1.

Which behavior should a nurse expect a client diagnosed with paranoid schizophrenia
disorder to exhibit?
A. Able to trust those who treat the client well
B. Sees the goodwill of others when none exists
C. Acts the opposite of what the client may be thinking or feeling
D. Analyzes the behavior of others to find hidden and threatening meanings

2. A nurse is evaluating a client diagnosed with bipolar personality who is currently

prescribed lithium (Eskalith) 300 mg tid. The client had a lithium level drawn, and
the results are as follows: Lithium levels-1.5 mEq/L. The nurse receives an order to
add fluoxetine (Prozac) 20 mg bid and to administer the first dose. Based on the
laboratory report findings, the nurse should: SELECT ALL THAT APPLY.
A. administer the dose of fluoxetine.
B. question the dose of lithium.
C. question the dose of fluoxetine.
D. notify the physician of the laboratory test results.
E. question the addition of fluoxetine.

3. When working with a client diagnosed with paranoid schizophrenia, a nurse

understands that the client most likely:
A. received little affection or approval in childhood.
B. experienced lack of empathy and lack of nurturing during upbringing.
C. experienced an early upbringing characterized by indifference leading to a pattern of
discomfort with affection.
D. received recognition for accomplishments in early childhood but not during
adolescence.

4. A client on a psychiatric unit is very demanding and belittling of one of the nurses.
The client is talking with others and telling them how mean the nurse is to clients.
Which nursing diagnosis is most appropriate for the client?
A. Chronic low self-esteem related to use of the defense mechanism splitting
B. Risk for other-directed violence related to negative verbal comments
C. Ineffective coping related to inability to interact with unit personnel
D. Social isolation related to negative behavior

5. A physician writes in a client’s progress notes, “Will switch medications from the
older medications to a newer GABA-ergic anticonvulsant to treat client’s instability of
mood, transient mood crashes, and inappropriate and intense outbursts of anger.”
Which medication should a nurse consider when reviewing the physician’s new
orders?
A. Gabapentin (Neurontin)
B. Lithium (Eskalith)
C. Carbamazepine (Tegretol)
D. Valproic acid (Depakote)

6. A client diagnosed with major depression is prescribed phenelzine (Nardil) for

decreasing impulsivity and self-destructive acts. The client is taught to avoid foods
high in tyramine when taking this medication to prevent:
A. cardiac rhythm abnormalities.
B. a hypotensive crisis.
C. a hypertensive crisis.
 D. poor absorption of the medication.

7. A nurse teaches the communication triad to a client to manage feelings. Which

components should the nurse teach? SELECT ALL THAT APPLY.
A. Using an “I” statement to identify the present feeling
B. Using a “you” statement to identify the cause of the feeling
C. Using a “they” statement to examine the effect of the client’s feelings on others
D. Making a nonjudgmental statement about an emotional trigger
E. Identifying what would restore comfort to the situation for the client

8. A nurse is caring for a client who has been diagnosed with psychotic fugue. In
reviewing the client’s medical record, which information in the client’s history should
indicate to the nurse that the diagnosis is correct? SELECT ALL THAT APPLY.
A. The client recently forgot all personal information following an accident.
B. The client left home and assumed a new identity following the loss of a child.
C. The client demonstrates having more than one distinct personality.
D. The client claims to have superhero qualities following a recent suicide attempt.
E. The client resides in a homeless shelter after being physically abused by his or her
spouse.

9. A nurse is treating a client diagnosed with dissociative identity disorder (DID). Which
actions should the nurse take when working with this client? SELECT ALL THAT
APPLY.
A. Focus on long-term goals.
B. Maintain a calm environment.
C. Use open communication.
D. Observe for signs of suicidal thoughts or behavior.
E. Document changes in the client’s behavior.

