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Situation: A nurse may encounter children with mental disorders. Her knowledge of these various disorders is vital. 16. When planning school interventions for a child with a diagnosis of attention deficit hyperactivity disorder, a guide to remember is to: A. provide as much structure as possible for the child B. ignore the child’s overactivity. C. encourage the child to engage in any play activity to dissipate energy D. remove the child from the classroom when disruptive behavior occurs 17. The child with conduct disorder will likely demonstrate: A. Easy distractibility to external stimuli. B. Ritualistic behaviors C. Preference for inanimate objects. D. Serious violations of age related norms. 18. Ritalin is the drug of choice for chidren with ADHD. The side effects of the following may be noted: A. increased attention span and concentration B. increase in appetite C. sleepiness and lethargy D. bradycardia and diarrhea 19. School phobia is usually treated by: A. Returning the child to the school immediately with family support. B. Calmly explaining why attendance in school is necessary C. Allowing the child to enter the school before the other children D. Allowing the parent to accompany the child in the classroom 20. A 10 year old child has very limited vocabulary and interaction skills. She has an I.Q. of 45. She is diagnosed to have Mental retardation of this classification: A. Profound B. Mild C. Moderate D. Severe 21. The nurse teaches the parents of a mentally retarded child regarding her care. The following guidelines may be taught except: A. overprotection of the child B. patience, routine and repetition C. assisting the parents set realistic goals D. giving reasonable compliments 22. The parents express apprehensions on their ability to care for their maladaptive child. The nurse identifies what nursing diagnosis: A. Hopelessness B. altered parenting role C. altered family process D. ineffective coping 23. A 5 year old boy is diagnosed to have autistic disorder. Which of the following manifestations may be noted in a client with autistic disorder? A. argumentativeness, disobedience, angry outburst B. intolerance to change, disturbed relatedness, stereotypes C. distractibility, impulsiveness and overactivity D. aggression, truancy, stealing, lying 24. The therapeutic approach in the care of an autistic child include the following EXCEPT: A. Engage in diversionary activities when acting -out B. Provide an atmosphere of acceptance C. Provide safety measures D. Rearrange the environment to activate the child 25. According to Piaget a 5 year old is in what stage of development: A. Sensory motor stage B. Concrete operations C. Pre-operational D. Formal operation Situation : The nurse assigned in the detoxification unit attends to various patients with substance-related disorders. 26. A 45 years old male revealed that he experienced a marked increase in his intake of alcohol to achieve the desired effect This indicates: A. Withdrawal B. Tolerance C. Intoxication D. psychological dependence 27. The client admitted for alcohol detoxification develops increased tremors, irritability, hypertension and fever. The nurse should be alert for impending: A. delirium tremens B. Korsakoff’s syndrome C. esophageal varices D. Wernicke’s syndrome 28. The care for the client places priority to which of the following: A. Monitoring his vital signs every hour B. Providing a quiet, dim room C. Encouraging adequate fluids and nutritious foods D. Administering Librium as ordered 29. Another client is brought to the emergency room by friends who state that he took something an hour ago. He is actively hallucinating, agitated, with irritated nasal septum. A. Heroin B. Cocaine C. LSD D. marijuana 30. A client is admitted with needle tracts on his arm, stuporous and with pin point pupil will likely be managed with: A. Naltrexone (Revia) B. Narcan (Naloxone) C. Disulfiram (Antabuse) D. Methadone (Dolophine) Situation: An old woman was brought for evaluation due to the hospital for evaluation due to increasing forgetfulness and limitations in daily function. 31. The daughter revealed that the client used her toothbrush to comb her hair. She is manifesting: A. Apraxia B. Aphasia C. Agnosia D. amnesia 32. She tearfully tells the nurse “I can’t take it when she accuses me of stealing her things.” Which response by the nurse will be most therapeutic? A. ”Don’t take it personally. Your mother does not mean it.” B. “Have you tried discussing this with your mother?” C. “This must be difficult for you and your mother.” D. “Next time ask your mother where her things were last seen.” 33. The primary nursing intervention in working with a client with moderate stage dementia is ensuring that the client: A. receives adequate nutrition and hydration B. will reminisce to decrease isolation C. remains in a safe and secure environment D. independently performs self care 34. She says to the nurse who offers her breakfast, “Oh no, I will wait for my husband. We will eat together” The therapeutic response by the nurse is: A. “Your husband is dead. Let me serve you your breakfast.” B. “I’ve told you several times that he is dead. It’s time to eat.” C. “You’re going to have to wait a long time.” D. “What made you say that your husband is alive? 35. Dementia unlike delirium is characterized by: A. slurred speech B. insidious onset C. clouding of consciousness D. sensory perceptual change Situation: A 17 year old gymnast is admitted to the hospital due to weight loss and dehydration secondary to starvation. 36. Which of the following nursing diagnoses will be given priority for the client? A. altered self-image 2 | Page
