Mental Health Nursing Practice Exam
Course Introduction
Mental Health Nursing focuses on the principles and practices essential for providing effective care to individuals experiencing mental health issues across the lifespan. The course covers assessment, therapeutic communication, intervention strategies, and collaboration with multidisciplinary teams. Emphasis is placed on understanding the biological, psychological, social, and cultural factors affecting mental well-being, alongside promotion of recovery and self-care. Students learn evidence-based approaches to managing diverse psychiatric conditions and develop skills for advocacy, ethical decision-making, and creating safe, supportive environments for mental health consumers and their families.
Recommended Textbook
Psychiatric Mental Health Nursing Concepts of Care in Evidence Based Practice 7th Edition by Mary
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Chapter 1: The Concept of Stress Adaptation
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Q1) A school nurse is assessing a distraught female high school student who is overly concerned because her parents can't afford horseback riding lessons. How should the nurse interpret the student's reaction to her perceived problem?
A)The problem is endangering her well-being.
B)The problem is personally relevant to her.
C)The problem is based on immaturity.
D)The problem is exceeding her capacity to cope.
Answer: B
Q2) A bright student confides in the school nurse about conflicts related to attending college, or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?
A)Meditation
B)Problem-solving training
C)Relaxation
D)Journaling
Answer: B
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3
Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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Q1) According to Maslow's hierarchy of needs, which situation on an in-patient psychiatric unit would require priority intervention by a nurse?
A)A client rudely complaining about limited visiting hours
B)A client exhibiting aggressive behavior toward another client
C)A client stating that no one cares
D)A client verbalizing feelings of failure
Answer: B
Q2) Which should the nurse recognize as an example of the defense mechanism of repression?
A)A student aware of the need to study for tomorrow's test goes to a movie instead.
B)A woman whose son was killed in Iraq does not believe the military report.
C)A man who is unhappily married goes to school to become a marriage counselor.
D)A woman was raped when she was 12 and no longer remembers the incident.
Answer: D
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4
Chapter 3: Theoretical Models of Personality Development
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Q1) A psychiatric nurse uses Sullivan's theories in group and individual therapy. According to Sullivan and other theorists like him, how are client symptoms viewed?
A)Client symptoms are viewed as learned behaviors that are maintained because they are reinforced.
B)Client symptoms are viewed as responses to anxiety arising from interpersonal relationships.
C)Client symptoms are viewed as internal conflicts arising from early childhood trauma.
D)Client symptoms are viewed as the misinterpretations of experiences.
Answer: B
Q2) Which concepts should a nurse identify as being included in the DSM-IV-TR definition of personality? (Select all that apply.)
A)Personality is an enduring pattern of perceiving.
B)Personality is influenced by relationships between the environment and self.
C)Personality is developed in sporadic stages that vary from person to person.
D)Personality is influenced by a wide range of social and personal contexts.
E)Personality is inborn and cannot be influenced by developmental progression. Answer: A, B, D
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Page 5
Chapter 4: Concepts of Psychobiology
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Q1) Which client statement reflects an understanding of the effect of circadian rhythms on psychopathology?
A)"When I dream about my mother's horrible train accident, I become hysterical."
B)"I get really irritable during my menstrual cycle."
C)"I'm a morning person.I get my best work done in the a.m."
D)"Every February, I tend to experience periods of sadness."
Q2) An instructor is teaching nursing students about neurotransmitters. Which term best explains the process of how neurotransmitters released into the synaptic cleft may return to the presynaptic neuron?
A)Regeneration
B)Reuptake
C)Recycling
D)Retransmission
Q3) A nurse should recognize that a decrease in norepinephrine levels would play a significant role in which mental illness?
A)Mania
B)Schizophrenia
C)Anxiety
D)Depression
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Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Q1) A client diagnosed with schizophrenia receives fluphenazine decanoate (Prolixin Decanoate) from a home health nurse. The client refuses medication at one regularly scheduled home visit. Which nursing intervention is ethically appropriate?
A)Allow the client to decline the medication and document.
B)Tell the client that if the medication is refused, hospitalization will occur.
C)Arrange with a relative to add medication to the client's morning orange juice.
D)Call for help to hold the client down while the injection is administered.