10. A nurse observes that a client diagnosed with intermittent explosive disorder is
becoming aggressive. The client is exhibiting tense posture and clenched fists and
has a defiant affect. Which actions should be taken by the nurse to de-escalate the
client’s aggression? Prioritize the nurse’s actions by placing each step in the correct
order.
1. Administer medication.
2. Attempt to talk the client down.
3. Provide the use of alternate physical outlets.
4. Apply physical restraints.
5. Call for assistance.
A. 3,1,2,5,4
B. 3,1,5,4,2
C. 3,1,2,4,5
D. 3,1,5,2,4

11. A client diagnosed with major depressive disorder expresses to a nurse that death
would be better than living with depression. The nurse determines that the client is
suffering from suicidal ideation and is at risk for committing suicide. Which nursing
intervention is priority for the client experiencing suicidal ideation?
A. Talking with the client about reasons to live and instilling positive affirmations
B. Educating the client on medical and psychological treatments for depression
C. Alerting the appropriate authorities and monitoring the client frequently
D. Assessing the surrounding environment for harmful substances or methods to commit
suicide
 12. A psychiatric nurse observes a client becoming increasingly agitated and threatening.
The nurse is aware of the signs that a crisis situation could occur. What should be the
nurse’s primary goal while intervening in a crisis?
A. Helping to reconstruct the client’s thought process
B. Eliminating and/or resolving present conflicts
C. Encouraging client to talk about feelings that led to the crisis
D. Securing a physician’s order for restraints

13. A client diagnosed with paraphilia, has been advised to participate in

psychoanalytical therapy. The client asks a nurse about what is involved with this
type of therapy. Which statement by the nurse accurately describes the focus of
psychoanalytical therapy?
A. Psychoanalytical therapy focuses on reducing the level of circulating androgens.
B. Psychoanalytical therapy focuses on aversion techniques.
C. Psychoanalytical therapy focuses on resolving early conflicts.
D. Psychoanalytical therapy focuses on achieving satiation.

14. A client diagnosed with schizophrenia is refusing to take a prescribed psychotropic

medication. A nurse attempts to persuade the client to comply with the physician’s
orders. Under which circumstance could the client be forced to take medication?
A. If the client begins to claim to be God
B. If the client claims to be a terrorist and threatens to kill a nurse
C. If the client threatens to leave the hospital
D. If the client talks about a previous suicide attempt

15. A client diagnosed with schizoaffective disorder was recently treated for a major
depressive episode. Following a 72-hour involuntary commitment, the client is stable
and asking to leave the hospital. Which client right should the nurse consider while
deciding if the client can be discharged?
A. Right to appropriate service plan
B. Right to least-restrictive treatment
C. Right to freedom from restraint
D. Right to refuse treatment

16. Mr. Olivar remarked “I am wary about people visiting, what with all the media news
about child kidnapping and robberies.” The nurse’s BEST response would be:
A. “Would you rather wish that I don’t come and visit as you may regard me as a
stranger?”
B. “I get that.” The nurse diverts the attention to talk about non-threatening topics.
C. “It must be distressing to think and feel the way you do”
D. “I acknowledge what you are saying. My concern is the health care of your family
and information are strictly confidential.”
17. Mrs. Olivar expressed that her socializing with neighbors is limited because her
husband thinks she is getting overly friendly with a guy next door. Which of the following
would the nurse emphasize as basic?
A. Keeping trust in the relationship
B. Avoid relating with neighbors to minimize conflict
C. Be assertive to express her individuality
D. Ignore the husband and just be supportive
 18. For the nurse to be effective in developing rapport with the family it is essential that
she keeps her appointment on time and stick to a care plan. She is applying the principles
of:
A. Responsibility and accountability C. Honesty and integrity
B. Consistency and predictability D. Empathy and compassion

19. Which of these symptoms if demonstrated by Mr. Olivar would necessitate referral to
a doctor?
A. Hypervigilance C. perfectionism
B. Blank affect D. Loss of reality contact