B. fluid volume deficit C. altered nutrition less than body requirements D. altered family process 37. What is the best intervention to teach the client when she feels the need to starve? A. Allow her to starve to relieve her anxiety B. Do a short term exercise until the urge passes C. Approach the nurse and talk out her feelings D. Call her mother on the phone and tell her how she feels 38. The client with anorexia nervosa is improving if:\ A. She eats meals in the dining room. B. Weight gain C. She attends ward activities. D. She has a more realistic self concept. 39. The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is that bulimic individuals A. have episodic binge eating and purging B. have repeated attempts to stabilize their weight C. have peculiar food handling patterns D. have threatened self-esteem 40. A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating habits. The goal for this problem is: A. Patient will learn problem solving skills B. Patient will have decreased symptoms of anxiety. C. Patient will perform self care activities daily. D. Patient will verbalize how to set limits on others. 41. In the management of bulimic patients, the following nursing interventions will promote a therapeutic relationship EXCEPT: A. Establish an atmosphere of trust B. Discuss their eating behavior. C. Help patients identify feelings associated with binge-purge behavior D. Teach patient about bulimia nervosa Situation: A 35 year old male has intense fear of riding an elevator. He claims “ As if I will die inside.” This has affected his studies. 42. The client is suffering from: A. A agoraphobia B. social phobia C. Claustrophobia D. xenophobia 43. Initial intervention for the client should be to: A. Encourage to verbalize his fears as much as he wants. B. Assist him to find meaning to his feelings in relation to his past. C. Establish trust through a consistent approach. D. Accept her fears without criticizing. 44. The nurse develops a countertransference reaction. This is evidenced by: A. Revealing personal information to the client B. Focusing on the feelings of the client. C. Confronting the client about discrepancies in verbal or non-verbal behavior D. The client feels angry towards the nurse who resembles his mother. 45. Which is the desired outcome in conducting desensitization: A. The client verbalize his fears about the situation B. The client will voluntarily attend group therapy in the social hall. C. The client will socialize with others willingly D. The client will be able to overcome his disabling fear. 46. Which of the following should be included in the health teachings among clients receiving Valium: A. Avoid taking CNS depressants like alcohol. B. There are no restrictions in activities. C. Limit fluid intake. D. Any beverage like coffee may be taken Situation: A 20 year old college student is admitted to the medical ward because of sudden onset of paralysis of both legs. Extensive examination revealed no physical basis for the complaint. 47. The nurse plans intervention based on which correct statement about conversion disorder? A. The symptoms are conscious effort to control anxiety B. The client will experience high level of anxiety in response to the paralysis. C. The conversion symptom has symbolic meaning to the client D. A confrontational approach will be beneficial for the client. 48. Nina reveals that the boyfriend has been pressuring her to engage in premarital sex. The most therapeutic response by the nurse is: A. “I can refer you to a spiritual counselor if you like.” B. “You shouldn’t allow anyone to pressure you into sex.” C. “It sounds like this problem is related to your paralysis.” D. “How do you feel about being pressured into sex by your boyfriend?” 49. Malingering is different from somatoform disorder because the former: A. Has evidence of an organic basis. B. It is a deliberate effort to handle upsetting events C. Gratification from the environment are obtained. D. Stress is expressed through physical symptoms. 50. Unlike psychophysiologic disorder Linda may be best managed with: A. medical regimen B. milieu therapy C. stress management techniques D. psychotherapy 51. Which is the best indicator of success in the long term management of the client? A. His symptoms are replaced by indifference to his feelings B. He participates in diversionary activities. C. He learns to verbalize his feelings and concerns D. He states that his behavior is irrational. Situation: A young woman is brought to the emergency room appearing depressed. The nurse learned that her child died a year ago due to an accident. 52. The initial nursing diagnosis is dysfunctional grieving. The statement of the woman that supports this diagnosis is: A. “I feel envious of mothers who have toddlers” B. “I haven’t been able to open the door and go into my baby’s room “ C. “I watch other toddlers and think about their play activities and I cry.” D. “I often find myself thinking of how I could have prevented the death. 53. The client said “I can’t even take care of my baby. I’m good for nothing.” Which is the appropriate nursing diagnosis? A. Ineffective individual coping related to loss. B. Impaired verbal communication related to inadequate social skills. C. Low esteem related to failure in role performance D. Impaired social interaction related to repressed anger. 54. The following medications will likely be prescribed for the client EXCEPT: A. Prozac B. Tofranil C. Parnate D. Zyprexa 55. Which is the highest priority in the post ECT care? A. Observe for confusion B. Monitor respiratory status C. Reorient to time, place and person D. Document the client’s response to the treatment Situation: A 27 year old writer is admitted for the second time accompanied by his wife. He is demanding, arrogant talked fast and hyperactive. 56. Initially the nurse should plan this for a manic client: A. set realistic limits to the client’s behavior B.repeat verbal instructions as often as needed 3 | Page
