1. A client with schizophrenia is started on Clozapine.

Which periodic measurements take priority in this

A. Complete blood count and absolute neutrophil count

B. ECG and blood pressure

C. Fasting blood glucose and fasting lipid panel

D. Height, weight, and waist circumference

2. A client with a diagnosis of schizophrenia with catatonia has recently been admitted to the psychiatric
unit. Which of the following is the priority nursing diagnosis?

A. Impaired social interaction

B. Impaired verbal communication

C. Risk for deficient fluid volume

D. Risk for impaired skin integrity

3. A nursing home client with major depressive disorder reports difficulty going to sleep until late at
night. The client gets up, paces the hallway, wrings the hands, and appears teary. What interventions
should be included in the client's nursing care plan? Select all that apply.

A. Allow the client to receive at least 20 minutes of natural sunlight each day

B. Encourage the client to take naps during the day to make up for lost sleep

C. Have the client engage in strenuous physical exercise just before bedtime

D. Spend time with the client in a quiet environment just before bedtime

E. Suggest that the client take a warm bath before going to bed

4. A client with severe major depressive disorder is lying in bed and has not moved for 3 hours. The
client will respond slowly to "yes" and "no" questions; otherwise, the client does not respond when
spoken to. The clinical manifestations exhibited by the client are known as:

A. Psychogenic dystonia

B. Psychogenic gait

C. Psychomotor retardation

D. Somatization

5. The new nurse is providing teaching to a client scheduled for electroconvulsive therapy (ECT). What
information given by the new nurse would cause the charge nurse to intervene?

A "Be sure to take your valproic acid prior to the procedure.

B - "Do not drive during the course of ECT treatment.

C. "Temporary confusion is common immediately after treatment."

D. "You should avoid eating 8 hours prior to the procedure."

6. An adolescent is brought to the emergency department by the parents after being found making
superficial cuts along the side of an arm with a razir blade. There are several minor cuts in various stages
of healing on the clients forearm. Which statement are appropriate for the nurse to make to the client's
parents? Select all that apply.

A "Everything is going to be all right."

B. "Tell me about when you started noticing this behavior."

C "We have the bleeding under control.'

D "Why didn't you bring your child in sooner?"

E "You must be very upset after seeing this."

A. Acknowledges poor interpersonal skills

B. Identifies new coping mechanisms

C. Increases caloric intake to gain weight

D. Verbalizes sources of conflict and anger

8. The nurse is admitting a client with malnutrition related to anorexia nervosa. Which of the following
actions are appropriate to include in the care of this client? Select all that apply.

A Allow the client to continue to exercise per usual routine

B Assist the client in reflecting on triggers of disordered eating

C. Maintain strict record of protein and calorie intake

D. Remain with the client for the duration of each meal

E. Weigh the client each morning prior to any oral intake

9. A client recently diagnosed with schizophrenia is hospitalized. The client appears distraught and says
to the nurse, "The voices are bad today they are so angry with me." Which of the following is the best
response by the nurse?

A. "Do you need something to help you calm down?"

B "Don't pay any attention to the voices. Let's go into the dayroom.

C. "The voices are not real. Tell them to go away.

D. "What are the voices saying to you?"

10 A nurse is caring for a client with bulimia nervosa. Which is the most important time for the nurse to
monitor the client's behavior?

A. During 1-2 hours after each meal

B. During every meal

C. During the evening meal

D. During the overnight hours

11. After a daily weigh-in, a client with anorexia nervosa realizes a 2-Ib weight gain. The client says to
the nurse in a distressed voice, "This is terrible. I'm so fat." What is the best response by the nurse?

A. "But you look so thin."

B. "I don't see you that way; you are making progress toward a healthy weight."

C. "If you continue to gain weight at this rate, you will be able to go home soon."

D. "You are not fat; it's all in your imagination.

12 The triage nurse is assessing a depressed client's risk for suicide after the client reports having
thoughts of self-injury yesterday. Which of the following statements by the client should the nurse
recognize as risk factors for suicide? Select all that apply.

A. "I am currently unemployed and looking for a job."

B. "I have been married for five years with three children."

C. "I have multiple firearms at home stored in a safe."

D. "It has been about a year since I last overdosed.

E. "My family and I attend weekly religious activities.

F. "Sometimes I experience feelings of hopelessness."

A. The client has a problem with authority figures

B. The client has an intense need to control the environment

C. The client is hearing voices

D. The client is trying to control anger

14. A client recently diagnosed with schizophrenia is brought to the mental health clinic by the identical
twin sibling for the first follow-up visit after hospitalization. The client’s sibling says to the nurse," I read
that schizophrenia runs in families. I quess I'm doomed. Which is the best response by the nurse?

