Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                

Final Examination

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 8

FINAL EXAMINATIONS

NCM117: Care of Clients w/ Maladaptive Patterns of Behavior, Acute and Chronic

A. Multiple Choice

Instruction: Read the following questions carefully and choose the letter that best describes the answer.
Shade your answer in the answer sheet paper. Use pencil No. 2 (no ink or ballpoint pens).

1. A client who is delusional says to the nurse, “The federal guards were sent to kill me.” What is the nurse’s best
response?

A. “The guards are not out to kill you.”

B. “I don’t believe this is true.”


C. “I don’t know anything about the guards. Do you feel afraid that people are trying to hurt you?”
D. “What makes you think the guards were sent to hurt you?”

2. A male client with delirium become disoriented and confused in his room at night. What is the most appropriate
initial nursing intervention?

A. Using a night-light and turning off the television.


B. Keeping the television and a soft light on during the night.
C. Moving the client next to the nurse’s station.
D. Playing soft music during the night and maintaining a well-lit room.

3. A depressed client verbalizes feelings of low self-esteem and self-worth with statements such as, “I’m such a
failure… I can’t do anything right!” What would be the best nursing response be?

A. Telling the client that this is not true and that we all have a purpose in life.
B. Remaining with the client and sitting in silence, this will encourage the client to verbalize the feelings.
C. Reassuring the client that you know how the client is feeling and that things will get better.
D. Identifying recent behaviors or accomplishments that demonstrate skill ability.

4. A client with diagnosis of “major depression recurrent with psychotic features” is admitted to the mental health
unit to create a safe environment to the client, the nurse most importantly devises a plan of care that deals
specifically with the client’s:

A. Altered thought processes


B. Altered Nutrition
C. Self-care deficit
D. Knowledge deficit

5. A depressed client is ready for discharge. The nurse feels comfortable that the client has a good understanding
of the disease process when the client states which the following?

A. “I’ll never let his happen to me again. I won’t let my boss or my job or my family gets to me!”.
B. “It’s important for me to eat well, exercise, and take my medication. If I’m begin to lose my appetite or not
sleep well, I’ve got to get in to see my doctor.”
C. I’ve learned that I am a good person and that I am worthy of giving and receiving love. I don’t ever want to
feel so weak or vulnerable again.
D. “I don’t know what happened to me. I’ve always been able to make decisions for myself and for my business. I
don’t ever want to feel so weak or vulnerable again!
6. A nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway, and
making aggressive and belligerent gestures at other clients. Which statement would be most appropriate to make
to make to this client?

A. “What is causing you to become agitated?”


B. “You need to stop that behavior now!”
C. “You will need to be restrained if you do not change your behavior.”
D. “You will need to be placed in seclusion.”

7. A nurse has been closely observing a client that has been displaying aggressive behaviors. The nurse observes
that the behavior displayed by the client is escalating. Which nursing intervention is least helpful to this, client at
this time?

A. Acknowledging the client’s behavior.


B. Maintaining a safe distance from the client.
C. Assisting the client to an area that is quiet.
D. Initiating confinement measures.

8. A nurse is preparing a discharge plan for the client who attempted suicide. The plan for the client who
attempted. The plan of care should focus on which of the following?
A. Follow-up appointments.
B. Contracts and immediately available crisis resources.
C. Encouraging the family to always be with the client.
D. Providing the hospital phone number.

9. Which behavior observed by the nurse indicates reason for suspicion that a depressed female adolescent client
may be suicidal?

A. The client becomes angry while speaking on the telephone and slams the receiver down on the hook.
B. The client runs out of the therapy group, swearing at the group leader, and runs to her room.
C. The client gets angry with her roommate when the roommate barrows the client’s clothes without asking.
D. The client gives away a prized compact disc and a cherished autograph picture of the performer.

10. A nurse is developing a plan of care for a client who is scheduled to have electroconvulsive therapy (ECT).
Which nursing diagnosis is a priority for this client.

A. Fear
B. Anxiety
C. Risk for aspiration
D. Body image disturbance

11. A hospitalized client is being considered for electroconvulsive therapy (ECT). The client appears calm. But
the family is anxious. The client’s mother begins to cry and states, “My son’s brain will be destroyed. How can
the doctor do this to him?” What is the nurse’s best response?