Q2) An involuntarily committed client is verbally abusive to the staff and repeatedly threatening to sue. The client records the full names and phone numbers of the staff. Which nursing action is most appropriate to decrease the possibility of a lawsuit?
A)Verbally redirect the client, and then limit one-on-one interaction.
B)Involve the hospital's security division as soon as possible.
C)Notify the client that documenting personal staff information is against hospital policy.
D)Continue professional attempts to establish a positive working relationship with the client.
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Page 7
Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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Q1) A Latin American man refuses to acknowledge responsibility for hitting his wife, stating instead, "It's the man's job to keep his wife in line." Which cultural belief should a nurse associate with this client's behavior?
A)Families are male dominated with clear male-female role distinctions.
B)Religious tenets support the use of violence in a marital context.
C)The nuclear family is female dominated and the mother possesses ultimate authority. D)Marriage dynamics are controlled by dominant females in the family.
Q2) Northern European Americans value punctuality, hard work, and the acquisition of material possessions and status. A nurse should recognize that these values may contribute to which form of psychopathology?
A)Dissociative disorders
B)Alzheimer's dementia
C)Stress-related disorders
D)Schizophrenia-spectrum disorders
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8
Chapter 7: Relationship Development
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Q1) A hungry, homeless client, diagnosed with schizophrenia, refuses to participate in an admission interview. A nurse streamlines the assessment, verbally assures safety, and provides a warm meal. What is the nurse promoting by these actions?
A)Sympathy
B)Trust
C)Veracity
D)Manipulation
Q2) When is self-disclosure by the nurse appropriate in a therapeutic nurse-client relationship?
A)When it is judged that the information may benefit the nurse and client
B)When the nurse has a duty to warn
C)When the nurse feels emotionally indebted toward the client
D)When it is judged that the information may benefit the client
Q3) On which task should a nurse place priority during the working phase of relationship development?
A)Establishing a contract for intervention
B)Examining feelings about working with a particular client
C)Establishing a plan for continuing aftercare
D)Promoting the client's insight and perception of reality
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Page 9
Chapter 8: Therapeutic Communication
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Q1) A client states, "You won't believe what my husband said to me during visiting hours. He has no right treating me that way." Which nursing response would best assess the situation that occurred?
A)"Does your husband treat you like this very often?"
B)"What do you think is your role in this relationship?"
C)"Why do you think he behaved like that?"
D)"Describe what happened during your time with your husband."
Q2) Which therapeutic communication technique should the nurse use when communicating with a client who is experiencing auditory hallucinations?
A)"My sister has the same diagnosis as you and she also hears voices."
B)"I understand that the voices seem real to you, but I do not hear any voices."
C)"Why not turn up the radio so that the voices are muted."
D)"I wouldn't worry about these voices.The medication will make them disappear."
Q3) Which nursing response is an example of the nontherapeutic communication block of requesting an explanation?
A)"Can you tell me why you said that?"
B)"Keep your chin up.I'll explain the procedure to you."
C)"There is always an explanation for both good and bad behaviors."
D)"Are you not understanding the explanation I provided?"
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Page 10
Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Q1) The nurse interviewed a client who was uncooperative, answered questions with minimal responses, and rarely made eye contact. Which is the most complete documentation of baseline data obtained during the interview?
A)"Appears uncooperative.Exhibits characteristics of depression."
B)"Maintains poor eye contact throughout interview process.Unable to answer interview questions due to depression."
C)"States, 'I don't need to be here.' when discussing admission status.Maintains minimal eye contact and offers little data related to triggers for admission."
D)"Unwilling to respond openly during interview."
Q2) Which nursing response would be appropriately used in the evaluation phase of the nursing process?
A)"If I were in your situation, I would not repeat a behavior that has caused problems."
B)"What do you think needs changing, and what do you want to do differently?"
C)"What exactly will it take to carry out your plan, and what else do you need to do?"
D)"This new approach seems to work for you."
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Chapter 10: Therapeutic Groups
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Q1) Which situation should a nurse identify as an example of an autocratic leadership style?
A)The president of Sigma Theta Tau assigns members to committees to research problems.
B)Without faculty input, the dean mandates that all course content be delivered via the Internet.
C)During a community meeting, a nurse listens as clients generate solutions.
D)The student nurses' association advertises for candidates for president.
Q2) A nursing instructor is teaching students about self-help groups like Alcoholics Anonymous (AA). Which student statement indicates that learning has occurred?