20. The paranoid client utilizes which of the following defense mechanisms?
A. Sublimation C. Rationalization
B. Projection D. Reaction formation

21. The defense mechanism utilized by manic patients to cover up depression is:
A. Reaction formation C. Displacement
B. Compensation D. Denial

22. The psychodynamics of depression according to Gabriela is the involvement of 3

governing personality components; id, ego, superego. Which of the following is the
“conscience”?
A. Id C. Super-ego
B. Ego D. None of the above

23. Which of these drugs is likely to be indicated for Gabriela during depressive
episodes?
A. Serenace (Haloperidol) C. Tofranil (Imipramine HCI)
B. Valium (Diazepam) D. Trilafon (Pherphenazine)

24. Therapeutic use of self is essential in relating with psychiatric patients. This is BEST
demonstrated in:
A. Sympathizing with the miserable feelings of Gabriela
B. Engaging Gabriela in productive activity
C. Engaging Gabriela in introspective thinking
D. Suppressing her own feelings toward Gabriela

25. After three days of antidepressant medication, Gabriela still manifests depression.
The nurse evaluates this as:
A. Unusual because action of antidepressant drug is immediate
B. Expected because it takes about two weeks for the medication to be effective
C. Unexpected because it takes within one week for the medication to be effective
D. Ineffective because perhaps the drug’s dosage is inadequate

26. The nurse is monitoring a client with Alcohol Abuse for signs of alcohol withdrawal.
Which of the following would alert the nurse to the potential for Delirium Tremens?
A. Hypertension, changes in LOC, hallucinations
B. Hypotension, ataxia, hunger
C. Stupor, agitation, muscular rigidity
D. Hypotension, coarse hand tremors, agitation
 27. The spouse of a client admitted to the mental health unit for alcohol withdrawal says
to the nurse “I should get out of this bad situation.” The most helpful response by the nurse
would be:
A. “I agree with you. You should get out of this situation.”
B. “What do you find difficult about this situation?”
C. “Why don’t you tell your husband about this?”
D. “This is not the best time to make that decision.”

28. The nurse determines that the wife of an alcoholic client is benefiting from attending
Al-Anon group when she hears the wife say:
A. “My attendance at the meetings has helped me to see that I provoke my husband’s
violence.”
B. “I no longer feel that I deserve the beatings my husband inflicts on me.”
C. “I can tolerate my husband’s destructive behavior now that I know they are common
with alcoholics.”
D. “I enjoy attending the meetings because they get me out of the house and away
from my husband.”

29. The client has been hospitalized and is participating in a substance abuse therapy
group sessions. On discharge, the client has consented to participate in AA community
groups. The nurse is monitoring the client’s response to the substance abuse sessions.
Which statement by the client best indicates that the client has developed effective coping
response styles and has processed information effectively for self use?
A. “I know I’m ready to be discharged. I feel I can say ‘no’ and leave a group of friends
if they are drinking… ‘No Problem.’”
B. “This group has really helped a lot. I know it will be different when I go home. But
I’m sure that my family and friends will all help me like the people in this group have…
They’ll all help me… I know they will… They won’t let me go back to my old ways.”
C. “I’m looking forward to leaving here. I know that I will miss all of you. So, I’m happy
and I’m sad, I’m excited and I’m scared. I know that I have to work hard to be strong and
that everyone isn’t going to be as helpful as you people.”
D. “I’ll keep all my appointments; go to all my AA groups; I’ll do everything I’m
supposed to… Nothing will go wrong that way.”

30. A hospitalized client with a history of alcohol abuse tells the nurse, “I am leaving
now. I have to go. I don’t want anymore treatment. I have things that I have to do right
away.” The client has not been discharged. In fact, the client is scheduled for an important
diagnostic test to be performed in 1 hour. After the nurse discusses the client’s concerns
with her, the client dresses and begins to walk out of the hospital room. The most important
nursing action is to:
A. Restrain the client until the physician can be reached
B. Call security to block all areas
C. Tell the client that the client cannot return to this hospital again if the client leaves
now.
D. Call the nursing supervisor.

