Psychiatric Nursing Practice Test Part 3

1. Francis who is addicted to cocaine withdraws from the drug. Nurse Ron should expect to observe:

a. Hyperactivity

b. Depression

c. Suspicion

d. Delirium

2. Nurse John is aware that a serious effect of inhaling cocaine is?

a. Deterioration of nasal septum

b. Acute fluid and electrolyte imbalances

c. Extra pyramidal tract symptoms

d. Esophageal varices

3. A tentative diagnosis of opiate addiction, Nurse Candy should assess a recently hospitalized client for signs of opiate withdrawal. These signs would include:

a. Rhinorrhea, convulsions, subnormal temperature

b. Nausea, dilated pupils, constipation

c. Lacrimation, vomiting, drowsiness

d. Muscle aches, papillary constriction, yawning

4. A 48 year old male client is brought to the psychiatric emergency room after attempting to jump off a bridge. The client’s wife states that he lost his job several months ago and has been unable to find another job. The primary nursing intervention at this time would be to assess for:

a. A past history of depression

b. Current plans to commit suicide

c. The presence of marital difficulties

d. Feelings of excessive failure

5. Before helping a male client who has been sexually assaulted, nurse Maureen should recognize that the rapist is motivated by feelings of:

a. Hostility

b. Inadequacy

c. Incompetence

d. Passion

6. When working with children who have been sexually abused by a family member it is important for the nurse to understand that these victims usually are overwhelmed with feelings of:

a. Humiliation

b. Confusion

c. Self blame

d. Hatred

7. Joy who has just experienced her second spontaneous abortion expresses anger towards her physician, the hospital and the “rotten nursing care”. When assessing the situation, the nurse recognizes that the client may be using the coping mechanism of:

a. Projection

b. Displacement

c. Denial

d. Reaction formation

8. The most critical factor for nurse Linda to determine during crisis intervention would be the client’s:

a. Available situational supports

b. Willingness to restructure the personality

c. Developmental theory

d. Underlying unconscious conflict

9. Nurse Trish suggests a crisis intervention group to a client experiencing a developmental crisis. These groups are successful because the:

a. Crisis intervention worker is a psychologist and understands behavior patterns

b. Crisis group supplies a workable solution to the client’s problem

c. Client is encouraged to talk about personal problems

d. Client is assisted to investigate alternative approaches to solving the identified problem

10. Nurse Ronald could evaluate that the staff’s approach to setting limits for a demanding, angry client was effective if the client:

a. Apologizes for disrupting the unit’s routine when something is needed

b. Understands the reason why frequent calls to the staff were made

c. Discuss concerns regarding the emotional condition that required hospitalizations

d. No longer calls the nursing staff for assistance

11. Nurse John is aware that the therapy that has the highest success rate for people with phobias would be:

a. Psychotherapy aimed at rearranging maladaptive thought process

b. Psychoanalytical exploration of repressed conflicts of an earlier development phase

c. Systematic desensitization using relaxation technique

d. Insight therapy to determine the origin of the anxiety and fear

12. When nurse Hazel considers a client’s placement on the continuum of anxiety, a key in determining the degree of anxiety being experienced is the client’s:

a. Perceptual field

b. Delusional system

c. Memory state

d. Creativity level

13. In the diagnosis of a possible pervasive developmental autistic disorder. The nurse would find it most unusual for a 3 year old child to demonstrate:

a. An interest in music

b. An attachment to odd objects

c. Ritualistic behavior

d. Responsiveness to the parents

14. Malou with schizophrenia tells Nurse Melinda, “My intestines are rotted from worms chewing on them.” This statement indicates a:

a. Jealous delusion

b. Somatic delusion

c. Delusion of grandeur

d. Delusion of persecution

15. Andy is admitted to the psychiatric unit with a diagnosis of borderline personality disorder. Nurse Hilary should expects the assessment to reveal:

a. Coldness, detachment and lack of tender feelings

b. Somatic symptoms

c. Inability to function as responsible parent

d. Unpredictable behavior and intense interpersonal relationships

16. PROPRANOLOL (Inderal) is used in the mental health setting to manage which of the following conditions?

a. Antipsychotic – induced akathisia and anxiety

b. Obsessive – compulsive disorder (OCD) to reduce ritualistic behavior

c. Delusions for clients suffering from schizophrenia

d. The manic phase of bipolar illness as a mood stabilizer

17. Which medication can control the extra pyramidal effects associated with antipsychotic agents?

a. Clorazepate (Tranxene)

b. Amantadine (Symmetrel)

c. Doxepin (Sinequan)

d. Perphenazine (Trilafon)

