NR 326 Psychiatric Mental Health Nursing Test Part 1

NR 326 Psychiatric Mental Health Nursing Test Part 1

Student Name

Chamberlain University

NR-326: Mental Health Nursing

Prof. Name

Date

Psychiatric Mental Health Nursing Test – Part 1

1. Your patient is very dependent and submissive. There are times that the patient is very clingy. This behavior reflects what type of personality disorder?
   a. Antisocial Personality
   b. Dependent Personality
   c. Manic Behavior
   d. Anxiety Disorder

2. The appropriate therapeutic distance between you and a psychiatric patient is?
   a. 0–18 inches
   b. 18–36 inches
   c. 12–25 feet
   d. 4 feet

3. Nurse Anna instructs a new nurse to use therapeutic communication skills with clients. Which technique exemplifies therapeutic communication?
   a. What are you thinking about?
   b. Why did you do that?
   c. You shouldn’t feel that way
   d. That’s not important

4. Mr. Juan has Alzheimer’s disease. The nurse’s intervention should focus on orienting the client. Which is most effective?
   a. Talk at length about past memories
   b. Provide simple and easily understood directions
   c. Ignore disorientation
   d. Encourage independent problem-solving

5. A therapy focusing on remotivation by directing attention outside oneself is called:
   a. Cognitive therapy
   b. Occupational therapy
   c. Psychodynamic therapy
   d. Recreational therapy

6. A 12-year-old male resembles the nurse’s younger brother. The nurse hugs him and cries with him. This is an example of:
   a. Counter-transference
   b. Transference
   c. Empathy
   d. Sympathy

7. A schizophrenic client is under your care. To reinforce functional behavior, the nurse should:
   a. Ignore inappropriate behavior
   b. Offer medication
   c. Compliment the client for cessation of acting out behaviors
   d. Use punitive measures

8. A client with a history of shoplifting is manipulative, aggressive, and impulsive. What personality disorder is most likely?
   a. Antisocial
   b. Dependent
   c. Borderline
   d. Obsessive-Compulsive

9. A client with PTSD returns complaining of fear, loss of control, and helplessness. The most appropriate nursing intervention is:
   a. Exploring the meaning of the traumatic event with the client
   b. Allowing the client time to heal
   c. Giving sleep medication to restore sleep-wake cycle
   d. Recommending a high-protein, low-fat diet

10. Jane is admitted with obsessive-compulsive symptoms. OCD is associated with:
    a. Physical signs with no physiologic cause
    b. Apprehension
    c. Inability to concentrate
    d. Repetitive thoughts and recurring, irresistible impulses

11. A client with OCD brushes his hair 15 times, causing skin irritation. Highest priority nursing intervention:
    a. Helping the client identify how ritual interferes with daily activities
    b. Exploring the purpose of the ritualistic behavior
    c. Setting consistent limits on the ritualistic behavior if it harms the client or others
    d. Using problem solving to manage anxiety

12. During alprazolam therapy, nurse should monitor for which dose-related reaction?
    a. Ataxia
    b. Hepatomegaly
    c. Urticaria
    d. Rash

13. A client with conversion disorder is unable to move his arms after witnessing trauma. Nurse should focus on:
    a. Helping the client identify and verbalize feelings about the incident
    b. Convincing the client arms aren’t paralyzed
    c. Developing rehabilitation strategies
    d. Talking about unrelated topics to avoid anxiety

14. A client with borderline personality disorder asks for extra medication. Nurse’s best response:
    a. “I’ll talk to the physician right away. They don’t give you enough medicine.”
    b. “I’ll have to discuss your request with the team. Can we talk about how you’re feeling right now?”
    c. “I don’t want to hear you say negative things about other nurses.”
    d. “You know you can’t have extra medication. Why do you keep asking?”