C. allow the client to get out feelings to relieve tension D. assign a staff to be with the client at all times to help maintain control 57. An activity appropriate for the client is: A. table tennis B. Painting C. Chess D. cleaning 58. The client is arrogant and manipulative. In ensuring a therapeutic milieu, the nurse does one of the following: A. Agree on a consistent approach among the staff assigned to the client. B. Suggest that the client take a leading role in the social activities C. Provide the client with extra time for one on one sessions D. Allow the client to negotiate the plan of care 59. The nurse exemplifies awareness of the rights of a client whose anger is escalating by: A. Taking a directive role in verbalizing feelings B. Using an authoritarian, confrontational approach C. Putting the client in a seclusion room D. Applying mechanical restraints 60. A client on Lithium has diarrhea and vomiting. What should the nurse do first: A. Recognize this as a drug interaction B. Give the client Cogentin C. Reassure the client that these are common side effects of lithium therapy D. Hold the next dose and obtain an order for a stat serum lithium level Situation: A widow age 28, whose husband died one year ago due to AIDS, has just been told that she has AIDS. 61. Pamela says to the nurse, “Why me? How could God do this to me?” This reaction is one of: A. Depression B. Denial C. Anger D. bargaining 62. The nurse’s therapeutic response is: A. “I will refer you to a clergy who can help you understand what is happening to you.” B. “ It isn’t fair that an innocent like you will suffer from AIDS.” C. “That is a negative attitude.” D. ”It must really be frustrating for you. How can I best help you?” 63. One morning the nurse sees the client in a depressed mood. The nurse asks her “What are you thinking about?” This communication technique is: A. Focusing B. Validating C. Reflecting D. giving broad opening 64. The client says to the nurse ” Pray for me” and entrusts her wedding ring to the nurse. The nurse knows that this may signal which of the following: A. Anxiety B. suicidal ideation C. Major depression D. Hopelessness 65. Which of the following interventions should be prioritized in the care of the suicidal client? A. Remove all potentially harmful items from the client’s room. B. Allow the client to express feelings of hopelessness. C. Note the client’s capabilities to increase self esteem. D. Set a “no suicide” contract with the client. Situation: A 14 year old male was admitted to a medical ward due to bronchial asthma after learning that his mother was leaving soon for U.K. to work as nurse. 66. The client has which of the following developmental focus: A. Establishing relationship with the opposite sex and career planning. B. Parental and societal responsibilities. C. Establishing ones sense of competence in school. D. Developing initial commitments and collaboration in work 67. The personality type of Ryan is: A. Conforming B. Dependent C. Perfectionist D. masochistic 68. The nurse ensures a therapeutic environment for the client. Which of the following best describes a therapeutic milieu? A. A therapy that rewards adaptive behavior B. A cognitive approach to change behavior C. A living, learning or working environment. D. A permissive and congenial environment 69. Included as priority of care for the client will be: A. Encourage verbalization of concerns instead of demonstrating them through the body B. Divert attention to ward activities C. Place in semi-fowlers position and render O2 inhalation as ordered D. Help her recognize that her physical condition has an emotional component 70. The client is concerned about his coming discharge, manifested by being unusually sad. Which is the most therapeutic approach by the nurse? A. “You are much better than when you were admitted so there’s no reason to worry.” B. “What would you like to do now that you’re about to go home?” C. “You seem to have concerns about going home.” D. “Aren’t you glad that you’re going home soon?” Situation: The nurse may encounter clients with concerns on sexuality. 71. The most basic factor in the intervention with clients in the area of sexuality is: A. Knowledge about sexuality. B. Experience in dealing with clients with sexual problems C. Comfort with one’s sexuality D. Ability to communicate effectively 72. Which of the following statements is true for gender identity disorder? A. It is the sexual pleasure derived from inanimate objects. B. It is the pleasure derived from being humiliated and made to suffer C. It is the pleasure of shocking the victim with exposure of the genitalia D. It is the desire to live or involve in reactions of the opposite sex 73. The sexual response cycle in which the sexual interest continues to build: A. Sexual Desire B. Sexual arousal C. Orgasm D. Resolution 74. The inability to maintain the physiologic requirements in sexual intercourse is: A. Sexual Desire Disorder B. Sexual Arousal Disorder C. Orgasm Disorder D. Sexual Pain disorder 75. The nurse asks a client to roll up his sleeves so she can take his blood pressure. The client replies “If you want I can go naked for you.” The most therapeutic response by the nurse is: A. “You’re attractive but I’m not interested.” B. “You wouldn’t be the first that I will see naked.” C. “I will report you to the guard if you don’t control yourself.” D. “I only need access to your arm. Putting up your sleeve is fine.” 4 | Page

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