A At the moment, I would worry more about now your sibling is doing

B The odds are about 50:50 that you will come down with the disease as well

C Would yoo like to talk to a health care provider about this?

D You are at risk for the disease. However, there are other factors that contribute to the development of
schizophrenia

16. A client has been admitted to the acute inpatient psychiatric unit with a diagnosis of major
depressive disorder (unipolar depression). The nurse understands that this diagnosis was made because
the client has been exhibiting at least a of which of the 2-key clinical finding daily for at least 2 weeks?

A Daily sleep disturbance or significant weight loss

B. Decreased ability to think or low energy

C. Depressed mood or loss of interest or pleasure

D. Thoughts of worthlessness or recurrent thoughts of death

17. The nurse is caring for a client with schizophrenia who has been experiencing visual hallucinations,
The client says in a trembling voice, "There's a bad man standing over there in the corner of my room.
What is the best response by the nurse?

A "I know you are frightened, but I do not see a man in your room."

B WIll make the bad man go away.

C. *Let's go into the dayroom and play chess."

D *Your illness is making you hallucinate.

17. A client with schizophrenia says to the nurse, The world turns as the world turns on a ball at the
beach. But all the world's a stagecoach and I took the bus home." The nurse recognizes this statement as
an example of which of the following?

A. Concrete thinking

B. Loose associations

C Tangentiality

D. Word salad

18. A patient who has severe depression is prescribed Isocarboxazid (Marplan). Which of the following
should the nurse tell the patient to avoid? Select all that apply

A. Bacon

B. Tofu

C. Coffee

D. Salami

E. Beer
19 When giving any monoamine oxidase inhibitors to patients who are severely depressed the nurse
must always check which of the following vital signs?

A Blood pressure

B Temperature

C. Heart rate

D. Respiratory rate

20. The doctor has prescribed haloperidol (Haldol) to a patient who has schizophrenia. Which of the
following effects of the drugs must the nurse report to the doctor immediately?

A. Dry mouth

B. Constipation and urinary retention

C. High fever and muscle stiffness

D. Orthostatic hypotension

21. A schizophrenic patient has been on clozapine (Clozaril) for more than a week now. The nurse has
noticed fine tremors on the hands of the patient. Which of the following adverse effects of the drug is
the patient having?

A. Neuroleptic malignant syndrome

B. Pseudoparkinsonism

C. Anticholinergic effect

D. Tardive dyskinesia

22. A patient is taking lithium (Eskalith) for the treatment of mania (bipolar type II). Which of the
following effects of lithium must the nurse repot to the doctor immediately?

A Increased thirst

B Headache

C. Confusion and vision changes

D. Dry mouth

23. The patient who is taking Fluoxetine (Prozac,) tells the nurse, I still feel depressed despite taking the
drug for 6 days now. - Which of the following is the appropriate response by the nurse?

A Maybe we should talk the doctor to Increase the dosage of the drug

B How many tablets have you been taking each day? have

C I understand how you feel but these kinds of drugs usually take 2 to 4 weeks to achieve its efficiency

D We can have you doctor with you to another alternative

24. The mother is asking the nurse when is the best time to administer methylphenidate (Ritalin) to her
child with attention deficit hyperactivity disorder (ADHD). Which of the following should the nurse say?
A In the morning

B. Before lunch

C In the afternoon

D At bedtime

25 A student nurse has learned that tardive dyskinesia is one of the adverse effects of antipsychotics
such as chlorpromazine (Thorazine). Which of the following is the best description of this adverse effect?
A Fine hand tremors and stooped posture

B. Restless leg

C. Lip smacking or tongue protrusion

26. Which of the following is the cornerstone treatment for dissociative disorders?

A. Psychotherapy

B. Cognitive behavior therapy

C Systematic desensitization

D. Pharmacotherapy

27. Which of the following is the goal in the treatment of dissociative Identity disorder?

A. For the patient to accept the trauma that has happened in the past

B. To identify all the alters" within the patient

C. To unite all "alters" Into a single entity

D. For the dominant "alter” to take over the patient

28. The nurse is caring for à patient with dissociative identity disorder. Which of the following is not a
symptom of this disorder?

A Memory loss of certain time periods, events, people, and personal information.

B. A sense of being detached from yourself and emotion

C. A false belief of being tortured by unknown people

D. A perception of the people and things around you as distorted and unreal

29. Dissociative disorders usually develop as a reaction to which of the following?

A. Drug addiction

B. Psychological trauma

C. Alcoholism

D. Genetic predisposition

30. In order for the psychiatrist to communicate with the different "alters" within the patient who is
diagnosed with dissociative identity disorder, the nurse must anticipate for which of the following
procedures to be done?

