but I do not hear C. Reflection and the defense
any voices.” mechanism of projection
C. “Why not turn up the radio so D. Encouraging descriptions of
that the voices are muted.” perceptions and the defense
D. “I wouldn’t worry about these mechanism of displacement
voices. The medication will make
them disappear.” ● 14. Which of the following
individuals are communicating a
● 12. Which nursing statement is a message? (Select all that apply.)
good example of the therapeutic
communication technique of ● A. A mother spanking her son for
offering self? playing with matches
B. A teenage boy isolating himself
● A. “I think it would be great if you and playing loud music
talked about that problem during C. A biker sporting an
our next group session.” eagle tattoo on his biceps
B. “Would you like me to D. A teenage girl writing, “No one
accompany you to your understands me.”
electroconvulsive therapy E. A father checking for new e-mail
treatment?” on a regular basis
C. “I notice that you are offering
help to other peers in the milieu.” ● 15. A mother rescues two of her
D. “After discharge, would you like four children from a house fire.
to meet me for lunch to review In the emergency department,
your outpatient progress?” she cries, “I should have gone
back in to get them. I should
● 13. A client slammed a door on have died, not them.” What is
the unit several times. The nurse the nurse’s best response?
responds, “You seem angry.” The
client states, “I’m not angry.” ● A. “The smoke was too thick. You
What therapeutic couldn’t have gone back in.”
communication technique has B. “You’re feeling guilty because
 you weren’t able to save your Peterson is hyperactive, intrusive, and
children.” has rapid, pressured speech. He has
C. “Focus on the fact that you could not slept in three days and appears
have lost all four of your children.”
thin and disheveled. Which of the
D. “It’s best if you try not to think
following is the most essential nursing
about what happened. Try to move
on.” action at this time?

● Answers and Rationale A. Providing a meal and beverage for Mr.

Peterson to eat in the dining room.
● B. Providing linens and toiletries for Mr.
Peterson to attend to his hygiene.
● 1. Answer: A. “You seem to be
C. Consulting with the psychiatrist to
motivated to change your
order a hypnotic to promote sleep.
behavior.”
D. Providing for client safety by limiting
● ADVERTISEMENT his privileges.
1. A man is admitted to the nursing
care unit with a diagnosis of cirrhosis. 3. Which of the following would best

He has a long history of alcohol indicate to the nurse that a depressed

dependence. During the late evening client is improving?

following his admission, he becomes

A. Reduced levels of anxiety.
increasingly disoriented and agitated.
B. Changes in vegetative signs.
Which of the following would the
C. Compliance with medications.
client be least likely to experience?
D. Requests to talk to the nurse.

A. Diaphoresis and tremors.

4. An elderly man is admitted to the
B. Increased blood pressure and heart
hospital. He was alert and oriented
rate.
during the admission interview.
C. Illusions.
However, his family states that he
D. Delusions of grandeur.
becomes disruptive and disoriented

2. Mr. Peterson, 35, is admitted for around dinnertime. One night he was

bipolar illness, manic phase, after shouting furiously and didn’t know

assaulting his landlord in an argument where he was. He was sedated and the

over Mr. Peterson is staying up all next morning he was fine. At

night playing loud music. Mr. dinnertime, the disruptive behavior

returned. The client is diagnosed as A. Information regarding recent mood
having sundown syndrome. The changes.
client’s son asks the nurse what B. Family functioning using a genogram.
causes sundown syndrome. The C. Ability to socialize with peers.
nurse’s best response is that it is D. Whether she has a sexual relationship
attributed to with a boyfriend.

A. An underlying depression. 7. A 34-year-old woman is admitted for

B. Inadequate cerebral flow. treatment of depression. Which of
C. Changes in the sensory environment. these symptoms would the nurse be
D. Fuctuating levels of oxygen exchange. least likely to find in the initial
assessment?
5. The nurse is discussing
electroconvulsive therapy (ECT) with a A. Inability to make decisions.
client who asks how long it will be B. Feelings of hopelessness.
before she feels better. The nurse C. Family history of depression.
explains that the beneficial effects of D. Increased interest in sex.
ECT usually occur within
8. The nurse is planning care for a
A. One week. client who has a phobic disorder
B. Three weeks. manifested by a fear of elevators.
C. Four weeks. Which goal would need to be
D. Six weeks. accomplished first? The client