A)"There is little research to support AA's effectiveness."
B)"Self-help groups used to be the treatment of choice, but their popularity is waning."
C)"These groups have no external regulation, so clients need to be cautious."
D)"Members themselves run the group, with leadership usually rotating among the members."
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12
Chapter 11: Intervention With Families
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Q1) An instructor is teaching about differentiated parent and adult child relationships. Students are instructed to give an example of a well-differentiated parent and adult child relationship. Which student example meets the instructor requirement?
A)An adult child considers, but is not governed by, the advice of his or her parents.
B)An adult child appears to listen, but ignores, the advice of his or her parents.
C)An adult child respects and is governed by the wishes of his or her parents.
D)An adult child never requests advice or feedback from his or her parents.
Q2) A depressed 21-year-old client has lived with his mother ever since the death of his father 3 years ago. After the client received a college acceptance, the mother repeatedly states, "That's wonderful. I'll be fine all alone." How would the nurse interpret the mother's statements?
A)The mother is withholding supportive messages.
B)The mother is expressing denigrating remarks.
C)The mother is communicating indirectly.
D)The mother is using double-bind communication.
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Chapter 12: Milieu Therapy - the Therapeutic Community
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Q1) In the role of milieu manager, which activity should the nurse prioritize?
A)Setting the schedule for the daily unit activities
B)Evaluating clients for medication effectiveness
C)Conducting therapeutic group sessions
D)Searching newly admitted clients for hazardous objects
Q2) A nurse attends an interdisciplinary team meeting on an inpatient unit. Which of the following individuals are typically included as members of the interdisciplinary treatment team in psychiatry? (Select all that apply.)
A)Respiratory therapist and psychiatrist
B)Occupational therapist and psychologist
C)Recreational therapist and art therapist
D)Social worker and hospital volunteer
E)Mental health technician and chaplain
Q3) A nurse working on an inpatient psychiatric unit is assigned to conduct a 45-minute education group. What should the nurse identify as an appropriate group topic?
A)Dream analysis
B)Creative cooking
C)Paint by number
D)Stress management
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Page 14
Chapter 13: Crisis Intervention
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Q1) A mother is concerned about her ability to perform in her new role. She is quite anxious and refuses to leave the postpartum unit. To offer effective client care, a nurse should recognize which information about this type of crisis?
A)This type of crisis is precipitated by unexpected external stressors.
B)This type of crisis is precipitated by preexisting psychopathology.
C)This type of crisis is precipitated by an acute response to an external situational stressor.
D)This type of crisis is precipitated by normal life-cycle transitions that overwhelm the client.
Q2) A despondent client who has recently lost her husband of 30 years tearfully states, "I'll feel a lot better if I sell my house and move away." Which nursing reply is most appropriate?
A)"I'm confident you know what's best for you."
B)"This may not be the best time for you to make such an important decision."
C)"Your children will be terribly disappointed."
D)"Tell me why you want to make this change."
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Chapter 14: Relaxation Therapy
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Q1) A nurse is teaching a client deep breathing exercises. The client asks, "Why do I need to make that funny shape with my lips when I breathe out?" What is the most appropriate nursing reply?
A)"You can actually exhale anyway you like; the lip shape is not important."
B)"Pursed lip breathing helps you control the exhalation and helps to keep your airways open."
C)"Don't worry about the lip shape; concentrate instead on the pace of your breathing."
D)"The shape of the lip decreases the cough and choking reflex."
Q2) A nurse working for a large corporation is teaching relaxation therapy to employees. Which relaxation technique should the nurse initially teach?
A)Deep-breathing exercises
B)Mental imagery
C)Biofeedback
D)Meditation
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Chapter 15: Assertiveness Training
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Q1) Which is the most appropriate nursing reply when a client asks what is the goal and benefit of assertive skills training?
A)"It protects the client from others who express aggressive feelings."
B)"It gives reliable, expert information so that clients may correct faulty behaviors."
C)"It clarifies misperceptions that have caused clients to distort reality."
D)"It improves communication skills in order to improve interpersonal relationships."
Q2) A teenager gets a "C" in algebra. The mother angrily states, "All you ever do is listen to music and text your friends." The teenager replies, "What is it that you're really upset about mom?" Which response pattern is the teenager expressing?