A. Electroconvulsive therapy

B. Pharmacotherapy

C. Cognitive behavior therapy

D Hypnotherapy

31. When interacting with an adolescent client with the diagnosis of anorexia nervosa, the nurse should:
A. Show empathy

B. Maintain control

C. Set and maintain limits

D. Focus on dietary nutrition

41. A nurse in the mental health unit Is having a conversation with a client diagnosed with posttraumatic
stress disorder. The client seems upset and anxious. The most appropriate nursing response to the
ESTATIOI client is which of the fallowing?

A. Don't worry so much.

B Everything is going to be all right.

C I can see that you are upset

42. A nurse is planning care for a group of clients on a mental health unit. The nurse notes that which of
the following assigned clients does not require interventions commonly used to treat anxiety disorders?
A A client with panic disorder

B A client with obsessive compulsive disorder (OCD)

C A client with multiple personality disorder

D. A client with social anxiety disorder

43 A client has been prescribed Disulfiram (Antabuse). A psychiatric home health nurse would be sure to
assess which of the following before giving the client the first dose of this medication?

A. History of hyperthyroidism ACTI

B. When the last full meal was consumed

C When was the last alcoholic drink was consumed

D. History of diabetes insipidus insipidus

44. À person with paranoid personality disorder is commonly characterized by:

A Anger

B Self-centeredness

C Fear

D Suspiciousness

45. One of the essential elements of nursing intervention for a patient with personality disorder is:

A Decrease environmental stimuli

B. Establish therapeutic relationship

C. Involve patient in social activities

D. Encourage verbal expression of feelings

16. When a person directs anger at himself or repress the anger, the danger is:

A Suicide

B. Depression

C. Hostility

D. Anxiety

47 These drugs act by blocking dopamine receptors in the CNS and sympathetic nervous system activity.
A. Anxiolytics

B. Neuroleptics

C. Antimanic

D Antidepressant

48, All of the following are examples of antipsychotic drugs except:

A Elavil

B Orap

C. Risperdal

D. Trilafon

49. Selective serotonin reuptake inhibitors are usually administered before noon to avoid:

A. Insomnia
B. Overeating

C. Oversleeping

D. Anorexia

50. Neuroleptic Malignant Syndrome is associated with high potency antipsychotic drugs and its cardinal
symptom is:

A. Muscle rigidity

B. Muteness

C Hyperthermia

D. Tremors

51. This occurs when emotional problems are converted to physical symptoms.

A. Displacement

B. Fixation

C. Conversion

D. Denial

53 Aloha was reprimanded by her professor when she was caught cheating during examination. When
she reached home that day, she cut her hair so short enough for her to be unrecognizable. This defense
mechanism is:

A Displacement

B. Conversion

B Fixation

D. Regression

54. Many persons who are well adjusted" in ordinary daily living become dependent and demanding
when physically ill and hospitalized. This is an example of the mechanism of:

A. Denial

B. Regression

C. Compensation

D. Reaction formation

54. A client taking the monoamine oxidase inhibitor (MAOI) and antidepressant isocarboxazid (Marplan)
Is instructed by the nurse to avoid which foods and beverages?

A Aged cheese and red wine

B. Milk and green leafy vegetables

C. Carbonated beverages and tomato products

D. Lean red meats and fruit juices

55. In Acute Stress Disorder (ASD), the client develops severe anxiety and dissociative symptoms after:
A. 2 months

B. 3 months

C. 1 month

D. 1 ½ months

56. In the treatment of ASD, which of the following is inappropriate?

A Alprazolam
B. Assertiveness training

C. Breathing exercises

D. Exposure therapy

57. All of the following are common compulsions in Obsessive-compulsive Disorder (OCD) EXCEPT:

A. Checking iron

B. Checking physical appearance

C. Hoarding

D. Handwashing

58. Doctor shopping is most common in what somatic symptom disorder?

A. Functional Neurological Symptom Disorder

B. Illness Anxiety Disorder

C. Somatization

D. Factitious Disorder

59. The nurse is aware that as anxiety increases, one's concept of reality alters. Therefore, when caring
for a client with a generalized anxiety disorder, the nurse's first Intervention should be to:

A Have the client verbalize feelings of anxiety

B. Administer the pra medication ordered by the physician

C. Remove as many stimuli from the client's environment as possible.

D. Have the client list the relief behavior that are used to reduce anxiety.

60. Trust is very essential in the process of psychotherapy. This may develop in the nurse-client
relationship when the nurse:

A. Avoid limit setting.

B. Encourages the client to use "testing” behavior.

C Tells the client how he should behave

D Uses consistence in approaching the client.