6. The nurse is assessing a 17-year-old A. Demonstrates the relaxation response

female who is admitted to the eating when asked.
disorders unit with a history of weight B. Verbalizes the underlying cause of the
fluctuation, abdominal pain, teeth disorder.
erosion, receding gums, and bad C. Rides the elevator in the company of
breath. She states that her health has the nurse.
been a problem but there are no other D. Role plays the use of an elevator.
concerns in her life. Which of the
following assessments will be the least 9. A teenage female is admitted with
useful as the nurse develops the care the diagnosis of anorexia nervosa.
plan? Upon admission, the nurse finds
a bottle of assorted pills in the client’s D. Pour fluid over the forehead backward
drawer. The client tells the nurse that towards the back of the head and say “I
they are antacids for stomach pains. baptize you in the name of the father, the
The best response by the nurse would son and the holy spirit. Amen.”
be
11. Which statement by the client
a. “These pills aren’t antacids since they during the initial assessment in the
are all different.” emergency department is most
b. “Some teenagers use pills to lose indicative of suspected domestic
weight.” violence?
c. “Tell me about your week prior to being
admitted.” a. “I am determined to leave my house in
d. “Are you taking pills to change your a week.”
weight?” b. “No one else in the family has been
treated like this.”
10. A mother with a Roman Catholic c. “I have only been married for two (2)
belief has given birth in an ambulance months.”
on the way to the hospital. The d. “I have tried leaving, but have always
neonate is in very critical condition gone back.”
with little expectation of surviving the
trip to the hospital. Which of these 12. Which of these statements by the
requests should the nurse in the nurse reflects the best use of
ambulance anticipate and be prepared therapeutic interaction techniques?
to do?
a. “You look upset. Would you like to talk
A. The refusal of any treatment for self about it?”
and the neonate until she talks to a b. “I’d like to know more about your
reader family. Tell me about them.”
B. The placement of a rosary necklace c. “I understand that you lost your
around the neonate’s neck and not to partner. I don’t think I could go on if that
remove it unless absolutely necessary happened to me.”
C. Arrange for a church elder to be at the d. “You look very sad. How long have you
emergency department when the been this way?”
ambulance arrives so a “laying on hands”
can be done
13. When planning the therapeutic D. Attaching a wander guard sensor band
milieu, it is MOST important to select to the client’s wrist
group activities which
16. A client with paranoid thoughts
A. Match the clients’ preferences refuses to eat because he believes the
B. Are consistent with clients’ skills food has poisoned. The MOST
C. Achieve clients’ therapeutic goals appropriate initial action is to
D. Build skills of group participation
A. Taste the food in the client’s presence
14. A client was admitted to the B. Suggest that food be brought from
psychiatric unit for severe depression. home
After several days, the client C. Simply state the food is not poisoned
continues to withdraw from other D. Inform the client he will be tube fed if
clients. Which of the following would he does not eat
be the MOST appropriate statement
by the nurse to promote interaction 17. The nurse is caring for a severely
with other clients? depressed client who has just been
admitted to the in-client psychiatric
a. “Your doctor thinks its good for you to unit. Which of the following is a
spend time with others.” PRIORITY of care?
b. “It is important for you to participate in
group activities.” A. Nutrition
c. “Painting this picture will help you feel B. Elimination
better.” C. Rest
d. “Come play Chinese Checkers with D. Safety
Gerry and me.”
18. A nurse is teaching
15. The nurse can BEST ensure the a stress-management program for a
safety of a demented client who client. Which of the following beliefs
wanders from the room by will the nurse advocate as a method of
coping with stressful life events?
A. Repeatedly reminding the client of
time and place A. Avoidance of stress is an important
B. Explaining the risks of becoming lost goal for living.
C. Using soft restraints B. Control over one’s response to stress
is possible. Mental Ch. 2
C. Most people have no control over their Study online at quizlet.com/_2jjeee
level of stress. 1.3 paradigms for aversive techniques: 1. paring
maladaptive behavior w/ noxious stimuli so anxiety/fear
D. Significant others are important to becomes ass. w/ once-pleasurable stimulus
provide care and concern. 2. punishment
3. avoidance training