A)Clouding and fogging
B)Shifting from content to process
C)Delaying assertively
D)Assuming responsibility for one's own statements
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17
Chapter 16: Promoting Self Esteem
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Q1) A nurse is working in a nursing home. How best can this nurse foster self-esteem in the residents of this facility?
A)Allowing them to remain in their rooms as much as they desire to maintain privacy
B)Administering anti-anxiety medications as ordered
C)Providing a sense of mastery over their environment by giving choices when appropriate
D)Teaching assertiveness skills and self-esteem principles
Q2) A client has continual problematic relationships and rejects others before possibly being rejected. Client states, "I am afraid of failing in my job responsibilities." Which correctly written nursing diagnosis should be prioritized for this client?
A)Poor self-esteem R/T negative self-image AEB fear of failure
B)Altered thought processes R/T anxiety AEB delusions
C)Role confusion R/T rejection and poor job productivity
D)High risk for violence: self-directed R/T rejection of others
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Chapter 17: Angeraggression Management
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Q1) Which nursing approach is likely to be most therapeutic when dealing with a newly admitted, hostile, suspicious client?
A)Places hand on the client's shoulder and states, "I will help you to your room."
B)Slowly and matter-of-factly state, "I am your nurse and I will show you to your room."
C)Firmly set limits by stating, "If your behavior does not improve you will be secluded."
D)Smiles and states, "I am your nurse.When do you want to go to your room?"
Q2) Which client statement demonstrates improvement in terms of anger/aggression management?
A)"I realize I have a problem expressing my anger appropriately."
B)"I know I can't use physical force anymore, but I intimidate someone with my words."
C)"It's bad to feel as angry as I feel.I'm working on eliminating this poisonous emotion entirely."
D)"Because my wife seems to be the one to set me off, I've decided to remain separated from her."
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Chapter 18: Intervention With a Suicidal Client
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Q1) A client has been brought to the emergency department for signs and symptoms of Chronic Obstructive Pulmonary Disease (COPD). The client has a history of a suicide attempt 1 year ago. Which nursing intervention would take priority in this situation?
A)Assessing the client's pulse oximetry and vital signs
B)Developing a plan for safety for the client
C)Assessing the client for suicidal ideations
D)Establishing a trusting nurse-client relationship
Q2) Which is a correctly written, appropriate outcome for a client with a history of suicide attempts who is currently exhibiting symptoms of low self-esteem by isolating self?
A)The client will not physically harm self.
B)The client will express three positive self-attributes by day 4.
C)The client will reveal a suicide plan.
D)The client will establish a trusting relationship with the nurse by day 1.
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Chapter 19: Behavior Therapy
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Q1) An adolescent client was recently admitted to the psychiatric unit because of impulsivity and acting-out behavior at school. The nurse should initially implement which nursing action?
A)Redirect the client to activities to decrease stress.
B)Explain the unit rules and consequences of breaking the rules.
C)Place the client on close observation to insure a trusting relationship.
D)Administer an anti-anxiety medication.
Q2) Parents decide to try the nurse practitioner's suggestion of time out when their child misbehaves. What teaching should the nurse practitioner provide the parents?
A)"Correct your child's behavior by using social isolation."
B)"Ignore the child's negative behavior."
C)"Add positive reinforcement for acceptable behavior."
D)"Temporarily move your child to an area where behavior is not being reinforced."
Q3) Which assumption is most reflective of a behavioral theory model?
A)Mental illness is characterized by structural and biochemical alterations.
B)Thought processes influence behaviors.
C)All personality development has a social context.
D)There is a basic relationship between stimulus and response.
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21
Chapter 20: Cognitive Therapy
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Q1) A nursing instructor is teaching about dichotomous thinking. Which student statement indicates that learning has occurred?
A)"Dichotomous thinking is when an individual views situations as being 'good or bad' or 'black or white.'"
B)"Dichotomous thinking is when an individual takes complete responsibility for situations without considering other circumstances."
C)"Dichotomous thinking is when an individual exaggerates the negative significance of an event."
D)"Dichotomous thinking is when an individual undervalues the positive significance of an event."
Q2) A client is experiencing auditory hallucinations. Using a cognitive strategy, which should the nurse encourage the client to do?