61. When caring for a client who has a diagnosis of conversion disorder with paralysis of the lower
extremities, it would be most therapeutic for the nurse to:

A Encourage the client to try to walk

B Tell the client there is nothing wrong

C Avoid focusing on the client’s physical symptoms

D Help the client follow through with the physical therapy plan

62. A nurse is caring for a client with a diagnosis of agoraphobia. Which of the following behaviors would
the nurse expect the client to describe when communicating with the client about the disorder?

A A need to wash hands several times before eating a meal.

B A fear of leaving the house

C A fear of speaking in public

D A fear of riding in elevators

63 Greediness is one characteristic in this stage of psychosexual development.

A Oral stage

B Anal stage
C Phallic stage

D. Genital stage

64. In this stage, development proceeds from prelogical to logical concrete thought.

A Sensory motor

B. Pre operational stage

C Concrete operational stage

D. Formal operational stage

65. The major psychosocial conflict of a 10-year-old will be which of the following?

A Intimacy vs. isolation

B Identity vs. role confusion

C. Industry vs. inferiority

D. initiative vs. quilt

66. Which of the following would indicate that the adolescent has already developed a sense of identity?

A. A teenager is performing poorly in his course because his parents chose the course for him.

B. A teenager who is not satisfied with his course because her friends opaded her to join them.

C. A teenager who secretly hides his sexuality to everyone, but in his thoughts he is a homosexual.

D. A teenager who excels very well In a course, and loves what he is studying.

67. The major task of a person in middle adulthood is to:

A. Develop a sense of intimacy

B. Guide the next generation

C. Develop a sense of Identity

D. Gain Independence

68. This is the major psychosocial crisis of the young adult

A. Intirnacy vs. Isolation

B Identity vs, role confusion

C. Integrity vs, despair

D. Industry vs. Isolation

67 The terms judgment and insights are sometimes used incorrectly. Insight is the ability to:

A Make appropriate choices

B. Control inappropriate impulses

C Explain one's psychiatric diagnosis

D. Understand the nature of one's problem or situation

68. The nurse documents, The patient described her husband's abuse in an emotionless tone and with a
Mat expression". This statement describes the patient's:

A Appearance

B. Affect

C. Mood

D. Thought Process
69. Jala says, "Give me 10 minutes to recall the name of our college professor who falled many students
in our anatomy class. " She is operating on her:

A. Subconscious

B Conscious

C. Unconscious

D Ego

80. In terminating the therapeutic relationship with Mandy prior to his discharge, Nurse Marimar should
do one of the following:

A Discourage discussion of past relationship.

B Focus less and less on the expression of feelings as termination of relationship nears

C Allow him to express his feelings about leaving the hospital.

D Discuss opportunities for future relations.

81. A busy woman attorney with a successful law practice is admitted to the acute care hospital with
epigastric pain. Since admission, she has called the nurse every 15 minutes with one request or another,
The patient is exhibiting:

A Repression

B Somatization

C Regression

D. Conversion

82. Gian lost an Important advertising account and had a flat tire on the way home. That evening, he
began to find fault with everyone. Which defense mechanism is he using?

A Displacement

B. Projection

C. Regression

D. Sublimation

83. Which primary unconscious defense mechanism keeps hignly anxiety- producing situations out of
conscious awareness?

A Identification

B. Repression

C Suppression

D. Denial

84. A busy woman attorney with a successful law practice is admitted to the acute care hospital with
epigastric pain. Since admission, she has called the nurse every 15 minutes with one request or another.
The patient is exhibiting:

A. Repression

B. Somatization

C Regression

D Conversion

85. Gian lost an important advertising account and had a flat tire on the way home. That evening, he
began to find fault with everyone, Which defense mechanism is he using?

A.Displacement

B. Projection
C Regression

D Sublimation

86. Which primary unconscious defense mechanism keeps highly anxiety-producing situations out of
conscious awareness?

A. Identification

B. Regression

C. Suppression

D. Denial

87 A nurse in the mental health unit is having a conversation with a client diagnosed with posttraumatic
stress disorder. The client seems upset and anxious. The most appropriate nursing response to the client
is which of the following?

A "Don't worry so much."

B. Everything is going to be all right.

C. 'I can see that you are upset."

D. "Why are you having so much trouble controlling your anxiety?

88. A mental health nurse is caring for a male client with a phobia. The nurse tells the client that the
ellent will attend a music therapy session. The client tells the nurse that he cannot sing and refuses to
attend. The most appropriate nursing response would be which of the following?