31. Which nursing intervention is most appropriate for a client with Anorexia Nervosa during initial
hospitalization on a behavioral therapy unit?
A. Emphasize the importance of good nutrition to establish normal weight.
B. Ignore the client’s mealtime behavior and focus instead on issues of dependence and
independence.
C. Help establish a plan using privileges and restrictions based on compliance with refeeding.
D. Teach the client information about the long-term physical consequence of anorexia.
32. 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 reinforce 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.

33. Juvy tells the nurse, “I feel so awful and inadequate.” Which of the following responses is best?
A. “You’re being too hard on yourself”
B. “Somebody you’ll feel better about things”
C. “Tell me something you like about yourself”
D. “Maybe relaxing by yourself will help you feel better

34. An appropriate behavior modification goal for a client with Anorexia Nervosa would be, the
client will:
A. Eat every meal for a week C. Attend group therapy every day
B. Gain a pound of weight a week D. Talk about food for 1 hour a day

35. Which of the following communication strategies is best to use with Juvy who is having problems
with peer relationships?
A. Use concrete language and maintain a focus on reality
B. Direct the client to talk about what is causing the anxiety
C. Teach the client to communicate feelings and express self appropriately
D. Comfort the client about being depressed and self-absorbed
36. Which information is most essential in the initial teaching session for the family of a
young adult recently diagnosed with Schizophrenia?
A. Symptoms of this disease imbalance in the brain.
B. Genetic history is an important factor related to the development of
Schizophrenia.
C. Schizophrenia is a serious disease affecting every aspect of a person’s
functioning.
D. The distressing symptoms of this disorder can respond to treatment with
medications.

37. A nurse is working with a client who has Schizophrenia, paranoid type. Which of the
following outcomes related to the client’s delusional perceptions would the nurse
establish?
A. The client will demonstrate realistic interpretation of daily events in the unit.
B. The client will perform daily hygiene and grooming without assistance.
C. The client will take prescribed medications without difficulty.
D. The client will participate in unit activities.

38. The parents of a young man with Schizophrenia express feelings of responsibility and
guilt for their son’s problems. How can the nurse best educate the family?
A. Acknowledge the parent’s responsibility.
B. Explain the biological nature of schizophrenia.
C. Refer the family to a support group
 D. Teach the parents various ways they must change
E. Ans: B.

39. While talking to a Schizophenic, the nurse notes that the patient frequently uses
unrecognizable words with no common meaning. The nurse knows that this is
termed as:
A. Echolalia C. Neologism
B. Clang association D. Word Salad

40. A client is prescribed with Chlorpromazine (Thorazine) for the treatment of his
Schizophrenia. This drug blocks the transmission of which of the following
substances?
A. Dopamine C. Norepinephrine
B. Epinephrine D. Thyroxine

41. When beginning a therapeutic relationship with a client, the nurse would assume that
the client:
A. Adopt a passive, dependent role
B. Demonstrates incompetence
C. Has the necessary capabilities
D. Develops solutions to his or her own problems

42. Which of the following statements best describes the key advantage of using groups
in psychotherapy?
A. Decreases the focus on the individual
B. Fosters the physician-client relationship
C. Confronts individuals with their short-comings
D. Fosters a new learning environment

43. The nursing department of a psychiatric hospital has organized a group of nurses to
develop a continuing education program on psychiatric mental health nursing
research and ethics. The group leader develops a list of tasks to be completed and
assigns one to each group member. The nurse is using what leadership style?
A. Laisser-faire C. Autocratic
B. Democratic D. Egalitarian

44. When developing a presentation about group types, which of the following would the
nursing instructor include as characteristics of a primary group?
A. High Degree of structure and authority
B. Explicit and implicit interdependent roles, boundaries and group norms
C. Large size and impersonal
D. Provision of education and culture values