A)"Try singing Happy Birthday until the voices are gone."
B)"Document what the voices are saying to note cause and effect."
C)"Try listening to music using headphones for distraction."
D)"Remind yourself that the voices are symptoms of your disease."
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Chapter 21: Electroconvolusive Therapy
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Q1) A client is scheduled for an initial treatment of electroconvulsive therapy (ECT). Which information should a nurse include when teaching about the potential side effects of this procedure?
A)"You may experience transient tangential thinking."
B)"You may experience some memory deficit surrounding the ECT."
C)"You may experience avolution for the remainder of the day."
D)"You may experience a higher risk for subsequent seizures."
Q2) During a course of 12 electroconvulsive therapy (ECT) treatments, an anxious client diagnosed with major depression refuses to bathe or attend group therapy. At this time, which of the following nursing diagnoses should be assigned to this client? (Select all that apply.)
A)Anxiety R/T post-ECT confusion and memory loss
B)Risk for injury R/T post-ECT confusion and memory loss
C)Disturbed thought processes R/T post-ECT confusion and memory loss
D)Altered sensory perception R/T post-ECT confusion and memory loss
E)Social isolation R/T post-ECT confusion and memory loss
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23
Chapter 22: Complementary Therapies
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Q1) Herbs and plants can be useful in treating a variety of conditions. Which herbal treatment should a nurse determine as appropriate for a client experiencing frequent migraine headaches?
A)Saint John's wort combined with an antidepressant
B)Ginger root combined with a beta-blocker
C)Feverfew, used according to directions
D)Kava-kava added to a regular diet
Q2) A client diagnosed with chronic migraine headaches is considering acupuncture. The client asks a clinic nurse, "How does this treatment work?" Which is the best response by the nurse?
A)"Western medicine believes that acupuncture stimulates the body's release of pain-fighting chemicals called endorphins."
B)"I'm not sure why he suggested acupuncture.There are a lot of risks, including HIV."
C)"Acupuncture works by encouraging the body to increase its development of serotonin and norepinephrine."
D)"Your acupuncturist is your best resource for answering your specific questions."
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24
Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) A nursing instructor is teaching about pharmacological treatments for attention deficit-hyperactivity disorder (ADHD). Which information about atomoxetine (Strattera) should be included in the lesson plan?
A)Strattera, unlike methylphenidate (Ritalin), is a central nervous system depressant.
B)When taking Strattera, a client should eliminate all red food coloring from the diet.
C)Strattera will be a life-long intervention for clients diagnosed with this disorder.
D)Strattera, unlike methylphenidate (Ritalin), is a selective norepinephrine reuptake inhibitor.
Q2) The nurse should recognize which of the following findings contribute to a client's development of attention deficit-hyperactivity disorder (ADHD)? (Select all that apply.)
A)The client's father was a smoker.
B)The client was born 7 weeks premature.
C)The client is lactose intolerant.
D)The client has a sibling diagnosed with ADHD.
E)The client has been diagnosed with dyslexia.
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Page 25
Chapter 24: Delirium, Dementia, and Amnestic Disorders
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Q1) After 1 week of continuous mental confusion, an elderly African American client is admitted with a preliminary diagnosis of Alzheimer's dementia. What should cause the nurse to question this diagnosis?
A)Alzheimer's dementia does not typically occur in African American clients.
B)The symptoms presented are more indicative of Parkinsonism.
C)Alzheimer's dementia does not develop suddenly.
D)There has been no T3 or T4 level evaluation ordered.
Q2) Which symptom should a nurse identify that would differentiate clients diagnosed with dementia disorders from clients diagnosed with amnesic disorders?
A)Dementia disorders involve disorientation that develops suddenly, whereas amnestic disorders develop more slowly.
B)Dementia disorders involve impairment of abstract thinking and judgment, whereas amnestic disorders do not.
C)Dementia disorders include the symptom of confabulation, whereas amnestic disorders do not include these symptoms.
D)Both dementia disorders and profound amnesia typically share the symptom of disorientation to place, time, and self.
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Chapter 25: Substance-Related Disorders
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Q1) Which client statement indicates a knowledge deficit related to substance abuse?
A)"Although it's legal, alcohol is one of the most widely abused drugs in our society."
B)"Tolerance to heroin develops quickly."
C)"Flashbacks from LSD use may reoccur spontaneously."