15. Angel is visibly anxious. Expected cardiovascular effect by sympathetic nervous system:
    a. Syncope
    b. Decreased blood pressure
    c. Increased heart rate
    d. Decreased pulse rate

16. A male client with Alzheimer’s disease is at risk for injury. Best preventive intervention:
    a. Provide detailed instructions
    b. Keep the client sedated
    c. Remove hazards from the environment
    d. Use restraints at all times

17. Rudy’s wife is worried about caring for her husband with Alzheimer’s. Most helpful nurse response:
    a. “You should start looking into nursing homes.”
    b. “What aspect of caring for your husband is causing you the greatest concern?”
    c. “You may benefit from a support group.”
    d. “Do you have children or friends to help?”

18. Most appropriate nursing action to diffuse impending violent behavior:
    a. Helping the client identify and express feelings of anxiety and anger
    b. Involving the client in a quiet activity
    c. Leaving the client alone
    d. Placing the client in seclusion

19. A client on imipramine 125 mg for 1 week reports feeling depressed. Best nurse response:
    a. “Imipramine may not be effective. Call your physician.”
    b. “It may take 2–3 weeks to reduce depression.”
    c. “The physician may need to increase the dosage.”
    d. “Don’t stop abruptly because of serious adverse effects.”

20. A male client with Alzheimer’s rambles incoherently. Best redirection activity:
    a. Fold towels and pillowcases
    b. Play cards with another client
    c. Participate in charades
    d. Perform aerobic exercise

21. Nursing preparations for ECT resemble those used for:
    a. Physical therapy
    b. Neurologic examination
    c. General anesthesia
    d. Cardiac stress testing

22. Activated charcoal inactivates which drug if given concomitantly?
    a. Warfarin
    b. Ipecac syrup
    c. Simethicone
    d. Famotidine

23. Most important point to stress when teaching ECT:
    a. An anesthesiologist will administer ECT
    b. ECT can cure depression
    c. ECT will induce a seizure
    d. The client will remember the shock but not the pain

24. Julius, an adolescent, becomes withdrawn, irritable, and gives away possessions. He is at risk for:
    a. Suicide
    b. Anorexia nervosa
    c. School phobia
    d. Psychotic break

25. Nurse preparing a client for ECT should ensure:
    a. The client sees family immediately before procedure
    b. Brain scan immediately after procedure
    c. Thorough medical evaluation
    d. Received lithium carbonate

Psychiatric Nursing Practice Test (with Answers)

1. Prescribe which medication for this client?
   a. Chlorpromazine (Thorazine)
   b. Imipramine (Tofranil)
   c. Lithium carbonate (Lithane)
   d. Fluphenazine decanoate (Prolixin Decanoate)

2. Which medication would reverse a dystonic reaction?
   a. Prochlorperazine (Compazine)
   b. Diphenhydramine (Benadryl)
   c. Haloperidol (Haldol)
   d. Midazolam (Versed)

3. How often must the nurse check a client in full leather restraints?
   a. Once per hour
   b. Once per shift
   c. Every 10 to 15 minutes
   d. Every 2 hours

4. Most therapeutic response to a client involved in a car accident while intoxicated:
   a. “Why didn’t you get someone else to drive you?”
   b. “Tell me how you feel about the accident.”
   c. “You should know better than to drink and drive.”
   d. “I recommend that you attend an Alcoholics Anonymous meeting.”

5. Early alcohol withdrawal symptoms are expected to:
   a. Begin after 7 days
   b. Not occur at all
   c. Begin anytime within the next 1 to 2 days
   d. Begin within 2 to 7 days

6. Highest priority in post-ECT care:
   a. Observe for confusion
   b. Monitor respiratory status
   c. Reorient to time, place, and person
   d. Document the client’s response

7. Common medical condition in clients with bulimia nervosa:
   a. Allergies
   b. Cancer
   c. Diabetes mellitus
   d. Hepatitis A

8. Personality disorder characterized by lack of remorse and abusive behavior:
   a. Narcissistic
   b. Paranoid
   c. Histrionic
   d. Antisocial