18. Which of the following statements should be included when teaching clients about monoamine oxidase inhibitor (MAOI) antidepressants?

a. Don’t take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)

b. Have blood levels screened weekly for leucopenia

c. Avoid strenuous activity because of the cardiac effects of the drug

d. Don’t take prescribed or over the counter medications without consulting the physician

19. Kris periodically has acute panic attacks. These attacks are unpredictable and have no apparent association with a specific object or situation. During an acute panic attack, Kris may experience:

a. Heightened concentration

b. Decreased perceptual field

c. Decreased cardiac rate

d. Decreased respiratory rate

20. Initial interventions for Marco with acute anxiety include all except which of the following?

a. Touching the client in an attempt to comfort him

b. Approaching the client in calm, confident manner

c. Encouraging the client to verbalize feelings and concerns

d. Providing the client with a safe, quiet and private place

21. Nurse Jessie is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety is:

a. Uticaria

b. Vertigo

c. Sedation

d. Diarrhea

22. When performing a physical examination on a female anxious client, nurse Nelli would expect to find which of the following effects produced by the parasympathetic system?

a. Muscle tension

b. Hyperactive bowel sounds

c. Decreased urine output

d. Constipation

23. Which of the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD)?

a. Divalproex (depakote) and Lithium (lithobid)

b. Chlordiazepoxide (Librium) and diazepam (valium)

c. Fluvoxamine (Luvox) and clomipramine (anafranil)

d. Benztropine (Cogentin) and diphenhydramine (benadryl)

24. Tony with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobia include:

a. Severe anxiety and fear

b. Withdrawal and failure to distinguish reality from fantasy

c. Depression and weight loss

d. Insomnia and inability to concentrate

25. Which nursing action is most appropriate when trying to diffuse a client’s impending violent behavior?

a. Place the client in seclusion

b. Leaving the client alone until he can talk about his feelings

c. Involving the client in a quiet activity to divert attention

d. Helping the client identify and express feelings of anxiety and anger

26. Rosana is in the second stage of Alzheimer’s disease who appears to be in pain. Which question by Nurse Jenny would best elicit information about the pain?

a. “Where is your pain located?”

b. “Do you hurt? (pause) “Do you hurt?”

c. “Can you describe your pain?”

d. “Where do you hurt?”

27. Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for:

a. General anesthesia

b. Cardiac stress testing

c. Neurologic examination

d. Physical therapy

28. Jose who is receiving monoamine oxidase inhibitor antidepressant should avoid tyramine, a compound found in which of the following foods?

a. Figs and cream cheese

b. Fruits and yellow vegetables

c. Aged cheese and Chianti wine

d. Green leafy vegetables

29. Erlinda, age 85, with major depression undergoes a sixth electroconvulsive therapy (ECT) treatment. When assessing the client immediately after ECT, the nurse expects to find:

a. Permanent short-term memory loss and hypertension

b. Permanent long-term memory loss and hypomania

c. Transitory short-term memory loss and permanent long-term memory loss

d. Transitory short and long term memory loss and confusion

30. Barbara with bipolar disorder is being treated with lithium for the first time. Nurse Clint should observe the client for which common adverse effect of lithium?

a. Polyuria

b. Seizures

c. Constipation

d. Sexual dysfunction

31. Nurse Fred is assessing a client who has just been admitted to the ER department. Which signs would suggest an overdose of an antianxiety agent?

a. Suspiciousness, dilated pupils and incomplete BP

b. Agitation, hyperactivity and grandiose ideation

c. Combativeness, sweating and confusion

d. Emotional lability, euphoria and impaired memory

32. Discharge instructions for a male client receiving tricyclic antidepressants include which of the following information?

a. Restrict fluids and sodium intake

b. Don’t consume alcohol

c. Discontinue if dry mouth and blurred vision occur

d. Restrict fluid and sodium intake

33. Important teaching for women in their childbearing years who are receiving antipsychotic medications includes which of the following?

a. Increased incidence of dysmenorrhea while taking the drug

b. Occurrence of incomplete libido due to medication adverse effects

c. Continuing previous use of contraception during periods of amenorrhea

d. Instruction that amenorrhea is irreversible

34. A client refuses to remain on psychotropic medications after discharge from an inpatient psychiatric unit. Which information should the community health nurse assess first during the initial follow-up with this client?

a. Income level and living arrangements

b. Involvement of family and support systems

c. Reason for inpatient admission

d. Reason for refusal to take medications

35. The nurse understands that the therapeutic effects of typical antipsychotic medications are associated with which neurotransmitter change?

a. Decreased dopamine level

b. Increased acetylcholine level

c. Stabilization of serotonin

d. Stimulation of GABA

36. Which of the following best explains why tricyclic antidepressants are used with caution in elderly patients?

a. Central Nervous System effects

b. Cardiovascular system effects

c. Gastrointestinal system effects

d. Serotonin syndrome effects

37. A client with depressive symptoms is given prescribed medications and talks with his therapist about his belief that he is worthless and unable to cope with life. Psychiatric care in this treatment plan is based on which framework?

a. Behavioral framework

b. Cognitive framework

c. Interpersonal framework

d. Psychodynamic framework

38. A nurse who explains that a client’s psychotic behavior is unconsciously motivated understands that the client’s disordered behavior arises from which of the following?

a. Abnormal thinking

b. Altered neurotransmitters

c. Internal needs

d. Response to stimuli

39. A client with depression has been hospitalized for treatment after taking a leave of absence from work. The client’s employer expects the client to return to work following inpatient treatment. The client tells the nurse, “I’m no good. I’m a failure”. According to cognitive theory, these statements reflect:

a. Learned behavior

b. Punitive superego and decreased self-esteem

c. Faulty thought processes that govern behavior

d. Evidence of difficult relationships in the work environment

40. The nurse describes a client as anxious. Which of the following statement about anxiety is true?

a. Anxiety is usually pathological

b. Anxiety is directly observable

c. Anxiety is usually harmful

d. Anxiety is a response to a threat

41. A client with a phobic disorder is treated by systematic desensitization. The nurse understands that this approach will do which of the following?

a. Help the client execute actions that are feared

b. Help the client develop insight into irrational fears

c. Help the client substitutes one fear for another

d. Help the client decrease anxiety

42. Which client outcome would best indicate successful treatment for a client with an antisocial personality disorder?

a. The client exhibits charming behavior when around authority figures

b. The client has decreased episodes of impulsive behaviors

c. The client makes statements of self-satisfaction

d. The client’s statements indicate no remorse for behaviors

43. The nurse is caring for a client with an autoimmune disorder at a medical clinic, where alternative medicine is used as an adjunct to traditional therapies. Which information should the nurse teach the client to help foster a sense of control over his symptoms?

a. Pathophysiology of disease process

b. Principles of good nutrition

c. Side effects of medications

d. Stress management techniques

44. Which of the following is the most distinguishing feature of a client with an antisocial personality disorder?

a. Attention to detail and order

b. Bizarre mannerisms and thoughts

c. Submissive and dependent behavior

d. Disregard for social and legal norms

45. Which nursing diagnosis is most appropriate for a client with anorexia nervosa who expresses feelings of guilt about not meeting family expectations?

a. Anxiety

b. Disturbed body image

c. Defensive coping

d. Powerlessness

46. A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful?

a. The parents reinforced increased decision making by the client

b. The parents clearly verbalize their expectations for the client

c. The client verbalizes that family meals are now enjoyable

d. The client tells her parents about feelings of low-self esteem

47. A client with dysthymic disorder reports to a nurse that his life is hopeless and will never improve in the future. How can the nurse best respond using a cognitive approach?

a. Agree with the client’s painful feelings

b. Challenge the accuracy of the client’s belief

c. Deny that the situation is hopeless

d. Present a cheerful attitude

48. A client with major depression has not verbalized problem areas to staff or peers since admission to a psychiatric unit. Which activity should the nurse recommend to help this client express himself?

a. Art therapy in a small group

b. Basketball game with peers on the unit

c. Reading a self-help book on depression

d. Watching movie with the peer group

49. The home health psychiatric nurse visits a client with chronic schizophrenia who was recently discharged after a prolong stay in a state hospital. The client lives in a boarding home, reports no family involvement, and has little social interaction. The nurse plan to refer the client to a day treatment program in order to help him with:

a. Managing his hallucinations

b. Medication teaching

c. Social skills training

d. Vocational training

50. Which activity would be most appropriate for a severely withdrawn client?

a. Art activity with a staff member

b. Board game with a small group of clients

c. Team sport in the gym

d. Watching TV in the dayroom

What Do You Think?