D)"Marijuana is like smoking cigarettes.Everyone does it.It's essentially harmless."
Q2) A client's wife has been making excuses for her alcoholic husband's work absences. In family therapy, she states, "His problems at work are my fault." Which is the appropriate nursing response?
A)"Why do you assume responsibility for his behaviors?"
B)"Codependency is a typical behavior of spouses of alcoholics."
C)"Your husband needs to deal with the consequences of his drinking."
D)"Do you understand what the term 'enabler' means?"
Q3) What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?
A)Risk for injury R/T central nervous system stimulation
B)Disturbed thought processes R/T tactile hallucinations
C)Ineffective coping R/T powerlessness over alcohol use
D)Ineffective denial R/T continued alcohol use despite negative consequences
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Chapter 26: Schizophrenia and Other Psychotic Disorders
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Q1) A client diagnosed with schizoaffective disorder is admitted for social skills training. Which information should be taught by the nurse?
A)The side effects of medications
B)Deep breathing techniques to decrease stress
C)How to make eye contact when communicating
D)How to be a leader
Q2) A client states, "I hear voices that tell me that I am evil." Which outcome related to these symptoms should the nurse expect this client to accomplish by discharge?
A)The client will verbalize the reason the voices make derogatory statements.
B)The client will not hear auditory hallucinations.
C)The client will identify events that increase anxiety and illicit hallucinations.
D)The client will positively integrate the voices into the client's personality structure.
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Chapter 27: Mood Diorders: Depression
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Q1) A 75-year-old client diagnosed with a long history of depression is currently on doxepin (Sinequan) 100 mg daily. The client takes a daily diuretic for hypertension and is recovering from the flu. Which nursing diagnosis should the nurse assign highest priority?
A)Risk for ineffective thermoregulation R/T anhidrosis
B)Risk for constipation R/T excessive fluid loss
C)Risk for injury R/T orthostatic hypotension
D)Risk for infection R/T suppressed white blood cell count
Q2) Which client statement expresses a typical underlying feeling of clients diagnosed with major depressive disorder?
A)"It's just a matter of time and I will be well."
B)"If I ignore these feelings, they will go away."
C)"I can fight these feelings and overcome this disorder."
D)"I deserve to feel this way."
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Chapter 28: Mood Disorders: Bipolar Disorder
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Sample Questions
Q1) A highly agitated client paces the unit and states, "I could buy and sell this place." The client's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client's behavior?
A)"Rates mood 8/10.Exhibiting looseness of association.Euphoric."
B)"Mood euthymic.Exhibiting magical thinking.Restless."
C)"Mood labile.Exhibiting delusions of reference.Hyperactive."
D)"Agitated and pacing.Exhibiting grandiosity.Mood labile."
Q2) A newly admitted client is diagnosed with bipolar disorder: manic episode. Which symptom related to altered thought is the nurse most likely to assess?
A)Pacing
B)Flight of ideas
C)Liability of mood
D)Irritability
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Chapter 29: Anxiety Disorders
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Q1) A cab driver, stuck in traffic, suddenly is lightheaded, tremulous, diaphoretic, and experiences tachycardia and dyspnea. An extensive workup in an emergency department reveals no pathology. Which medical diagnosis is suspected, and what nursing diagnosis takes priority?
A)Generalized anxiety disorder and a nursing diagnosis of fear
B)Altered sensory perception and a nursing diagnosis of panic disorder
C)Pain disorder and a nursing diagnosis of altered role performance
D)Panic disorder and a nursing diagnosis of anxiety
Q2) Which treatment should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)?
A)Long-term treatment with diazepam (Valium)
B)Acute symptom control with citalopram (Celexa)
C)Long-term treatment with buspirone (BuSpar)
D)Acute symptom control with ziprasidone (Geodon)
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Chapter 30: Somatoform and Disassociative Disorders
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Q1) Which are examples of primary and secondary gains that clients diagnosed with somatoform pain disorders may experience?
A)Primary: chooses to seek a new doctor; secondary: euphoric feeling from new medications
B)Primary: euphoric feeling from new medications; secondary: chooses to seek a new doctor
C)Primary: receives get-well messages; secondary: pain prevents attendance at family reunion
D)Primary: pain prevents attendance at family reunion; secondary: receives get-well messages
Q2) A client is diagnosed with hypochondriasis. Which of the following symptoms is the client most likely to exhibit? (Select all that apply.)