45. During a group therapy session, a teenage girl says she’s fat and ugly and everybody
makes fun of her. This statement reflects which common adolescent fear or
anxiety?
A. Fear of the unknown
B. Fear of loss of respect, love and emerging self-esteem
C. Anxiety related to guilt
D. Anxiety about body image and changes in physical appearance
46. When caring for psychiatric-mental health clients whose ability to give informed
consent depends on their degree of psychiatric impairment, the nurse’s priority
obligation is to:
 A. Assess the client’s legal capacity when that client is asked to give consent
B. Prevent the client from revoking consent
C. Obtain informed consent when the primary provider cannot be present
D. Persuade the client to consent

47. The nurse overhears two psychiatric nurses talking about their patient inside the lift.
The nurses' action violates clearly which ethical concept?
A. Anonymity C. Autonomy
B. Beneficence D. Confidentiality

48. A 35-year-old man was hospitalized 2 weeks ago for Acute Mania. The patient is
incapable of making his own decision because of the cognitive relapse. The nurse
decides for the health of the client in the absence of the patient’s relatives. The nurse
is displaying what ethical principle?
A. Justice C. Beneficence
B. Veracity D. Paternalism

49. The nurse fails to assess a client in physical restraints according to the frequency
stipulated in the hospital’s policy. The nurse’s behavior could legally constitute which
of the following?
A. False imprisonment C. Breach of client privacy
B. Negligence D. Malpractice

50. The patient is showing severe anxiety upon interview. The nurses understand that
the patient’s anxiety may have predisposed to his mother’s gestational period during
her:
A. 1st trimester C. 3rd trimester
B. 2nd trimester D. pre-conjugal period

51. While this client is in the psychiatric facility, the priority of care is:
A. Managing his behavior
B. Prevent further deterioration
C. Focusing on the needs of the wife
D. Establishing a bowel and bladder retraining program

52. The best approach in helping a confused, older client is to provide an environment
with:
A. Space for privacy C. A trusting relationship
B. Group involvement D. Activities that are varied

53. An older male client in the psychiatric unit becomes upset while in the day room.
When attempting to deal with the situation, the nurse should:
A. Instruct the client to be quiet
B. Allow the client to act out until he tires
C. Give directions in a firm, low pitched voice
D. Lead the client from the room by taking him by his arm

54. When working with clients who exhibit mild cognitive impairment, the nursing
intervention considered most appropriate would be:
A. Reality orientation C. Behavioral
B. Behavioral confrontation D. Reflective communication
 55. A 78-year-old male has been brought to the clinic by his family because they believe
he has become increasingly confused over the past week. The nurse can validate the
client’s orientation by asking him to:
A. Explain a proverbs C. Identify the name of the hospital
B. State where he was born D. Recall what he had eaten for breakfast

56. Which of the following findings is expected for a client with dissociative identity
disorder (DID)?
A. a close history relationship with her mother
B. a history of performing poorly at school
C. inability to recall certain events or experiences
D. consistency in the performance of certain tasks or skills

57. Which of the following interventions is appropriate when caring for Alberto?
A. Remind the alter personalities they’re part of the host personality.
B. Interact with the client only when the host personality is in control.
C. Establish an empathetic relationship with each emerging personality.
D. Provide positive reinforcement to the client when calm alter personalities are
present instead of angry ones.

58. While interacting with Alberto, the nurse observes one of the alter personalities take
over. Alberto goes from being very calm to angry and shouting. Which of the following
responses would be most appropriate?
A. “Is one of you upset?”
B. “Why have you become angry?”
C. “Tell me what you’re feeling right now.”
D. “Let me speak to someone who isn’t angry.”