19. A student nurse is caring for a 2.According to Freud, which aspect of the personality
motivates an individual to seek perfection?
75-year-old client who is very A. Id
B. Ego
confused. The student’s
C. Superego: C. Superego
communication tools should include:
3.The art of nursing: Provide care, compassion, and
advocacy; enhance comfort and well-being
A. Written directions for bathing.
4.Automatic thoughts/cognitive distortions: rapid,
B. Speaking very loudly. unthinking responses based on schemas; intense and
frequent in psychiatric disorders such as depression and
C. Gentle touch while guiding ADLs anxiety; irrational and lead to false assumptions and
(activities of daily living). misinterpretations

D. Flat facial expression. 5.Aversion thearpy: Punishment; used to treat addictions,

hallucinations, etc; treatment of choice when other less
drastic measures have failed to produce desired effects
20. When a husband takes out his
6.Behavior therapy: Based on assumption that changes in
work frustrations and anger by maladaptive behavior can occur without insight into
abusing his wife at home, the nurse underlying cause

will identify this crisis as which type? 7.Biofeedback: Form of behavior therapy and is
successfully used today, esp. for controlling body's
physiological response to stress and anxiety
A. Psychiatric emergency crisis
8.Biological theories: focus on neurological, chemical,
B. Developmental crisis biological, and genetic; how body and brain interact to
C. Anticipated life transition create emotions, memories, and perceptual experiences

D. Dispositional crisis 9.Biological theories and nursing: Social, environmental,

cultural, and economic all play a role in treatment and
development of mental disorders; focuses on qualities of
Answers and Rationale a therapeutic relationship, understanding pt's
perspective, communicating to facilitate recovery

10.Classical responses are...: involuntary

1. Answer D. Delusions of grandeur 11.Cognitive-Behavioral therapy (beck): test distorted

beliefs and change way of thinking; reduce symptoms
(schemata, automatic thoughts, and cognitive
ADVERTISEMENT distortions)

● 12.Cognitive theory: Dynamic interplay b/w individuals and

environment; thoughts come before feelings and actions;
thoughts about work and our place in it are based on
 own UNIQUE perspectives which may or may not be 25.Hildegard Peplau's Theory of Interpersonal
based on reality Relationships in Nursing: Influenced by Sullivan's work
(mother of psychiatric nursing)
13.Conditioning: pairing a behavior with a condition that
reinforces or diminishes the behavior's occurence 26.Id: Source of all drives, instincts, reflexes, needs, genetic
inheritance, and capacity to respond as well as the
14.Conscious: Tip of iceberg; all material a person is aware wishes that motivate us; cannot tolerate frustration and
of at one time such as perceptions, memories, thoughts, seeks to discharge tension and return to a more
fantasies, and feelings comfortable level of energy; lacks ability to problem
solve (it is not logical and operates according to pleasure
15.Countertransference: Unconscious feelings that the
principle); only needs that counts are its own (ex.
health care worker has toward patient
hungry, screaming infant)
16.Defense mechanisms: Automatic coping sytles that
27.Implicationof nursing for behavioral
protect people from anxiety and maintain self-image by
theories: modifying or replacing behaviors and behavior
blocking feeling, conflicts, and memory (ex. denial,
management
regression)
28.Interpersonalpsychotherapy has approved
17.Developmental model is important part of nursing
successfully in the treatment of 
assessment: helps determine what types of
A. Depression
interventions are most likely to be effective
B. Bipolar
(age-appropriate interventions)
C. Schizophrenia
18.Ego: Problem solver and reality tester; able to D. OCD: A. Depression
differentiate subjective experiences, memory images,
29.Maslow's Hierarchy of Needs: Human beings are active
and objective reality and attempts to negotiate with the
participants in life, striving for self-actualization; when
outside world (ex. hungry adult knows to seek where he
needs are met, higher needs are able to emerge; when
can go eat and do it)
lower level needs are met, then higher needs can
19.Erikson's eight stages of psychosocial emerge
development: Infancy (0-1.5y), early childhood (1.5-3),
30.MilieuTherapy: Use of total environment; people,
preschool (3-6), school age (6-12), adolescence (12-20),
setting, structure, and emotional climate are all important
early adulthood (20-35), middle adulthood (35-65), later
to healing
years (65-death)
31.Modeling: therapist provides role model for specific
20.Extinction: Absence of reinforcement; decreases
identified behaviors and pt learns through imitation
behavior by withholding a reward that has become
habitual 32.Negative reinforcement: removal of an objectionable or
aversive stimulus (ex. walking through park once viscous
21.Foundation for Hildegard Peplau's theory: Participant
dog is pickedup)
observer; mutuality, respect for patient, unconditional
acceptance, empathy 33.Operantconditioning: bases for behavior modification
and uses positive reinforcement to increases desired
22.Freud's Psychoanalytic theory: Personality structure,
behaviors (ex. kid throwing fit for candy)
level of awareness, anxiety, role of defense
mechanisms, and psychosexual development 34.Operant conditioning is...: voluntary