A. “It sounds as though you need to speak to the psychiatrist.


B. “Your son has decided to have this treatment. You should be supportive of him.”
C. “Perhaps you’d like to see the ECT room and speak to the staff.”
D. “It sounds as though you have some concerns about the ECT procedure. Why don’t we all sit down together
and discuss any concerns you may have.”
12. A client is admitted to a mental health unit for treatment of psychotic behavior. The client is at the locked exit
door and is shouting, “Let me out. There’s nothing wrong with me. I don’t belong here.” The nurse analyzes this
behavior as:

A. Projection
B. Denial
C. Regression
D. Rationalization

13. A nurse is caring for a client with a phobia who is being treated for the condition. The client is introduced to
short periods of exposure to the phobic object while in a relaxed state. The nurse understands that this form of
behavior modification can be best described as:

A. Systematic desensitization
B. Self-control therapy
C. Milieu therapy
D. Aversion therapy

14. A client is unwilling to go out of the house for fear of “doing something crazy in public.” Because of this fear,
the client remains homebound except when accompanied outside by the spouse. Based on this data, the nurse
determines that the client is experiencing which of the following;

A. Social phobia
B. Agoraphobia
C. Claustrophobia
D. Hypochondriasis

15. A client is admitted to the mental health unit which a diagnosis of schizophrenia. A nursing diagnosis
formulated for the client is “altered thought process secondary to paranoia.” In formulating nursing intervention
with the members of the health care team. The nurse provides instructions to do which of the following?

A. Avoid laughing and whispering in front of the client.


B. Increase socialization of the client with peers.
C. Have the client sign a release of information to appropriate parties so that adequate data can be obtained for
assessment purposes.
d. Begin to educate the client about social support in the community.

16. A client is admitted to a medical nursing unit with a diagnosis of acute blindness. Many tests are performed,
and there seems to be no organic reason why this client cannot see. A nurse later learns that the became blind after
witnessing a hit-and-run car accident, when a family of three was killed. The nurse suspects that the client may be
experiencing which of the following”

A. Psychosis
B. Conversion disorder
C. Dissociative disorder
D. Repression

17. A nurse is caring for a male client diagnosed with catatonic stupor. The client is lying on the bed, with his
body pulled into a fetal position. Which of the following is the most appropriate nursing intervention?

A. Leaving the client alone and intermittently checking on him.


B. Taking the client into the day room with other clients so that they can help watch him.
C. Sitting quietly beside the client and asking occasional open-ended questions.
D. Asking direct questions to encourage the client to talk.
18. The statement that would best describe the practice of psychiatric nursing would be to:

A. Helping people with present or potential mental health problems.


B. Ensuring client’s legal and ethic rights by acting a client advocate.
C. Focusing interpersonal skills on people with physical or emotional problems.
D. Acting in a therapeutic way with people diagnosed as having a mental disorder.

19. An acutely ill client with diagnosis of schizophrenia has just been admitted to the mental health unit. When
working with client, initially the nurse’s most therapeutic action would be to:

A. Use diversional activity and involve the client in occupational therapy.


B. Build trust and demonstrate acceptance by spending some time with the client.
C. Delay one-to-one interactions until medications reduce the psychotic symptoms.
D. Involve the client in multiple small group discussions to distract attention from the fantasy world.

20. After several weeks of caring for a client in the terminal stage of an illness the nurse becomes increasingly
aware of a need to get away from the relationship for a period of time. The best initial action of the nurse would
be to:

A. Ask to be assigned to another client.


B. Request vacation time for s few days.
C. Seek support from the colleagues on the unit.
D. Withdraw emotional involvement from the client.

21. In psychiatric nursing, the most important tool the nurse brings to helping relationship is:

A. Oneself and a desire to help


B. Advanced communication skills management
C. Knowledge of psychopathology
D. Years of experiencing in milieu

22. An elderly client has not been eating well since admission. The client repeatedly states, “No one cares.” The
most appropriate response by the nurse would be:

A. “We all care about you, now please eat.”


B. “You know you have to eat to stay alive.”
C. “I care about you. What foods do you specially like?”
D. “I care about you. Please eat some of this food for me.”