A)Obsessive-compulsive traits
B)Pseudocyesis
C)Anxiety
D)Flat affect
E)Depression
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Chapter 31: Issues Related to Human Sexuality and Gender
Identity
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Q1) A nurse is counseling a client diagnosed with transgenderism. Which characteristic would differentiate this disorder from transvestic fetishism?
A)Clients diagnosed with transvestic fetishism are dissatisfied with their gender, whereas clients diagnosed with transgenderism are not.
B)Clients diagnosed with transgenderism are dissatisfied with their gender, whereas clients diagnosed with transvestic fetishism are not.
C)Clients diagnosed with transgenderism never engage in cross-dressing, whereas clients diagnosed with transvestic fetishism do.
D)Clients diagnosed with transvestic fetishism never engage in cross-dressing, whereas clients diagnosed with transgenderism do.
Q2) A 52-year-old client states, "My husband is upset because I don't enjoy sex as much as I used to." Which priority client data should a nurse initially collect?
A)History of hysterectomy
B)Date of last menstrual cycle
C)Use of birth control methods
D)History of thought disorder
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Chapter 32: Eating Disorders
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Q1) A morbidly obese client is prescribed an anorexiant medication. The nurse should prepare to teach the client about which medication?
A)Diazepam (Valium)
B)Dexfenfluramine (Redux)
C)Sibutramine (Meridia)
D)Pemoline (Cylert)
Q2) A nurse should identify topiramate (Topamax) as the drug of choice for which of the following conditions? (Select all that apply.)
A)Binge eating with obesity
B)Bingeing and purging with a diagnosis of bulimia nervosa
C)Weight loss with a diagnosis of anorexia nervosa
D)Amenorrhea with a diagnosis of anorexia nervosa
E)Emaciation with a diagnosis of bulimia nervosa
Q3) A nurse observes dental deterioration when assessing a client diagnosed with bulimia nervosa. What explains this assessment finding?
A)The emesis produced during purging is acidic and corrodes the tooth enamel.
B)Purging causes the depletion of dietary calcium.
C)Food is rapidly ingested without proper mastication.
D)Poor dental and oral hygiene leads to dental caries.
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Page 34
Chapter 33: Adjustment and Impulse Control Disorders
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Q1) A nurse is caring for a client who is suspected of having the diagnosis of trichotillomania. What condition must be ruled out prior to a definitive diagnosis of this disorder?
A)Bipolar disorder
B)Alopecia areata
C)Post-traumatic stress disorder
D)Body dysmorphic disorder
Q2) A client, who recently delivered a stillborn baby, has a diagnosis of adjustment disorder unspecified. The nurse case manager should expect which client presentation that is characteristic of this diagnosis?
A)The client worries continually and appears nervous and jittery.
B)The client complains of a depressed mood, is tearful, and feels hopeless.
C)The client is belligerent, violates the rights of others, and defaults on legal responsibilities.
D)The client complains of many physical ailments, refuses to socialize, and quits her job.
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Chapter 34: Personality Disorders
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Q1) The nurse plans to confront a client about secondary gains related to extreme dependency on spouse. Which nursing statement would be most appropriate?
A)"Do you believe dependency issues have been a lifelong concern for you?"
B)"Have you noticed any anxiety during times when your husband makes decisions."
C)"What do you know about individuals who depend on others for direction?"
D)"How have the specifics of your relationship with your spouse benefited you?"
Q2) Which adult client should a nurse identify as exhibiting the characteristics of a dependent personality disorder?
A)A physically healthy client who is dependent on meeting social needs by contact with 15 cats
B)A physically healthy client who has a history of depending on intense relationships to meet basic needs
C)A physically healthy client who lives with parents and relies on public transportation
D)A physically healthy client who is serious, inflexible, perfectionistic, and depends on rules to provide security
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Chapter 35: The Aging Individual
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Q1) An elderly client has met the criteria for a diagnosis of major depressive disorder. The client does not respond to antidepressant medications. Which treatment should a nurse anticipate that the physician would prescribe for this client?