9. Pill rolling tremors and muscle rigidity on Haldol indicate:
   a. Tardive dyskinesia
   b. Pseudoparkinsonism
   c. Akinesia
   d. Dystonia

10. Only effective treatment for alcoholism:
    a. Psychotherapy
    b. Total abstinence
    c. Alcoholics Anonymous (AA)
    d. Aversion therapy

11. Least desirable outcome for a male client with schizophrenia:
    a. The client spends more time by himself
    b. The client doesn’t engage in delusional thinking
    c. The client doesn’t harm himself or others
    d. The client demonstrates ability to meet self-care needs

12. “Pray for me” and giving possessions indicates:
    a. Anxiety
    b. Suicidal ideation
    c. Major depression
    d. Hopelessness

13. Therapeutic response to sexually inappropriate comment:
    a. “You’re attractive but I’m not interested.”
    b. “You wouldn’t be the first I have seen naked.”
    c. “I will report you to the guard.”
    d. “I only need access to your arm. Putting up your sleeve is fine.”

14. Earliest stage of grief in burn patient:
    a. Outburst of anger
    b. Questions about job retraining
    c. Statements that “it’s a dream” and “it didn’t really happen”
    d. Wanting to be left alone

15. Anxiety level indicated by extreme panic behaviors:
    a. Mild
    b. Moderate
    c. Panic
    d. Severe

16. Most appropriate intervention during panic:
    a. Discuss coping mechanisms
    b. Encourage expression of feelings
    c. Apply soft restraints
    d. Stay with patient and provide assurance and safety

17. Observations supporting borderline personality disorder:
    a. Flat affect, social withdrawal
    b. Suspiciousness, hypervigilance
    c. Lack of self-esteem, strong dependency needs, impulsive behavior
    d. Insensitivity, sexual acting out, violence

18. Time for chlorpromazine to eliminate delusions and hallucinations:
    a. Several minutes
    b. Several hours
    c. Several days
    d. Several weeks

19. Nursing role in addressing guilt of smoking during pregnancy:
    a. Empathy
    b. Guidance
    c. Role modeling
    d. Teaching

20. Appropriate response to paranoid delusions about poisoning:
    a. “It’s against the nursing code of ethics.”
    b. “I’m a nurse, and you’re a patient in the hospital. I’m not going to harm you.”
    c. “I’m not poisoning you. How could I steal your soul?”
    d. “I sense anger. Are you feeling angry today?”

21. Condition necessary for positive self-esteem:
    a. Consistent limits
    b. Critical environment
    c. Inconsistent boundaries
    d. Physical discipline

22. Phase of alcoholism with loss of control:
    a. Prealcoholic phase
    b. Early alcoholic phase
    c. Crucial phase
    d. Chronic phase

23. Best recommendation for daily suicidal thoughts:
    a. No-suicide contract
    b. Weekly outpatient therapy
    c. Second psychiatric opinion
    d. Intensive inpatient treatment

24. Best response to self-inflicted lacerations in borderline personality disorder:
    a. “You’re on suicide precautions.”
    b. “I’m going to tell your physician.”
    c. “Tell me what instrument you used.”
    d. “The team needs to know… let’s talk about it first.”

25. Adverse effect of Flumazenil (Romazicon):
    a. Seizures
    b. Shivering
    c. Anxiety
    d. Chest pain]

NR 326 Psychiatric Mental Health Nursing Test Part 1

Neurotransmitters, Symptoms, and Nursing Interventions

1. Primary neurotransmitter associated with schizophrenia:
   a. Serotonin
   b. Norepinephrine
   c. Dopamine
   d. Acetylcholine

2. Positive symptom of schizophrenia:
   a. Flat affect
   b. Avolition
   c. Delusions

3. Negative symptom of schizophrenia:
   a. Hallucinations
   b. Delusions
   c. Affective flattening
   d. Disorganized speech

4. Most critical suicide assessment factor:
   a. Family history
   b. Existence of a suicide plan
   c. Substance abuse
   d. Previous hospitalization