23. A male nurse is caring for a client. The client states, “You know, I’ve never had a male nurse before.” The
nurse best reply would be:

A. “Does it bother you to have a male nurse?”


B. “There aren’t many of us, we’re a minority.”
C. “How do you feel about having a male nurse?”
D. “You sound upset. Would you prefer a female nurse?”

24. The most advantageous therapy for a preschool-age child with a history of physical and sexual abuse would
be:

A. Play therapy
B. Psychodrama
C. Group therapy
D. Family therapy
25. During a one-to-one interaction with a nurse, the client states, “I’m worried about going home.” The nurse
responds. “Tell me more about this.” This response is an example of:

A. Focusing
B. Clarifying
C. Reflecting
D. Refocusing

26. A nurse assigned to care for a regressed 19-years-old college student newly admitted to the psychiatric unit
with a 1-month history of talking to unseen people and refusing to get out of bed, go to class, or get involved in
daily grooming activities. The nurse’s initial efforts should be directed toward helping the client by:

A. Providing frequent rest periods to avoid exhaustion


B. Facilitating the client’s social relationships with a peer group
C. Reducing environmental stimuli and maintaining dietary intake
D. Attempting to establish a meaningful relationship with the client.

27. A depresses client has been started on a tricyclic antidepressant. The nurse teaches the client to expect to
notice a significant change in the depression within:

A. 12 to 16 hours
B. 4 to 6 days
C. 1 to 4 weeks
D. 5 to 6 weeks

28. A client is receiving lithium carbonate. While this medication is being administered, it is important that the
nurse:

A. Test the client’s urine weekly


B. Restrict the client’s sodium intake
C. monitor the client’s blood level
D. Withhold the client’s other medication for 1 week

29. A client in the hyperactive phase of a mood disorder, bipolar type, is receiving lithium carbonate. The nurse
notes that the client’s lithium blood level is 1.8 mEq/L. It would be the most appropriate for the nurse to:

A. Continue the usual dose of lithium and note any adverse reactions.
B. Discontinue the drug until the lithium serum level drop to 0.5 mEq/L.
C. Notify the physician immediately, since the lithium serum level may be toxic
D. Ask the physician to increase the dose of the lithium, since the serum level is too low.

30. A client on maintenance dose of lithium therapy develops hand tremors, muscle hyper-irritability, and mental
confusion. The nurse should:

A. Withhold the medication, obtain blood levels, and call the physician.
B. Check for nausea, vomiting, thirst, and polyuria before administering the next dose of lithium
C. Expect these side effects, administer the medication as ordered, and note these findings in the record
D. Withhold the medication, check the blood pressure, and, if within normal limits, administer the correct dosage.

31. A psychiatric client is to be discharged with orders for haloperidol (Haldol) therapy. When developing a
teaching plan for discharge, the nurse should include cautioning the client against:

A. Driving at night
B. Staying in the sun
C. Ingesting wines and cheeses
D. Taking medications containing aspirin
32. A client has been on an acute care psychiatric unit for 3 days and is receiving haloperidol (Haldol) tablets
orally to reduce agitation and preoccupation with auditory hallucinations since the medication was started. The
priority nursing intervention would be to:

A. Ask the psychiatrist to change the medication


B. Secure an order for prn sedation until the client calms down
C. Assess to make certain the client is swallowing the medication
D. Recognize that the therapeutic level of the drug has not been achieved

33. The nurse evaluates that the teaching about taking the medication amitriptyline (Elavil) has been understood
when the client states:

A. “I must discontinue this medication if side effects occur.”


B. “I don’t need to be concerned about taking my medications.”
C. “It is necessary to take each dose of my medication as ordered.”
D. “I may find it necessary to adjust the dosage if side effects occur.”