A)Electroconvulsive therapy (ECT)
B)Neuroleptic therapy
C)An antiparkinsonian agent
D)An anxiolytic agent
Q2) A son who recently brought his extremely confused parent to a nursing home for admission reports feelings of guilt. Which is the appropriate nursing reply?
A)"Support groups are held here on Mondays for children of residents in similar situations."
B)"You did what you had to do.I wouldn't feel guilty if I were you."
C)"Support groups are available to low-income families."
D)"Your parent is doing just fine.We'll take very good care of him."
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Chapter 36: Victims of Abuse or Neglect
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Q1) A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement should indicate to a nurse that the student is handling this situation in a healthy manner?
A)"I know that it was not my fault."
B)"My boyfriend has trouble controlling his sexual urges."
C)"If I don't put myself in a dating situation, I won't be at risk."
D)"Next time I will think twice about wearing a sexy dress."
Q2) A woman describes a history of physical and emotional abuse in intimate relationships. Which additional factor should a nurse suspect?
A)The woman may be exhibiting a controlled response pattern.
B)The woman may have a history of childhood neglect.
C)The woman may be exhibiting codependent characteristics.
D)The woman might be a victim of incest.
Q3) Which assessment data should a school nurse recognize as signs of physical neglect?
A)The child is often absent from school and seems apathetic and tired.
B)The child is very insecure and has poor self-esteem.
C)The child has multiple bruises on various body parts.
D)The child has sophisticated knowledge of sexual behaviors.
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Page 38
Chapter 37: Community Mental Health Nursing
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Q1) A client on the inpatient unit tells a student nurse, "My life has no purpose. I can't think about living another day, but please don't tell anyone about the way I feel. I know you are obligated to protect my confidentiality." Which is the most appropriate reply by the student nurse?
A)"The treatment team is composed of many specialists who are working to improve your ability to function.Sharing this information with the team is critical to your care."
B)"Let's discuss steps that will resolve negative lifestyle choices that may increase your suicidal risk."
C)"You seem to be preoccupied with self.You should concentrate on hope for the future."
D)"This information is secure with me because of client confidentiality."
Q2) A 27-year-old client was diagnosed 5 years ago with schizophrenia. What course of treatment should the nurse expect to be implemented?
A)Eventual admission for long-term care in a psychiatric facility
B)Community-based care with numerous brief hospitalizations
C)Case management in the community with few relapses
D)Occasional contact with outpatient counselors and psychiatrists
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Chapter 38: Forensic Nursing
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Q1) A forensic nurse assesses hesitation wounds on a client diagnosed with borderline personality disorder. What assessment data led to this conclusion?
A)Bruising in various stages of discoloration
B)Deep cuts exposing muscle tissue of the wrist
C)Superficial, sharp-force wounds on the lower part of the client's body
D)Vertical lacerations of the face
Q2) Which factor impedes the establishment of a therapeutic relationship between a nurse and a prison inmate?
A)The misinterpretation of relationships as sexual, based on sexual activity deprivation
B)The inmate's suspicion of the nurse's attempt to establish rapport
C)The wide socioeconomic gap between the nurse and inmate
D)The limited inmate freedom that might generate resentments
Q3) A forensic nurse assesses patterned injuries on a 3-year-old child. What assessment data led to this conclusion?
A)Multiple minute cuts and abrasions
B)Generalized bruising of the buttock
C)Circular burn marks, the size of a lit cigarette
D)Stab wounds resulting from sharp object penetration
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Chapter 39: The Bereaved Individual
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Sample Questions
Q1) A nurse is caring for an Irish client who has recently lost a spouse. The client states to the nurse, "I'm planning an elaborate wake and funeral." According to George Engel, what purpose would these rituals serve?
A)To delay the recovery process initiated by the loss of the client's spouse
B)To facilitate the acceptance of the loss of the client's spouse
C)To avoid dealing with grief associated with the loss of the client's spouse
D)To eliminate emotional pain related to the loss of the client's spouse
Q2) A woman returns home after delivering a stillborn infant to find that neighbors have dismantled the nursery that she and her husband planned. According to Worden, how should a nurse expect the neighbor's action to affect the woman's grieving task completion?
A)This action may hamper the woman from continuing a relationship with her infant.
B)This action would help the woman forget the sorrow and move on with life.
C)This action communicates full support from her neighbors.
D)This action would motivate the woman to look to the future and not the past.
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