59. A 40-year-old lost her home in a flood last month. When questioned about her
feelings about the loss, she doesn’t remember being in a flood or owning a home. This client
most likely has which of the following disorders?
A. Depersonalization disorder C. Dissociative fugue
B. Dissociative amnesia D. Dissociative identity disorder

60. Which of the following nursing interventions is the most appropriate for a client who
had an episode of dissociative fugue?
A. Let the patient verbalize fear and anxiety he feels.
B. Encourage the client to share his experiences during the episode.
C. Have the client sign a contract stating he won’t leave the premise again.
D. Tell the client he won’t resolve his problems by running away from them.

61. When using behavior modification to foster toilet training efforts for Theresa, the
nurse should reinforce appropriate use of the toilet by giving the child a:
A. Piece of fruit C. Hug and praise
B. Piece of candy D. Choice of rewards

62. The most common characteristic of autistic children is that they:

A. Respond to any stimulus
B. Respond to little external stimulus
C. Seem unresponsive to the environment
D. Are totally involved with the environment
 63. Theresa is mostly nonverbal and has limited eye contact. To promote social
interaction, the nurse initially should:
A. Engage in parallel play while sitting next to the child
B. Encourage the child to vocalize through sound games and songs
C. Provide play opportunities for the child to play with other children
D. Use therapeutic holding when the child does not respond to verbal interactions

64. Cathy, a six year old child is hyperactive and usually does not listen to her parents.
She has ADHD. One of the major behavioral characteristics of children with attention deficit
disorders is their:
A. Overreaction to stimuli C. Delayed speech development
B. Continued use of rituals D. Inability to use abstract thought

65. Attention Deficit Hyperactivity Disorders (ADHD) in children is treated with:

A. Lorazepam (Ativan)
B. Haloperidol (Noldol)
C. Methocarbamol (Robaxin)
D. Atomoxetine

66. After 1 week, B states, “Now that my baby is dead and I’m too old to have another
one, I don’t want to live anymore.” The nurse should respond by saying:
A. “Life doesn’t look very promising to you right now, but let’s talk about this.”
B. “You shouldn’t feel so hopeless. Many women are having babies at their forties.”
C. “I care about you, and I want you to live.”
D. “What about your husband and other children? Do you think they need you?”

67. B and her husband begin to express concern about the proposed ECT treatment.
Which nursing action is most appropriate initially?
A. Refer all questions to the physician who will administer the ECT treatment.
B. Listen for misconceptions and clarify any confusing information.
C. Orient B and her husband to the ECT unit so they become familiar and
comfortable with the surroundings.
D. Provide B and her husband booklets explaining the procedure in simple,
understandable terms

68. By providing B and her husband with an opportunity to discuss ECT treatment openly
and directly, the nurse communicates the idea that:
A. ECT should not be feared
B. ECT will reverse the depression
C. ECT is a positive treatment alternative
D. ECT is safe procedure

69. Which side effects are most common after ECT treatment?
A. Headache and dizziness
B. Diarrhea and urinary incontinence
C. Nausea and vomiting
D. Temporary memory loss and confusion
 70. The physician decides to start C on Lithium therapy. Which of the following best
describes her dietary requirements while she is receiving this medication?
A. A high calorie diet with reduced sodium and adequate fluid intake
B. Regular diet with normal sodium and adequate fluid intake
C. A low calorie diet with reduced sodium and increased fluid intake
D. A regular diet with reduced sodium and adequate fluid intake

71. Any surgery should be delayed, if possible, because of the effects on personality
development during the:
A. oral stage
B. anal stage
C. oedipal stage
D. latency stage

72. A child scores between 55 and 68 on a standardized intelligent quotient (IQ)

assessment testing. The nurse is aware that this degree of intellectual impairment would be
considered:
A. Mild
B. Severe
C. Profound
D. Moderate

73. Autism can usually be diagnosed when the child is about:

A. 2 years of age
B. 6 years of age
C. 6 months of age
D. 1 to 3 months of age

74. One of the major behavioral characteristics of children with Attention-Deficit

Disorders is their:
A. Overreaction to stimuli
B. Continued use of rituals
C. Retarded speech development
D. Inability to use abstract thinking.

75. Attention-deficit Hyperactivity Disorder in children is usually treated with:

A. Lorazepam (Ativan)
B. Haloperidol (Haldol)
C. Methocarbamol (Robaxin)
D. Methylphenidate hydrochloride (Ritalin)

76. School phobia is usually treated by:

A. Returning the child to school immediately
B. Calmly explaining why attendance at school is necessary
C. Allowing the parent to accompany the child to the classroom
D. Allowing the child to enter the classroom before other children

77. The childhood problem that has legal as well as emotional aspects and cannot be
ignored is:
A. School phobia
B. Fear of animals
C. Fear of monsters
D. Sleep disturbances
 78. The major difference between Anorexia Nervosa and Bulimia Nervosa is that an
individual with bulimia nervosa is:
A. Obese and is attempting to lose weight
B. Has distorted body image and sees the body as fat
C. Recognizes that there is a problem but is helpless to correct it.
D. Is struggling with a conflict of dependence vs. independence

79. A young female client, age 16, is admitted to the psychiatric service with the
diagnosis of Anorexia Nervosa. She has lost 20 pounds in 6 weeks. She is very thin but
excessively concerned about being overweight. Her daily intake is 10 cups of coffee. The
most important initial nursing intervention would be to:
A. Explain the value of nutrition
B. Compliment her in her lovely figure
C. Try to establish a relationship of trust
D. Explore the reason why she does not eat

80. The nurse recognizes that Dementia of Alzheimer’s type is characterized by:
A. Aggressive acting out behavior
B. Periodic remissions and exacerbations
C. Hypoxia of selected areas of the brain
D. Areas of brain destruction called senile plaques

81. The approach that would be most helpful in meeting the needs of a client
hospitalized with diagnosis of Dementia of the Alzheimer’s type is:
A. Providing a nutritious diet in high carbohydrates and proteins
B. Simplifying the environment as much as possible while eliminating need
for choices
C. Providing an opportunity for many alternative choices in the daily schedule to
stimulate interest
D. Developing a consistent nursing plan with fixed time schedule to provide for
physical and emotional need.

82. When planning care for a client with Delirium, Dementia, or other cognitive
disorders, the nurse should appropriately:
A. Teach the client new social skills to encourage participation
B. Encourage the client to talk about the past and early experiences
C. Discuss current events to keep the client in contact with reality
D. Maintain the daily routine of living with which the client is familiar

83. The best approach in helping a very confused elderly is to provide an environment
with:
A. A specific routine
B. Group environment
C. A trusting relationship
D. Activities that are varied

84. The current trend in treatment of the elderly with Delirium, Dementia, or other
cognitive disorder is to:
A. Provide occupational therapy
B. Maintain them in the community
C. Medicate during stressful periods
D. Encourage the assumption of responsibilities
 85. When answering questions from the family of a client with Alzheimer’s Disease, the
nurse explains that this disease is:
A. A slow, relentless deterioration of the mind
B. A functional disorder that occurs in the later years
C. A disease that first emerges in the fourth decade of life occur
D. Easily diagnosed through laboratory and psychological tests

86. It is important for a team working with clients who have a diagnosis of Dementia
adopt a common approach of care because these clients need to:
A. Relate in a consistent manner to staff
B. Learn that the staff cannot be manipulated
C. Accept external controls that are fairly applied.
D. Have sameness and consistency on their environment

87. A young client is a narcotic dependent who had surgery to repair a laceration of the
heart caused by a bullet. The client is receiving Methadone Hydrochloride, which:
A. Allows symptom-free termination of narcotic addiction
B. Converts narcotic use from an illicit to legally controlled drug
C. Skin dryness, scratching under incisional dressing
D. Lethargy, refusal to participate a therapeutic exercise

88. A client undergoing alcohol detoxification asks if attendance at Alcoholics Anonymous

is required. The nurse’s best reply would be:
A. “You’ll find that you’ll need their support.”
B. “Do you have feelings about going to these meetings?”
C. “No, it is best to wait until you feel really need them.”
D. “Yes, because you will learn how to cope with your problem.”