34. When Monoamine Oxidase Inhibitors (MAOIs) are prescribed, the client should be cautioned against:

A. Prolonged exposure to the sun


B. Ingesting wines and aged cheeses
C. Engaging in active physical exercise
D. The use of medications with an elixir base

35. The nurse is aware that Freud’s phallic stage of psychosexual development, which compares with Erickson’s
psychosocial phase of initiative vs. guilt, is best seen at:

A. Adolescence
B. 6 to 12 years
C. Birth to 1 year
D. 3 to 5 ½ years

36. A male college student who is smaller than average and unable to participate in sports becomes the life of the
party and stylish dresser. This example of mechanism of:

A. Introjection
B. Sublimation
C. Compensation
D. Reaction formation

37. The basic emotional task for the toddler is:

A. Trust
B. Industry
C. Identification
D. Independence

38. Resolution of the oedipal complex takes place when the child:

A. Rejects the parent of the same sex


B. Introjects behaviors of both parents
C. Identifies with the parent of the same sex
D. Identifies with the parent of the opposite sex
39. A 35-year-old woman is brought to a mental hospital by her husband. The client is in a stupor and the husband
states that her drinking has intensified in three years since their son died. Taking this history into consideration,
the nurse makes a tentative nursing diagnosis of:

A. Dysfunction grieving
B. Disabled family coping
C. Disturbed personal identity
D. Disturbed thought processes

40. When the nurse is communicating with a client with substance-induced persisting dementia, the client cannot
remember facts and fill in the gaps with imaginary information. The nurse is aware that this is typical of:

A. Concretism
B. Confabulation
C. Flight of ideas
D. Associative looseness

41. The nurse, working in a mental health facility, determines that the priority nursing intervention for a newly
admitted client with bulimia nervosa would be to:

A. Monitor the client continuously


B. Observe the client during meals
C. Teach the client to measure intake and output
D. Involve the client in developing a daily meal plan

42. A characteristic that would suggest to the nurse that an adolescent may have bulimia would be:

A. Badly stained teeth


B. A positive body image
C. A previous history of gastritis
D. Frequent regurgitation and re-swallowing

43. One afternoon the nurse on the unit overhears a young female client having an argument with her boyfriend.
A while later the client complains to the nurse that dinner is always late and the meals are terrible. The nurse
recognizes that the defense mechanism the client is using is:

A. Projection
B. Dissociation
C. Displacement
D. Intellectualization

44. Although upset by a young client’s continuous complaints about all aspects of care, the nurse ignores them
and attempts to divert the conversation. Immediately following this exchange with the client, the nurse discusses
with a friend the various stages of development of young adults. The defense mechanism the nurse is using is:

A. Substitution
B. Sublimation
C. Identification
D. Intellectualization
45. In an attempt to remain objective and support a client during crisis, the nurse uses imagination and
determination to project the self into the client’s emotions. The nurse accomplishes this by using the technique
known as:

A. Empathy
B. Sympathy
C. Projection
D. Acceptance

46. A 9 years old boy has just been told he must stay in the hospital in traction for at least two weeks. The nurse
finds him crying and unwilling to talk. At this time, the nurse should give the highest priority to:

A. Giving him privacy and allowing him to cry


B. Trying to distract him to prevent embarrassment
C. Telling him that his injury will not be permanent
D. Arranging for him to have a tutor begin immediately

47. A terminally ill 76 years old client is very quiet and unwilling to have visitors. During the initial contact with
the client, the nurse should:

A. Attempt to understand what the death and dying process means to the client
B. Avoid talking about the client’s condition unless the client initiates the discussion
C. Ascertain how much pain the client is experiencing and what medications have been ordered
D. Explore the extent to which the client is aware of the prognosis and the client’s feeling about the situation

48. A female client terminally ill with cancer says to the nurse, “My husband is avoiding me. He doesn’t love me
anymore because of this damn tumor!” The nurse most appropriate response would be:

A. “What makes you think he doesn’t love you?”


B. “Avoidance is a defense; he needs your help to cope
C. “He is probably having difficult dealing with your illness.”
D. “You seem very upset. Tell me how your husband avoiding you.”

49. With the diagnosis of a possible pervasive developmental autistic disorder, the nurse would find it most
unusual for 3 years old to demonstrate:

A. Ritualistic behavior
B. An attachment to odd objects
C. An interest in music
D. Responsiveness to the parents

50. The nurse is aware that language development in autistic child resembles:

A. Echolalia
B. Stuttering
C. Speech lag
D. Scanning speech

“Success is no accident. It is hard work, perseverance, learning, studying, sacrifice and most of all, love of what
you are doing or learning to do.”

― Pelé, Brazillian pro footballer

You might also like