5. Underlying feeling in rapists:
   a. Hostility toward women
   b. Desire for power and control
   c. Lack of sexual satisfaction
   d. Need for intimacy

6. Sexual abuse ambivalence due to:
   a. Identification with abuser
   b. Powerlessness and needs met by abuser
   c. Seeks approval
   d. Repressed anger

7. Anger directed at staff after abortion is:
   a. Displacement
   b. Projection
   c. Reaction formation
   d. Denial

8. Most important in coping with crisis:
   a. Personal strength and supportive individuals
   b. Professional counseling
   c. Financial resources
   d. Religious beliefs

9. Goal of crisis intervention groups:
   a. Long-term therapy
   b. Explore unconscious conflict
   c. Medication management
   d. Reestablish psychological equilibrium through problem solving

10. Nursing observation indicating client comfort:
    a. Avoids eye contact
    b. Changes subject frequently
    c. Verbalizes problems motivating behavior
    d. Remains withdrawn

11. Most effective therapy for phobias:
    a. Psychoanalysis
    b. Cognitive therapy
    c. Behavior modification using desensitization
    d. Medication therapy

12. Key anxiety indicator:
    a. Increased appetite
    b. Narrowed perceptual field
    c. Increased libido
    d. Clear concentration

13. Symptom of autism:
    a. Excessive attachment
    b. Strong social interest
    c. Heightened awareness of environment
    d. Lack of responsiveness to others

14. Delusion type believing the body is diseased:
    a. Delusions of grandeur
    b. Somatic delusions
    c. Persecutory delusions
    d. Nihilistic delusions

15. Borderline personality disorder assessment finding:
    a. Coldness, detachment
    b. Somatic symptoms
    c. Inability to parent
    d. Unpredictable behavior, intense interpersonal relationships

16. PROPRANOLOL (Inderal) is used to manage:
    a. Antipsychotic-induced akathisia and anxiety
    b. OCD rituals
    c. Schizophrenic delusions
    d. Bipolar mania

17. Medication controlling extrapyramidal effects:
    a. Clorazepate
    b. Amantadine (Symmetrel)
    c. Doxepin
    d. Perphenazine

18. MAOI teaching includes:
    a. Don’t take aspirin or NSAIDs
    b. Weekly blood level screening
    c. Avoid strenuous activity
    d. Don’t take medications without consulting physician

19. Acute panic attack may present with:
    a. Heightened concentration
    b. Decreased perceptual field
    c. Decreased cardiac rate
    d. Decreased respiratory rate

20. Initial interventions for acute anxiety exclude:
    a. Touching the client
    b. Approaching calmly
    c. Encouraging verbalization
    d. Providing safe, quiet space

21. Common physiological response to stress:
    a. Uticaria
    b. Vertigo
    c. Sedation
    d. Diarrhea

22. Parasympathetic effect in anxious female client:
    a. Muscle tension
    b. Hyperactive bowel sounds
    c. Decreased urine output
    d. Constipation

23. Effective drugs for OCD:
    a. Divalproex & Lithium
    b. Chlordiazepoxide & Diazepam
    c. Fluvoxamine & Clomipramine
    d. Benztropine & Diphenhydramine

24. Classic phobia signs:
    a. Severe anxiety and fear
    b. Withdrawal, reality distortion
    c. Depression and weight loss
    d. Insomnia, poor concentration

25. Appropriate action to diffuse impending violence:
    a. Place in seclusion
    b. Leave alone
    c. Quiet activity to divert attention
    d. Help client identify and express anxiety/anger

26. Best question to assess pain in Alzheimer’s:
    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 prep for ECT resembles:
    a. General anesthesia
    b. Cardiac stress testing
    c. Neurologic examination
    d. Physical therapy

28. MAOI client should avoid tyramine in:
    a. Figs & cream cheese
    b. Fruits & yellow vegetables
    c. Aged cheese & Chianti wine
    d. Green leafy vegetables