89. Drug abuse is best defined as:

A. An excessive drug use inconsistent with acceptable medical practice.
B. A physiologic need for the drug
C. The clients emotional or motivational readiness
D. The qualitative level of the client’s physical state

90. A primary consideration for the nurse when caring for a client with a history of
substance abuse is to:
A. Set firm, consistent limits and not vary from them
B. Use the same type of communication pattern that the client uses
C. Avoiding upsetting the client by calling attention to the drug abuse problem
D. Realize that the client will probably need more pain medication than a non-abuser.

91. The major reason for treating severe psychiatric disorders with neuroleptics is to:
A. Decrease neurotic symptoms
B. Decrease psychotic symptoms
C. Prevent destructiveness of the client
D. Improve social skills and poor judgment
 92. Nursing interventions for a client diagnosed with a Schizoid Personality disorder
should be appropriately directed toward:
A. Helping the client enter into group recreational activities
B. Convincing the client that the hospital staff is trying to help
C. Helping the client learn to trust the staff through selected experiences
D. Arranging the hospital environment so that the client’s contact with other clients is
limited.

93. One evening, the nurse finds a client who has been experiencing persecutory
delusions and tried to get out of the door. The client states, “Please let me go. I trust you.
The Mafia are going to kill me tonight.” The nurse should respond:
A. “You are frightened. Come with me to your room and we can talk about
it.”
B. “Nobody here wants to harm you, you know that. I’ll come with you to your
room.”
C. “Come with me to you room. I’ll lock the door and no one will harm you.”
D. “Thank you for trusting me. Maybe you can trust me when I tell you no one can
kill you while you’re here.”

94. A delusional client refuses to eat because of a belief that the food is poisoned. One of
the most appropriate ways for the nurse to initially intervene is to:
A. Taste the food in the client’s presence
B. Simply state that the food is not poisoned
C. Suggest that the food be brought from home
D. Bizarre behaviors associated with drug use.

95. Prominent symptoms of Paranoid Schizophrenia lasting for at least one month are:
A. Delusions and hallucinations
B. Poverty of speech and apathy
C. Disturbed relationship and poor grooming
D. Bizarre behaviors associated with drug use

96. The activity that would be the least therapeutic for severely depressed clients would
be:
A. Specific, simple instructions to be followed
B. Simple, easily completed, short term projects
C. Monotonous, repetitive projects and activities
D. Allowing the clients to plan their own activities

97. When caring for an extremely depressed client, the staff should set specific goals
directed toward helping the client:
A. Set realistic goals
B. Develop trust in others
C. Express hostile feelings
D. Get involved in activities

98. When developing a nursing care plan for a depressed client, the staff should set
specific goals directed toward helping the client.
A. Allowing time for the client’s slowness when planning activities
B. Helping the client focus on family strengths and support systems
C. Encouraging the client to perform a menial tasks to meet the need for punishment
D. Repeating again and again that the staff views the client as worthwhile and
important
 99. A client is placed on suicide precautions. The most therapeutic way to provide these
precautions would be to:
A. Remove all sharp or cutting instruments
B. Not allow the client to leave his / her room
C. Give the client the opportunity to ventilate feelings
D. Assign a staff member to be with the client at all times

100. The nurse is assigned to care for a 39 year old, hyperactive, manic client who
exhibits flights of ideas. The client is not eating. The nurse recognizes this might be
because:
A. The client feels undeserving of the food
B. The client is too busy to take time to eat
C. The client wishes to avoid the dining room
D. The client believes that at this time, there is no need for food