Tiêu đề 3. FC PSYCH (Mr. Fajardo) - SC ✅

1 | Page FINAL COACHING PSYCHIATRIC NURSING Prepared by: Mr. Kevin Fajardo, MAN, PHRN, USRN November 2025 Philippine Nurse Licensure Examination Review NAME: DATE: SCORE: _____ “FIRST TAKER AKO, AT LAST TAKE KO NA ‘TO! Situation 1: A 35-year-old male employee was rushed to the psychiatric ward by his officemates after suddenly shouting in the office that his supervisor was “conspiring” to destroy his career. Upon arrival, he is observed to be agitated, restless, and tearful. During the admission interview, the nurse notices that the client’s speech is pressured, and he insists that his boss is plotting against him. The nurse begins the initial assessment and reflects on the ethical, personal, and professional issues that arise when providing psychiatric nursing care. 1. Ethical concerns in psychiatric diagnosis may arise primarily from which factor? A. Inadequate communication skills B. Lack of compassion C. Subjectivity D. Objectivity 2. During reflection, the nurse tells her mentor: “The client’s tone reminded me of my father’s anger, which made me anxious.” This statement demonstrates: A. Positive self-projection B. Self-awareness C. Assertiveness D. Self-mastery 3. A nurse says: “I’m not sure how I’ll react when faced with a violent client.” Which response from the nurse manager BEST enhances the staff nurse’s self- awareness? A. “How would you go about de-escalating a violent individual?” B. “Have you had a negative experience with a violent client before?” C. “Describe what you would do when the client becomes aggressive.” D. “Think about how you usually respond to angry or aggressive people.” 4. In psychiatric nursing, self-awareness, knowledge of human behavior, and communication skills combine to form the foundation of what core concept? A. Positive self-projection B. Therapeutic use of self C. Assertiveness D. Self-mastery Situation 2: A 28-year-old female with generalized anxiety was voluntarily admitted to the psychiatric unit after complaining that her excessive worrying was interfering with her work and sleep. During admission, she expresses fear of being “locked in,” but the nurse reassures her that she retains her rights because she entered voluntarily. The nurse continues to explain her rights and monitors her adjustment to admission. 5. When a client is voluntarily admitted to a psychiatric unit, the nurse should anticipate which behavior? A. Fearfulness regarding treatment measures B. Anger and aggressiveness toward staff C. Willingness to participate in planning her care D. Resistance to all forms of treatment 6. The nurse evaluates statements that may require warning third parties. Which situation clearly indicates a duty to warn? A. “I hate all the police.” B. “I will blow up Malacañang Palace.” C. “I’ll get them before they get me.” D. “If I can’t have my girlfriend, then no one can.” 7. During her stay, the client insists on leaving the hospital against medical advice (AMA). Which nursing action BEST respects her autonomy while fulfilling the nurse’s responsibility? A. Call security to block the client from leaving B. Restrain the client until the physician arrives C. Explain risks, ask client to sign AMA form, and allow discharge D. Tell the client she cannot return if she leaves Situation 3: A 22-year-old college student is admitted to the psychiatric unit after experiencing shortness of breath, palpitations, dizziness, and a feeling of impending doom during a class presentation. He reports that these episodes have occurred several times over the past month, causing him to avoid social and academic activities. He also describes himself as a “worrier” since high school, often lying awake at night with racing thoughts. The nurse is assigned to assess him and plan appropriate care. 8. During the assessment, the nurse observes the client pacing, wringing his hands, and stating, “I just need to keep moving.” Which nursing response is MOST therapeutic? A. “Are you feeling anxious?” B. “You need to sit down and relax.” C. “You must be experiencing a problem right now.” D. “Is something bothering you?” 9. The nurse classifies the client’s condition as panic anxiety when observing which behavior? A. The client is hallucinating and becomes dangerous to others B. The client remains calm but worries about the future C. The client can still follow directions with assistance D. The client is irritable but maintains logical thinking 10. The client with generalized anxiety disorder (GAD) says, “I know I worry too much, but I just can’t control it.” Which nursing goal is MOST appropriate? A. “The client will suppress all anxious thoughts.” B. “The client will report fewer episodes of anxiety interfering with daily life.” C. “The client will eliminate all anxiety through medications.” D. “The client will avoid stressful situations entirely.” 11. Before starting benzodiazepine therapy for anxiety, the nurse’s priority assessment should focus on: A. Client’s motivation for treatment B. Client’s coping strategies * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *

3 | Page Dissociative fugue Dissociative identity disorder Depersonalization/derealization disorder 30. During a dissociative episode, the nurse plans a quick grounding intervention. Which is MOST appropriate and effective in the moment? A. Ask the client to repeat affirmations such as, “I am safe.” B. Ask the client to name five objects and their colors, and describe one texture they can feel C. Tell the client to avoid talking about feelings until symptoms stop D. Allow the client to isolate quietly until the episode passes SITUATION 8: Somatoform & Related Disorders A 30-year-old woman is admitted after developing sudden paralysis of her right leg following a heated argument with her partner. Neurological tests reveal no organic cause. Meanwhile, another patient in the unit frequently exaggerates symptoms to gain hospital admission, while a different client persistently worries about having a serious illness despite normal diagnostic results. The nurse is assigned to care for these clients and must differentiate among the common somatic and related disorders. 31. A man facing trial suddenly reports severe chest pain and faints in court. Workup is negative. He later admits he wanted to delay the trial. This is BEST described as: A. Conversion disorder B. Malingering C. Factitious disorder D. Somatic symptom disorder 32. A young woman repeatedly presents to different hospitals with fabricated symptoms, requests invasive tests, and is found to inject herself with bacteria to cause fever. She denies lying and insists she is sick. This is BEST classified as: A. Conversion disorder B. Malingering C. Factitious disorder (Munchausen’s syndrome) D. Hypochondriasis 33. The nurse documents that the client with conversion disorder shows “primary gain.” Which statement reflects this? A. “Now I don’t have to face my partner after the fight.” B. “At least my family is now visiting me in the hospital.” C. “My supervisor will not punish me since I am ill.” D. “The doctor finally believes that I am really sick.” 34. A client with a somatic system disorder asks the nurse: “Why can’t the doctors find anything wrong with me? I know my body — I am sick.” Which is the most therapeutic response? A. “It’s all in your head, you just need to relax.” B. “Your tests are normal; maybe you are exaggerating.” C. “I know your symptoms feel real; let’s talk about how stress affects the body.” D. “Don’t worry, we’ll keep repeating the tests until something shows up.” 35. The client’s husband asks, “Is my wife just faking her symptoms?” Which is the BEST response by the nurse? A. “Yes, she just wants attention.” B. “No, her symptoms are unconscious and feel real to her.” C. “Don’t ask me; you should ask your wife.” D. “She is exaggerating because she’s stressed.” SITUATION 9: Alzheimer’s Disease A 72-year-old woman is admitted to the psychiatric unit due to progressive forgetfulness, wandering at night, and difficulty performing daily activities. Her children report that she sometimes forgets their names and once attempted to leave the house at 2:00 a.m., saying she needed to “go to work.” On the unit, the nurse observes disorientation, poor short-term recall, and anxiety about daily routines. 36. The earliest and most common initial symptom of Alzheimer’s disease is: A. Impaired motor coordination B. Loss of recent memory C. Hallucinations D. Incontinence 37. client with early Alzheimer’s suddenly cannot recognize her daughter. This symptom is called: A. Apraxia B. Aphasia C. Agnosia D. Amnesia 38. Which behavior is most characteristic of middle-stage Alzheimer’s disease? A. Subtle forgetfulness only B. Complete dependence on others for care C. Wandering and disorientation to time/place D. Bedridden and unable to communicate 39. Priority nursing diagnosis for a client who frequently wanders at night: A. Risk for injury B. Disturbed thought processes C. Social isolation D. Anxiety 40. The nurse finds the client attempting to leave the hospital at night, saying, “I need to go home to cook for my children.” Which is the most therapeutic response? a. “That’s impossible; your children are all grown now.” b. “Why don’t you stop thinking about your children?” c. “Tell me more about your children while we walk back to your room.” d. “You must not leave the unit without permission.” 41. Which medication is commonly prescribed to slow progression of Alzheimer’s disease? A. Haloperidol B. Donepezil C. Lithium carbonate D. Fluoxetine 42. The family asks why their mother is more agitated and confused at night. The nurse explains this phenomenon as: Cognitive decline Confabulation Sundowning syndrome Perseveration SITUATION 10: Suicide Risk and Nursing Care A 20-year-old college student is admitted to the psychiatric unit after expressing suicidal thoughts to his dormitory roommate. During admission, he tells the nurse: “I feel hopeless. There’s no point in going on.” He appears withdrawn, avoids eye contact, and has lost 10 pounds in the last month. The nurse is assigned to conduct a suicide risk assessment and implement precautions. 43. Which statement by the client is the STRONGEST indicator of imminent suicide risk? A. “I wish I could just fall asleep and never wake up.” B. “Sometimes I get sad, but I know I’ll be okay.” C. “I feel better now, you don’t need to worry about me.” D. “I can’t concentrate on my studies.” 44. Which client history places him at the highest risk for suicide? A. Has supportive family and strong religious belief B. Recently lost his job and attempted suicide once before C. Reports feeling anxious during exams D. States he occasionally drinks alcohol socially 45. Priority nursing action when the client states: “I’m going to kill myself tonight.” A. Explore reasons for his hopelessness B. Notify the physician and document C. Ask the client if he has a specific plan D. Place the client on strict bed rest 46. Which environment is MOST appropriate for a suicidal client? A. Private room with dim lights B. Semi-private room near the nurse’s station C. Secluded quiet area of the unit