23.Freud's Psychosexual stages of development: oral, 35.Apatient is admitted to your unit who has an
anal, phallic, latency, genital uncanny resemblance to your older sister. As a
child, your older sister bossed you around and
24.Hierarchy levels: Physiological (basic needs - food,
criticized you constantly. You realize that you are
oxygen, water, sex), safety (security, law, order, freedom
responding negatively to this patient. What is going
from fear), belonging and love needs (intimate
on?
relationships, love, overcoming loneliness), esteem
What should the nurse do?: Countertransference
needs (high self-regard and can beel confident,
Nurse should realize importance of maintaining
valuable), self-actualization (striving to everything person
self-awareness and seeking supervisory guidance as the
is capable of becoming)
therapeutic relationship progresses
36.Pavlov's classical conditioning theory: noticed dogs 1948 is called
were able to anticipate when food would be coming and A. Cognition-Behavior Therapy
would salivate before tasting meat (psychic secretion); B. Milieu Therapy
theory found that when neutral stimulus was paired with C. Psychoanalytic Therapy
another stimulus, the neutral could stimulate the other D. Interpersonal Therapy: B. Milieu Therapy

37.Positivereinforcement: causes behavior to occur more 49.Transference: Feelings that the patient has toward
frequently (ex. 3.8 GPA after studying hard) health care workers that were originally held toward
significant others in life
38.Preconscious: Below surface of awareness; contains
material that can be retrieved easily through conscious 50.Unconscious: repressed memories, passions, and
effort unacceptable urges lying deep below surface; exerts a
powerful yet unseen effect on the conscious thoughts
39.Punishment: unpleasant consequence; and feelings of the individual; person is usually unable to
positive - give; negative - take away retrieve unconscious material w/out help of therapist

40.Purpose of theories: help us explain behavior; 51.Watson's behaviorism theory: developed school of

foundation of mental health and mental health nursing; thought (behaviorism); personality traits and responses
treatment therapies are based on these were socially learned through classical conditioning

41.Rational-Emotive Behavior Therapy (ellis): aims to 52.Which theorist most influenced the professional
eradicate irrational beliefs; recognize thoughts that are practice of psychiatric nursing?
not accurate (thoughts tend to take form of shoulds, A. Harry Stack Sullivan
oughts, and musts) B. Hildegard Peplau
C. Erik Erikson
42.Schemata, automatic thoughts, and cognitive
D. Ivan Pavlov: B. Hildegard Peplau
distortions are terms that relate to
A. rational-emotive behavioral therapy 53.Who is the first nurse theorist to describe the
B. cognitive-behavioral therapy nurse-patient relationship as the foundation of
C. operant conditioning therapy nursing practice?
D. biofeedback: B. Cognitive-behavioral therapy A. Florence Nightingale
B. Jean Watson
43.The science of nursing: Application of knowledge to:
C. Hildegard Peplau
understand broad range of human problems and
D. Erik Erikson: C. Hildegard Peplau
psychosocial phenomena; intervene in relieving pt's
suffering and promote growth

44.Skinner'soperant conditioning theory: voluntary

behaviors are learned through consequences and
behavioral responses are elicited through reinforcement

45.Sullivan's Interpersonal Theory: Purpose of all

behavior is to get needs met through interpersonal
interactions and to reduce or avoid anxiety

46.Superego: Moral component of personality; has

conscious and ideas of reality; ideal rather than real,
seeks perfection as opposed to seeking pleasure or
engaging reason

47.Systematic desensitization: involves the development

of behavior tasks customized to the pt's specific fears;
four steps (break down fear, exposure to fear, design
hierarchy of fears, practice techniques to reduce fear)

48.Thetherapy that used total environment to treat

disturbed children created by Bruno Bettlehein in