29. Post-ECT expectations:
    a. Permanent short-term memory loss
    b. Permanent long-term memory loss
    c. Transitory short-term, permanent long-term loss
    d. Transitory short and long term memory loss and confusion

30. Common adverse effect of lithium:
    a. Polyuria
    b. Seizures
    c. Constipation
    d. Sexual dysfunction

31. Signs of antianxiety overdose:
    a. Suspiciousness, dilated pupils
    b. Agitation, hyperactivity
    c. Combativeness, sweating, confusion
    d. Emotional lability, euphoria, impaired memory

32. Tricyclic antidepressant discharge instruction:
    a. Restrict fluids & sodium
    b. Don’t consume alcohol
    c. Discontinue if dry mouth/blurred vision
    d. Restrict fluid & sodium

33. Teaching for women on antipsychotics:
    a. Dysmenorrhea increases
    b. Incomplete libido
    c. Continue contraception during amenorrhea
    d. Amenorrhea irreversible

34. Community health nurse first assessment for medication refusal:
    a. Income & living arrangements
    b. Family & support involvement
    c. Reason for admission
    d. Reason for refusal

35. Therapeutic effect of typical antipsychotics is due to:
    a. Decreased dopamine level
    b. Increased acetylcholine
    c. Serotonin stabilization
    d. GABA stimulation

36. Tricyclic antidepressants used with caution in elderly due to:
    a. CNS effects
    b. Cardiovascular effects
    c. GI effects
    d. Serotonin syndrome

37. Psychiatric care addressing depressive beliefs uses:
    a. Behavioral framework
    b. Cognitive framework
    c. Interpersonal framework
    d. Psychodynamic framework

38. Psychotic behavior unconsciously motivated arises from:
    a. Abnormal thinking
    b. Altered neurotransmitters
    c. Internal needs
    d. Response to stimuli

39. Cognitive theory interpretation of “I’m a failure”:
    a. Learned behavior
    b. Punitive superego & low self-esteem
    c. Faulty thought processes governing behavior
    d. Evidence of workplace conflict

40. True statement about anxiety:
    a. Usually pathological
    b. Directly observable
    c. Usually harmful
    d. Response to a threat

41. Systematic desensitization in phobia:
    a. Helps execute feared actions
    b. Develop insight into fears
    c. Substitute one fear for another
    d. Helps decrease anxiety

42. Successful outcome for antisocial personality disorder:
    a. Exhibits charming behavior
    b. Decreased impulsive behaviors
    c. Statements of self-satisfaction
    d. No remorse for behaviors

43. Teaching autoimmune disorder client in alternative medicine setting:
    a. Pathophysiology
    b. Nutrition
    c. Side effects
    d. Stress management techniques

44. Most distinguishing feature of antisocial personality disorder:
    a. Attention to detail
    b. Bizarre mannerisms
    c. Submissive & dependent
    d. Disregard for social & legal norms

45. Nursing diagnosis for anorexia nervosa with guilt:
    a. Anxiety
    b. Disturbed body image
    c. Defensive coping
    d. Powerlessness

46. Successful family therapy in anorexia nervosa:
    a. Parents reinforce decisions
    b. Parents verbalize expectations
    c. Client verbalizes family meals enjoyable
    d. Client shares low self-esteem

47. Cognitive approach to client with dysthymia reporting hopelessness:
    a. Agree with feelings
    b. Challenge accuracy of belief
    c. Deny hopelessness
    d. Present cheerful attitude

48. Activity to help major depression client express self:
    a. Art therapy in small group
    b. Basketball game
    c. Reading self-help book
    d. Watching movie

49. Day treatment program for chronic schizophrenia client helps with:
    a. Managing hallucinations
    b. Medication teaching
    c. Social skills training
    d. Vocational training

50. Most appropriate activity for severely withdrawn client:
    a. Art activity with staff member
    b. Board game with small group
    c. Team sport
    d. Watching TV