Title 3. FC PSYCH (Mr. Fajardo) - SC ✅

2 | Page C. Client’s alcohol and CNS depressant use D. Client’s social support network Situation 4 - Bulimia Nervosa A 19-year-old college student was admitted to the psychiatric unit after her parents became concerned about frequent vomiting episodes following large meals. She admitted to binge eating whenever she feels upset, followed by guilt and self-induced vomiting. On admission, her potassium level was noted to be low, and she appeared anxious about her body image. The nurse is assigned to her care and begins planning interventions. 12. The nurse’s initial goal for a client with bulimia nervosa is to: A. Control eating impulses B. Identify anxiety-causing situations C. Eat only three meals per day D. Avoid vomiting after eating 13. Bulimia nervosa is BEST defined as a/an: A. Disorder of unknown origin associated with starving oneself B. Pathological disorder of binge eating followed by vomiting C. Phobic disorder of fear of obesity D. Eating disorder associated only with vomiting 14. The client is learning self-monitoring as part of therapy. Which nursing intervention is MOST beneficial? A. Assist in making daily meal plans for 1 week B. Encourage ignoring impulses related to food C. Teach nutrition content and calories of food D. Ask client to journal feelings and experiences related to food 15. The nurse evaluates progress. Which behavior BEST indicates positive progress? A. Identifies calorie content of each meal B. Spends time resting in room after meals C. Identifies healthy coping strategies for anxiety D. Verbalizes knowledge of unhealthy eating patterns 16. Which of the following conditions is the MOST life- threatening complication in bulimia? A. Hypokalemia leading to cardiac arrhythmias and arrest B. Metabolic acidosis and renal failure C. Hyponatremia and circulatory collapse D. Hypernatremia and congestive heart failure Situation 5 - Anorexia Nervosa A 16-year-old high school student was admitted after her parents reported progressive weight loss, refusal to eat, and excessive exercise. On admission, she is 12% below ideal body weight, insists she is still “fat,” and cuts food into tiny pieces without eating. She avoids group meals and spends long periods jogging in place inside her room. 17. Which client statement requires the nurse’s immediate intervention? A. “I always check my weight every morning.” B. “I feel anxious if I don’t exercise at least 2 hours daily.” C. “I eat only vegetables and drink water during meals.” D. “I know I am underweight, but I still feel fat.” 18. The nurse must assign the most appropriate roommate for this client. Who should the nurse choose? A. Client with pneumonia B. Client who is quiet and undergoing diagnostic tests C. Client who thrives on controlling others D. Client who could benefit from assistance during meals 19. Which intervention BEST supports the principles of cognitive-behavioral therapy (CBT) in anorexia nervosa? A. Exploring family conflicts about food B. Examining the client’s distorted thoughts about body image C. Encouraging avoidance of mirrors D. Providing group meals with strict monitoring 20. Which behavior reflects the anxiety management style often seen in anorexia nervosa? A. Observing rigid diet and exercise rules B. Engaging in impulsive social behaviors C. Using humor and distraction during stress D. Seeking constant approval from peers 21. The client is started on fluoxetine (Prozac). Which is the most important nursing consideration? A. Fluoxetine can cause appetite suppression and weight loss B. Clients often object to the side effect of weight gain C. Fluoxetine makes patients giddy and silly D. Clients with anorexia gain no benefit from SSRIs SITUATION 6: Personality Disorders 22. The nurse develops a care plan for a client with schizoid personality disorder. Which primary outcome should be prioritized? A. Recognizes personal limits B. Validates ideas before acting C. Copes with and controls emotions D. Functions effectively in the community 23. A client with borderline PD tells the nurse: “You are the only one who cares. The night shift nurses are all useless.” The nurse recognizes this as: A. Splitting B. Projection C. Rationalization D. Denial 24. Which nursing response is MOST therapeutic in the above situation? A. “Thank you for trusting me more than the night shift staff.” B. “All nurses care about you; you should not say bad things.” C. “Let’s focus on your feelings when you think others don’t care.” D. “Don’t compare the staff; everyone is trying their best.” 25. A narcissistic client says: “I don’t need therapy; I’m obviously smarter than you.” Which is most therapeutic? A. “If you’re so intelligent, why are you here?” B. “You sound confident; let’s talk about your treatment goals.” C. “That’s rude; you should apologize.” D. “You shouldn’t talk that way.” 26. Dependent client says: “Can you choose my clothes? I can’t decide.” Best nursing intervention? A. Choose clothes for client B. Encourage choosing between two outfits C. Reinforce proper wearing of hospital clothes to the client. D. Tell client to ask family 27. A histrionic client dresses provocatively and seductively, interrupting the group to gain attention. Best intervention? A. Ignore client outfit B. Redirect focus to other group members C. Ask client to explain why they want attention D. Praise client’s outfit SITUATION 7: Dissociative Disorders A 27-year-old woman is brought to the ER by barangay tanods after being found wandering in a neighboring town. She is alert but cannot state her full name, address, or where she works. VS are stable; neuro exam and head CT are unremarkable. She becomes tearful when asked about recent stressors but says, “I… I just can’t remember.” Two days later on the ward, she introduces herself with a different name, speaks with a distinct accent, and refers to the nurse as if meeting her for the first time. At other times she reports, “I feel like I’m floating outside my body and everything looks unreal—like a movie.” The team asks you to prioritize nursing care. 28. The client’s inability to recall important personal information (e.g., name and address) after a stressful period, with normal neurological findings, is most consistent with which disorder? A. Dissociative amnesia B. Dissociative fugue C. Dissociative identity disorder D. Depersonalization/derealization disorder 29. During another interaction, the client reports: “Sometimes I feel like I’m floating above my body and the world seems unreal—like I’m watching myself from outside.” This symptom profile is MOST consistent with: Dissociative amnesia