A. You don't have to sing at the session. You can listen and enjoy the music.

B. "Why don't you want to attend? What is the real reason?

C The physician has prescribed this therapy for you.

D You must go. You have no choice.

89. Folie a deux is synonymous to what type of psychotic disorder?

A Brief Psychotic Disorder

B Schizophreniform

C Schizoaffective

D Shared Psychosis

90. A schizophrenic client is manifesting a bizarre delusion. An example of bizarre delusion is/are. Select
all that apply.

A Jealous delusion

B Nihilistic delusion

C Somatic delusion

D. Thought insertion

91. A 72-yr-old man tells the nurse that he cannot perform most of the physical activities he could do 5
years ago because of overall joint aches and pains. What can the nurse do to assist the patient to
prevent further deconditioning and decrease the risk for developing musculoskeletal problems?

A Limit weight-bearing exercise to prevent stress on fragile bones and possible hip fractures

B Advise the patient to avoid the use of canes and walkers because they increase dependence on
ambulation aids.

C Advise the patient to increase his activity by more frequently climbing stairs in buildings and other
environments with steps.
D. Discuss the use of stretching and warm up, as well as strengthening exercises to decrease aches and
pain so that exercise can be maintained

92. Application of RICE (rest, ice, compression, and elevation) is indicated for Initial management of
which type of injury?

A Muscle spasms

B. Sprains and strains

C. Repetitive strain injury

D. Dislocations and subluxations

93. A patient with chronic osteomyelitis has been hospitalized for a surgical debridement procedure.
What does the nurse explain to the patient as the rationale for the surgical treatment?

A Removal of the infection prevents the need for bone and skin grafting

B. Formation of scar tissue has led to a protected area of bacterial growth.

C The process of depositing new bone blocks the vascular supply to the bone,

D. Antibiotics are not effective against microorganisms that cause chronic osteomyelitis.

94 A patient with osteomyelitis has a nursing diagnosis of risk for injury, What is an appropriate nursing
intervention for this patient?

A. Use careful and appropriate disposal of soiled dressings.

B. Gently handle the Involved extremity during movement.

C Measure the circumference of the affected extremity daily.

D. Range-of-motion (ROM) exercise every 4 hours to the involved extremity,

95. Following 7 days of IV antibiotic therapy, a patient with acute osteomyelitis of the tibia, is prepared
for discharge from the hospital. The nurse determines that additional instruction is needed when the
patient makes which statement?

A. I will need to continue antibiotic therapy for 4 to 6 weeks."

B. I should notify the HCP if the pain in my leg becomes worse."

C. "I shouldn't bear weight on my affected leg until healing is complete."

D. "I do not need to do anything special while taking the antibiotic therapy.

96. During a follow-up visit to a patient with acute osteomyelitis treated with IV antibiotics, the home
health nurse is told by the patient's wife that she can hardly get the patient to eat because his mouth is
so sore. In assessing the patient's mouth, what is the most likely finding that the nurse should expect to
find?

A A dry, cracked tongue with a central furrow

B. White, curd-like membranous lesions of the mucosa

C. Ulcers of the mouth and lips surrounded by a reddened base

D. Single or clustered vesicles on the tonque and buccal mucosa

97 What are characteristics of Paget's disease? Select all that apply.

A. Results from vitamin D deficiency

B. Loss of total bone mass and substance

C. Abnormal remodeling and resorption of bone

D. Most common in bones of spine, hips, and wrists

E. Replacement of normal marrow with vascular connective tissue

98.Which female patients are at risk for developing osteoporosis? Select all that apply.
A 60-yr-old white aerobics instructor

B. 55-yr-old Asian American cigarette smoker

C. 62-yr-old African American on estrogen therapy

D. 68-yr-old white who is underweight and inactive

E. 58-yr-old Native American who started menopause prematurely

99 Identify methods to specifically prevent osteoporosis in postmenopausal women. Select all that
apply.

A. Eating more beef

B. Eating 8 ounces of yogurt daily

C. Performing weight-bearing exercise

D. Spending 15 minutes in the sun each day

E. Taking postmenopausal estrogen replacement

100. A patient is started on alendronate (Fosamax) once weekly for the treatment of osteoporosis. The
nurse determines that further instruction about the drug is needed when what is said by the patient?

A. "I should take the drug with a meal to prevent stomach irritation."

B. This drug will prevent further bone loss and increase my bone density."

C "I need to sit or stand upright for at least 30 minutes after taking the drug."

D. "I will still need to take my calcium supplements while taking this new drug."