4 | Page D. Locked isolation room 47. Which nurse statement is MOST therapeutic when the client says: “I can’t take it anymore. I want to end everything.” A. “Don’t say that. You have so much to live for.” B. “Things will get better, you just need to wait.” C. “You must feel very overwhelmed. Can you tell me more?” D. “Why would you think about doing that to your family?” 48. Which intervention should be included in the care plan for a suicidal client? A. Assign 1:1 observation and remove sharp objects B. Place the client in seclusion until suicidal thoughts stop C. Encourage the client to promise never to attempt suicide again D. Allow the client privacy to maintain dignity SITUATION 11: Electroconvulsive Therapy (ECT) A 48-year-old woman with severe depression has not responded to antidepressant medications and is scheduled for a course of electroconvulsive therapy (ECT). She is anxious about the procedure and asks many questions. During treatment, the nurse assists the psychiatrist and anesthesiologist, and afterward provides recovery care. 49. Which instruction is MOST appropriate for the nurse to give before the client undergoes ECT? A. “You will be fully awake during the procedure.” B. “You should remain NPO for 6–8 hours before treatment.” C. “You can drive yourself home immediately after the procedure.” D. “ECT will permanently cure your depression.” 50. After ECT, the client is drowsy and repeatedly asks, “What happened to me?” The nurse’s BEST response is: A. “You just had ECT. Sometimes it causes temporary memory loss.” B. “Don’t worry, you’ll remember everything soon.” C. “Why do you keep asking? I already told you.” D. “It’s confidential; I cannot tell you.” 51. During the recovery phase immediately after ECT, which nursing intervention is the PRIORITY? A. Monitor airway and breathing until client is fully awake B. Provide orientation materials such as clocks and calendars C. Document seizure duration and client’s response D. Offer emotional support to the family 52. The nurse prepares medications prior to ECT. Which drug is MOST commonly administered immediately before the procedure to prevent musculoskeletal injury during the induced seizure? A. Succinylcholine (Anectine) B. Atropine sulfate C. Diazepam (Valium) D. Haloperidol (Haldol) SITUATION 12: Psychiatric Therapies A psychiatric nurse is assigned to clients undergoing various forms of therapy. One client is newly diagnosed with major depression, another with borderline personality disorder, while a group of adolescents with substance use disorder are admitted for rehabilitation. The nurse incorporates different theoretical frameworks to guide care. 53. A client with major depression is started on cognitive-behavioral therapy (CBT). The nurse knows the primary goal of CBT is to: A. Explore unconscious conflicts from childhood B. Restructure negative thought patterns C. Encourage free association and dream analysis D. Enhance social interaction through peer support 54. A client with borderline personality disorder is referred to dialectical behavior therapy (DBT). The nurse explains DBT focuses on: A. Teaching relaxation techniques only B. Mindfulness, distress tolerance, and emotional regulation C. Interpreting dreams and unconscious wishes D. Isolating the client from stressful situations 55. A group of clients in rehab for substance use disorder are assigned to group therapy. Which outcome is MOST expected? A. Exploring unconscious motivations for drug use B. Learning from peers’ experiences and gaining mutual support C. Mastering personal independence without social contact D. Relying on the leader for all problem solving 56. During psychodynamic therapy, a client begins to transfer feelings toward the therapist that were originally directed toward a parent. The nurse identifies this as: A. Countertransference B. Transference C. Projection D. Reaction formation 57. A 25-year-old female with borderline personality disorder is referred to therapy focusing on mindfulness, emotional regulation, and distress tolerance skills. Which therapy is this? A. Cognitive-behavioral therapy (CBT) B. Psychoanalysis C. Dialectical behavior therapy (DBT) D. Milieu therapy 58. A 32-year-old client with depression is asked to keep a diary of negative thoughts and replace them with positive alternatives. Which therapy is this? A. Psychoanalysis B. Cognitive-behavioral therapy (CBT) C. Reality orientation therapy D. Family therapy 59. In a psychiatric ward, Nurse Cruz maintains a safe, structured environment with clear rules, group meetings, and client participation in decisions. This best describes: A. Behavior therapy B. CBT C. Milieu therapy D. DBT SITUATION 13: A psychiatric nurse is caring for different clients across the lifespan. In daily care, she applies principles from psychodynamic theory, psychosocial development (Erikson), cognitive development (Piaget), interpersonal theory (Sullivan), and interpersonal nursing theory (Peplau). 60. A 3-year-old child insists on feeding herself but spills food on the table. The mother scolds her harshly, grabs the spoon, and feeds her instead. According to Erikson’s psychosocial stages, failure at this stage may lead the child to develop: A. Inferiority B. Shame and doubt C. Guilt D. Mistrust 61. A client with schizophrenia says: “I don’t want to talk to you because people always judge me.” The nurse recalls Harry Stack Sullivan’s Interpersonal Theory, which emphasizes that mental health is MOST influenced by: A. Unconscious conflicts from childhood B. The quality of interpersonal relationships C. Reinforcement of learned behaviors D. Resolving cognitive distortions 62. According to Hildegard Peplau’s Theory of Interpersonal Relations, when first meeting a newly admitted client, the nurse’s role is to: A. Act as a surrogate to replace family support B. Establish trust in the orientation phase C. Assist the client to achieve independence in the termination phase D. Work with the client to accomplish goals in the working phase 63. A 9-year-old client struggles with schoolwork and compares herself to peers. According to Erikson, successful resolution of this stage is shown by: