NCLEX STUDY REVIEW GUIDE
1. A group of nursing students in a psychiatric-mental health rotation are reviewing information about various theorists associated with self, therapeutic use of self, and the therapeutic relationship. The students demonstrate understanding of the materal when they identify which theorist as having identified three core conditions for a therapeutic relationship?
a. Hildegard Peplau
b. Phil Barker
c. Carl Rogers
d. Joyce Travelbee
2. A group of nursing students are reviewing information
about theories of mental illness. The students demonstrate a
need for additional review when they attribute which of the
following as a concept identified by Albert Bandura?
a. Reciprocal determination
b. Behavior modeling
c. Cognitive dissonance
d. Self-efficacy
3. The most important reason why a full physical health assessment is warranted for patients with depressive symptoms is that:
a. they are less likely to complain about their physical health and may have an undiagnosed medical problem.
b. physical health complications are likely to arise from antidepressant therapy.
c. the attention afforded to the patient during the assessment is beneficial in decreasing social isolation.
d. physiological changes may be the underlying cause of depression, and, if present, must be addressed.
4. Which of the following would the nurse identify as a major issue involved with intermittent explosive disorder?
a. Fear of discovery
b. Ineffective health maintenance
c. Injury
d. Substance abuse
5. The nurse is providing care to a patient with frontotemporal dementia. The nurse develops a plan of care for this patient, integrating knowledge about which of the following?
a. The patient has a much shorter life expectancy.
b. The patient has probably experienced multiple
ministrokes.
c. The patient’s memory will remain intact.
d. The patient is at risk for falls due to muscle rigidity.
6. A nurse is integrating Travelbee’s theory of the nurse–patient relationship into the care being provided to a patient. Which of the following is demonstrated when the nurse implements actions to alleviate the ill person’s distress?
a. Emerging identities
b. Empathy
c. Sympathy
d. Rapport
7. When providing care to individuals involved in a community disaster, which of the following would be the priority?
a. Food and water
b. Safety
c. Shelter
d. Referrals
8. The following are the steps of Bailey’s Journey of Grief Model.
Place the steps in their proper sequence after the experience
of loss.
a. Searching
b. Reinvestment
c. Protest
d. Reorganization
e. Despair
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9. Influencing means using one’s persuasive powers.
Psychiatric nurses are well-equipped to participate in the
political process because they are skilled at:
a. Influencing people to change their views, consider new options, have new perspectives and open their minds
to new ideas
b. Developing treatment plans that affect change for the
individual
c. Understanding personalities and personality disorders
d. Juggling multiple facets of a person’s care and tend to
think holistically
10. A group of nursing students are reviewing information about systems theory. The students demonstrate the need for additional review when they identify which of the following?
a. The interactions of a system are viewed in a linear fashion.
b. The parts of a closed system are isolated from the
environment.
c. A change in one component affects other components.
d. An open system is dynamic and constantly changing.
11. When describing the concept of self, which of the following would be most appropriate to include?
a. Discovery of personal identity throughout life
b. A typically positive process of feedback
c. The similarities shared with others in the environment
d. An interaction among two or more individuals
12. A patient states,“I get so anxious sometimes. I just don’t know what to do.”The nurse responds by saying,“You should try to do some exercise when you start to feel this way. I know it helps me when I get anxious.”The nurse is using which of the following?
a. Clarifying
b. False reassurance
c. Validating
d. Giving advice
13. A patient with schizophrenia is about to start medication therapy with clozapine. Which of the following would be most important for the nurse to do?
a. Obtain a baseline white blood cell count
b. Monitor the patient for high fever
c. Suggest the use of hard candy to alleviate dry mouth
d. Assess for cogwheel rigidity
14. Which of the following best depicts a psychiatric-mental health nurse case manager acting in the role of a consultant?
a. Instructing the patient about the need for adhering to his medication schedule.
b. Promoting patient access to the least restrictive treatment method.
c. Recommending possible vocational services that would be appropriate.
d. Proactively identifying potential barriers that may affect the patient.
15. A nurse is providing an in-service presentation for staff members of a clinic about how the clinic is promoting culturally competent care. Which of the following would the nurse include?
a. Emphasis on mental health as a separate entity from primary health care
b. Services that are broad in scope, reflecting general cultural concepts
c. Services that are focused primarily on the major cultural group
d. Focus on the help-seeking behaviors of the unique populations being served
16. When applying Maslow’s hierarchy of needs, which needs category would be the highest level to be achieved?
a. Safety
b. Self-actualization
c. Love
d. Self-esteem
17. When describing Travelbee’s view of suffering to a class, which of the following would the instructor include?
a. It is confined to situations involving physical illness.
b. It is easily controlled through communication.
c. It can range from simple discomfort to extreme anguish.
d. It determines how a person will survive.
18. A group of psychiatric-mental health nurses are preparing an inservice presentation about stress and crisis. Which of the following would the group most likely include in the presentation?
a. Crisis can be a chronic situation due to stress.
b. An unknown stimulus is responsible for the crisis.
c. The stress associated with crisis must be real.
d. Crisis is not considered a mental illness.
19. A mother and her adult daughter are experiencing a conflict.
As a result, the mother turns to her sister and focuses her
attention on her. The adult daughter then begins to focus on
her work role. Applying the Bowen Family Systems Model,
which of the following is present?
a. Differentiation of self
b. Emotional triangle
c. Multigenerational transmission
d. Corrective recapitulation of the primary family group
20. A nurse assesses a patient and determines that the patient is in the alarm stage of responding to stress. Which of the following would the nurse most likely assess?
a. Pupil constriction
b. Decrease in heart rate
c. Rapid respirations
d. Dry skin
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21. A nursing instructor is developing a class for a group of students about the theories of mental health and illness. When gathering information for a discussion on cognitive theories, which of the following would the instructor most likely include?
a. Development of psychoanalytic theory
b. Thorndike
c. Seligman
d. Beck
e. Bandura
22. A nursing instructor is preparing a class for a group of students about case management in psychiatric-mental health nursing. Which of the following would the instructor most likely
include about psychiatric-mental health case management?
a. It is a method of care delivery that is unique to psychiatric-mental health nursing.
b. It is a health care financing strategy aimed at reducing costs.
c. It involves multidisciplinary collaboration to achieve outcomes.
d. It involves reducing fragmentation of care during illness episodes.
23. A patient has been severely depressed and expressing suicidal thoughts. She was started on antidepressant medication four days ago. She is now more energized and communicative. Which of the following would be most important for the nurse to do?
a. Allow the patient to have unsupervised passes to her home.
b. Encourage the patient to participate in group activities. c. Increase vigilance with the patient’s suicidal precautions. d. Recognize that the patient’s suicidal potential has
decreased.
24. Travelbee identifies three major concepts for her theory.
Which concept provides the nurse with the most powerful
intervention?
a. Hope
b. Suffering
c. Human being
d. Empathy
25. A patient is being admitted to the inpatient unit with a diagnosis of borderline personality disorder. When preparing to assess this patient, which of the following would the nurse need to keep in mind?
a. The patient is likely to demonstrate behaviors to get attention.
b. The patient’s behavior typically reflects a need to prevent abandonment.
c. The patient most likely has a history of involvement with law enforcement.
d. The patient will exhibit an extreme suspiciousness about others.
26. A psychiatric-mental health nurse (PMHN) is working
with patients with psychiatric-mental health disorders who
are incarcerated. The nurse is engaging in which of the
following?
a. Forensic nursing b. Disaster response c. Case management d. Telehealth
27. A patient is brought to the emergency department by an emergency medical team because the patient was behaving violently. When talking with the patient, the nurse notices that he suddenly shifts the conversation from one topic to another but the topics are completely unrelated. The nurse would document this finding as which of the following?
a. Delusion
b. Hallucination
c. Neologism
d. Loose association
28. A group of nursing students are reviewing information about substance abuse in adolescence. The students demonstrate an understanding of the information when they identify which of the following as the most commonly abused substance in adolescence?
a. Cocaine b. Cannabis c. Alcohol
d. Amphetamines
29. A patient with an anxiety disorder is asked to imagine specific aspects of the feared situation while engaged in relaxation. The nurse identifies this as which of the following?
a. Flooding
b. Systematic desensitization
c. In vivo exposure
d. Implosion therapy
30. After reviewing information related to the symptoms of schizophrenia, a group of nursing students indicate the need for additional review when they identify which of the following as a positive symptom?
a. Delusion
b. Hallucination
c. Affective flattening
d. Echolalia
31. When engaging in critical thinking, the psychiatric-mental health nurse draws a reasonable conclusion after looking at the evidence and proposing alternatives. The nurse is using which cognitive skill?
a. Evaluation
b. Explanation
c. Interpretation
d. Inference
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32. The psychiatric-mental health nurse is using the Cut-down, Annoyed, Guilty and Eye-opener (CAGE) assessment tool
to screen for alcohol abuse. Which question would the nurse ask first?
a. “Have you ever had a drink first thing in the morning to steady your nerves?”
b. “Have people annoyed you by criticizing your drinking?”
c. “Have you ever felt you should cut down on your drinking?”
d. “Have you ever felt bad or guilty about your drinking?”
33. The nurse is preparing to assess a patient with acute psychosis for the first time. Which of the following would be a priority?
a. Providing a gentle touch to calm the patient
b. Taking as long as necessary to gather all the
information
c. Focusing on the type of delusions the patient is
experiencing
d. Assessing for indications of suicidal ideation
34. Which of the following would the nurse expect to assess in a patient who is diagnosed with an obsessive-compulsive personality disorder?
a. Preoccupation with details
b. Suspiciousness of others
c. Exaggerated sense of self-importance
d. Unwillingness to get involved with others
35. During an interpersonal relationship, a patient identifies that a nurse reminds him of his grandmother and begins to respond to the nurse as he would his grandmother. The nurse recognizes this as which of the following?
a. Boundary testing
b. Transference
c. Boundary crossing
d. Counter-transference
36. A nursing instructor is preparing a class on anxiety disorders and the biological influences associated with this group
of illnesses. Which of the following would the instructor include as a primary neurotransmitter involved in the anxiety response?
a. Gamma-aminobutyric acid (GABA)
b. Serotonin
c. Dopamine
d. Norepinephrine
37. Which statement by a patient with bipolar disorder would indicate the need for additional education about his prescribed lithium carbonate therapy?“I will:
a. drink about 2 liters of liquids daily.”
b. restrict my intake of salt.”
c. take my medications with food.”
d. have my blood drawn like the doctor ordered.”
38. A psychiatric-mental health patient requires level two case management services. Which of the following most likely would be involved?
a. Crisis prevention
b. Extensive services
c. Crisis management
d. Supportive services
39. A patient with alcohol intoxication and a blood alcohol level of 190 mg percent is exhibiting signs of withdrawal. Which
of the following would the nurse expect to assess? Select all that apply.
a. Restlessness
b. Visible hand trembling
c. Hypersensitivity to light
d. Auditory hallucinations
e. Pulse rate less than 89 beats per minute
f. Seizures
40. After teaching a group of students about housing services along the continuum of care, the instructor determines that the students need additional teaching when they identify which of the following as an example?
a. Halfway house
b. Psychiatric home care
c. Supervised apartment
d. Therapeutic foster care
41. A group of nursing students are reviewing ethical principles and theories. They demonstrate understanding of the information when they identify utilitarianism as which of the following?
a. Honesty
b. Fair and equal treatment
c. Doing no harm
d. Greater good
42. A psychiatric-mental health nurse (PMHN) is engaged in advocacy for patients of a local clinic. The nurse is employing which ethical principle?
a. Beneficence
b. Fidelity
c. Kantianism
d. Veracity
43. A patient with anorexia nervosa disorder engages in binge eating and purging behaviors. Which of the following would the patient be least likely to use for purging?
a. Diuretics b. Enemas c. Laxatives
d. Antiemetics
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44. A group of nursing students are reviewing the various risk factors associated with psychiatric-mental health disorders. The students demonstrate understanding of the information when they identify which of the following as a family risk factor?
a. Poverty
b. High crime rate
c. Placement in foster care
d. Temperament
45. A nurse is assessing a patient with an eating disorder for complications. Which of the following might the nurse assess?
a. Hypertension
b. Increased muscle strength
c. Cold intolerance
d. Tachycardia
46. During a group session, the group leader notices that a member is boasting about his accomplishments in an effort to get the group to focus on him rather than focus on the task of the group. The leader would identify this behavior as reflecting which role?
a. Encourager
b. Energizer
c. Recognition seeker
d. Standard setter
47. When integrating critical thinking, clinical decision making, the interpersonal relationship, and the nursing process, which of the following would be of primary importance?
a. Nurse’s self-awareness
b. Setting for care
c. Patient’s needs
d. Achievement of outcomes
48. A nurse is interviewing an adolescent for indications of suicidal ideation. Which patient statement would be a cause for concern?
a. “Don’t worry, I’m not going to be bothering anyone anymore.”
b. “Sometimes I feel like my parents are dictators.”
c. “I used to like to draw, but I’ve found music is more
relaxing.”
d. “School is okay but I’d much rather play sports.”
49. The same student nursing government organization (SNGO) meets to decide on its first approach to taking political action. They agree to lobby select administrators for the changes they feel are important. How would they initially be most effective?
a. Buy radio time to get their message across.
b. Put up flyers around the campus.
c. Meet with the administrators individually.
d. Send out college wide emails.
50. A group of nursing students are reviewing information about Peplau’s phases of the nurse–patient relationship and how they apply to the nursing process. The students demonstrate understanding of the information when they identify which of Peplau’s phases as correlating to the implementation step of the nursing process?
a. Orientation b. Identification c. Exploitation d. Resolution
51. The nurse is reviewing the medical record of a patient, that reveals that the patient experiences intense sexual arousal when being bound and humiliated. The nurse interprets this information as characteristic of which of the following?
a. Sexual masochism
b. Sexual sadism
c. Frotteurism
d. Fetishism
52. The psychiatric-mental health nurse is working with a patient diagnosed with alcohol abuse and is describing the
12-step program of Alcoholics Anonymous. Which of the following would the nurse include?
a. Participants are selected based on their ability to attend meetings.
b. The desire to quit drinking is the underlying concept.
c. Sponsors are selected by the leader of the group
meeting.
d. Sobriety requires that the person focus on future
events.
53. A group is in the orientation phase of development. The group facilitator would be involved with which of the following?
a. Keeping the group on task
b. Clarifying what is happening in the group
c. Reviewing group accomplishments
d. Describing group expectations
54. A nurse is observing the behavior of an 18-month-old child.
The child is playing with a toy that involves placing different
shaped blocks into the appropriately shaped opening. The
child is attempting to place a round block into the round
hole. The nurse interprets this as indicating which of the
following?
a. Circular reaction
b. Object permanence
c. Symbolic play
d. Magical thinking
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55. A student nursing government organization (SNGO) has become aware of an important issue needing addressed at the college. The SNGO decides that they can address the issue through political action because:
a. It is a group of people organizing themselves to influence others to make changes.
b. They can threaten a lawsuit if their demands are not met.
c. They want to proceed cautiously to avoid upseting the administration.
d. They do not want to damage their future careers as nurses.
56. A psychiatric-mental health nurse is a member of several groups. Which of the following would be considered an informal group?
a. Treatment team
b. Specialty nursing association
c. Friends from work
d. Nurses working on the unit
57. A nurse is preparing a presentation for a local community group about abuse and violence. Which of the following would the nurse most likely include?
a. Abuse is primarily seen in lower socioeconomic areas where poverty is rampant.
b. Children typically are around the ages of 8 to 10 years when they suffer abuse.
c. Abuse indicates an underlying mental health disorder that is out of control.
d. An abuser frequently uses more than one method to achieve the goal.
58. A psychiatric-mental health nurse case manager is reviewing a patient’s assessment information and determines that more information is needed to determine why the patient stopped coming to the clinic for his medication prescription. The nurse is demonstrating which of the following?
a. Communication b. Critical thinking c. Negotiation
d. Collaboration
59. During a group session, a member states that she feels embarrassed about being arrested for trying to steal clothing from a department store. Several other group members
then share similar feelings about their involvement with law enforcement, which then leads to a discussion about thinking about consequences and learning from the experience. The leader interprets this interaction as reflecting which curative factor?
a. Instillation of hope
b. Universality
c. Altruism
d. Imitative behavior
60. A nursing instructor is creating a teaching plan for a class about critical thinking. Which of the following would the instructor be least likely to include as a necessary cognitive skill?
a. Analysis b. Creativity c. Inference
d. Self-regulation
61. A patient is receiving a second-generation antipsychotic agent. Which of the following might this be?
a. Chlorpromazine
b. Haloperidol
c. Fluphenazine
d. Aripiprazole
62. A patient with panic disorder is prescribed venlafaxine. The nurse identifies this agent as which of the following?
a. Selective serotonin reuptake inhibitor (SSRI)
b. Serotonin/norepinephrine reuptake inhibitor (SNRI)
c. Benzodiazepine
d. Atypical antipsychotic
63. A psychiatric-mental health nurse is working as a case manager and has a caseload of 120 patients. The nurse is responsible for assessing the patients’needs and arranging for services. The nurse is functioning within which case management model?
a. Broker case management
b. Clinical case management
c. Intensive case management
d. Continuum of care
64. The following tasks reflect the stages of growth and development as identified by Sullivan. Place them in the order in which they would occur beginning with infancy.
a. Self-identity development
b. Delayed gratification
c. Same-sex relationships
d. Oral gratification
e. Opposite-sex relationships
f. Peer relationships
65. The nurse is assessing a patient in whom pathological gambling is suspected. Which statement(s) would the nurse interpret as reflecting the diagnostic criteria for this condition? Select all that apply.
a. “I find myself going back to the casino the next day to get even.”
b. “I started out with small amounts, but now I’m using half of my paycheck.”
c. “I might bet $5 on a football pool every so often.”
d. “I’m going to hit the jackpot again, like I did once
before.”
e. “I went to the racetrack after I told my wife I had to
work late.”
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66. A nurse is providing primary prevention to a local community group about psychiatric-mental health disorders. Which of the following would the nurse include as a protective factor? Select all that apply.
a. Flexibility
b. High intelligence
c. Limited social relationships
d. Absence of recreational activities
e. Adequate economic resources
67. The nurse is conducting an interview with a patient diagnosed with schizophrenia. Throughout the conversation, the patient responds to questions and statements with, “okay.”The nurse interprets this as reflecting which of the following?
a. Affective flattening
b. Alogia
c. Avolition
d. Anhedonia
68. The psychiatric nurse understands that dysthymia differs from a major depression episode in that dysthymia:
a. Typically has an acute onset.
b. Involves delusional thinking.
c. Is a chronic low-level depression.
d. Does not include suicidal ideation.
69. A nurse working at a homeless shelter in a large downtown area should be aware that there are many factors that contribute to homelessness of the mentally ill. Which
of the following would the nurse identify as potentially contributing to homelessness? Select all that apply.
a. Substance abuse
b. Poverty
c. Inadequate housing
d. Low-paying jobs
e. Rise in public assistance
f. Affordable health care
70. While interacting with a patient, the patient says,“How about we meet later after you are done with work and go grab a cup of coffee and talk?”Which response by the nurse would be most appropriate?
a. “That sounds like fun but I’m busy after work.”
b. “Remember, I’m here as a professional to help you.”
c. “Don’t be silly. I can’t meet you after work.”
d. “Okay, but this needs to be our secret.”
71. When assessing an older adult for suspected abuse, the nurse interviews the victim together with the caregiver based on which rationale?
a. To evaluate the patient and caregiver relationship
b. To identify inconsistencies in their statements
c. To confirm the patient’s level of alertness
d. To determine the need for adult protective services
72. A situation with a patient is escalating and the staff determines that restraints are necessary. Which of the following would occur first?
a. Explaining that the staff is there to help
b. Approaching the patient slowly as a unit
c. Taking down the patient to apply the restraints
d. Obtaining an order for the restraints
73. A group of nursing students is reviewing the different types of drugs that may be used to treat dementia of the Alzheimer’s type. The students demonstrate a need for additional study when they identify which of the following as an example of a cholinesterase inhibitor?
a. Donepezil
b. Rivastigmine
c. Galantamine
d. Atorvastatin
74. A nurse is working in an area that has a high concentration of Asian immigrants and is developing a plan to minimize possible risk factors for poor mental health. Which of the following would the nurse least likely address?
a. Social isolation
b. Interaction with new culture
c. Feelings of persecution
d. Stress of acculturation
75. A group of nursing students is reviewing information
about the interpersonal theorists, Peplau and Travelbee. The
students demonstrate understanding of the information
when they identify which person as a key influence on
Peplau?
a. Harry Sullivan
b. Victor Frankl
c. Ida Orlando
d. Sigmund Freud
76. The nurse is assessing an elderly patient. The nurse determines that the patient is at risk for suicide based on which of the following? Select all that apply.
a. Female gender
b. Living alone
c. History of diabetes, arthritis, and stroke
d. Polypharmacy
e. Recent death of spouse
77. When describing the possibility of developing a psychiatric- mental health disorder related to a medical condition, which disorder would the nurse identify as most common and problematic?
a. Schizophrenia
b. Acute stress disorder
c. Personality disorder
d. Depression
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78. A group of students are reviewing information about the impact of culture, race, and ethnicity on mental health
and mental health care delivery. The students demonstrate understanding when they identify which of the following as reflecting cognitive styles?
a. Methods for processing information
b. Information denoting evidence for change
c. Primary locus of decision making
d. Sources of anxiety and anxiety reduction
79. A group of nursing students are reviewing information related to impulse control disorders. The students demonstrate an understanding of the information when they identify which behavior as characteristic of trichotillomania?
a. Fire setting
b. Stealing
c. Pulling out of hair
d. Property destruction
80. A nurse is preparing a presentation about polypharmacy to a local church group of seniors. Which of the following would the nurse least likely include as a common unresolved issue contributing to this problem?
a. Depression
b. Fear
c. Anxiety
d. Pain
81. A nurse is preparing a presentation for a local community group about health care disparities and minorities. The nurse uses the African American population as an example. Which of the following would the nurse include in the presentation?
a. They are more likely to receive a diagnosis for mental health conditions.
b. The rates for suicide are lower in this population.
c. They tend to report physical complaints related to
mental illness.
d. Lower doses of psychotropic medications are
commonly prescribed.
82. The nurse is developing a teaching plan for a patient with an impulse control disorder. The nurse integrates knowledge of which of the following in this plan?
a. An increase in tension leads to an increase in arousal.
b. The act immediately leads to feelings of regret.
c. A need for pleasure is the driving force for acting.
d. Increased arousal leads to a rise in stress.
83. When describing vulnerable populations to a group
of students, which of the following would the nursing
instructor include?
a. They typically experience increased risks for depression.
b. Advocacy is a primary nursing role.
c. The patient is usually completely dependent on the
nurse.
d. Children are more vulnerable than the elderly.
84. In planning care for a patient newly admitted with severe major depressive disorder, the primary nursing intervention would be to:
a. Avoid a stressful situation by asking for the patient’s participation in the plan.
b. Teach the patient about relapse and the signs and symptoms of mania.
c. Assess if the patient has more than two weeks worth of medication.
d. Evaluate the patient’s cognitive functioning and ability to participate in planning care.
85. A nurse is preparing an in-service presentation about sexual dysfunction for a group of nurses involved in a continuing education course. As part of the presentation, the nurse is planning to describe the classic male sexual response cycle. Place the phases of the cycle in the order in which the nurse would present the information.
a. Resolution
b. Desire
c. Orgasm
d. Excitement
86. A patient who is exhibiting acute psychotic symptoms is determined to be of threat to himself. Which level of care would be most appropriate for the patient to receive?
a. Acute inpatient care
b. Partial hospitalization
c. Psychiatric emergency care
d. Residential services
87. A nurse is preparing a presentation for a senior citizen group about stresses that may affect their physical and mental health. Which of the following would the nurse least likely include as an effect of stress?
a. Increased physiologic aging
b. Enhanced immune function
c. Slowing of normal mental changes
d. Increased risk for depression
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88. When describing the results of integrating interpersonal models in psychiatric-mental health nursing, which of the following would be least appropriate to include?
a. Therapeutic communication
b. Milieu management
c. Psychopharmacology
d. Process groups
89. While performing a routine health check-up on a teenager who is 5 feet tall and 100 lbs, a nurse begins to suspect that a patient may be experiencing an eating disorder. Which statement by the patient would lead the nurse to suspect this?
a. “Look at me, look at how fat I am.”
b. “My last period was about 6 weeks ago.”
c. “I just lost 5 pounds so I could fit into my prom dress.”
d. “I usually like to swim about 3 times a week.”
90. A nursing instructor is preparing a class discussion about the development of mental health care over time. Which of the following would the instructor include as occurring first?
a. Development of psychoanalytic theory
b. Establishment of the National Institute of Mental
Health
c. Use of medical treatments such as bloodletting and
immobilization
d. Emphasis on supportive, sympathetic care in a clean,
quiet environment
91. The nurse is working with the parents of a child with a mental health problem in developing a system of rewards and punishments for the child’s behavior. The nurse is demonstrating integration of which theorist?
a. Freud b. Pavlov c. Skinner d. Erikson
92. A patient is being referred for a Level 2 ambulatory behavioral health care service. Which of the following might the nurse expect to be used?
a. Partial hospitalization program b. Assertive community treatment c. Day treatment program
d. Clubhouse program
93. A nursing instructor is preparing a class lecture about impulse control disorder. When describing kleptomania, which of the following would the instructor include?
a. The patient needs the item for personal use.
b. The item is too expensive for the patient to purchase.
c. The object reflects an expression of anger.
d. The person lacks a need for the object.
94. A patient with anorexia is admitted to the in-patient facility because of cardiovascular problems. The patient’s minimal normal acceptable weight is 125 pounds. Which weight would the nurse interpret as indicative of anorexia?
a. 118 pounds b. 112 pounds c. 107 pounds d. 100 pounds
95. A nurse is working with a patient diagnosed with dementia to foster the patient’s personhood. Which of the following would be appropriate to use? Select all that apply.
a. Intimidation
b. Labeling
c. Acceptance
d. Objectification
e. Collaboration
f. Recognition
96. When describing physical boundaries to a group of nursing students, which of the following would the instructor use as an example of this type of boundary?
a. Feelings b. Choices c. Touching
d. Spirituality
97. A patient with dementia of the Alzheimer’s type is demonstrating increasing problems with wandering. In addition, the patient’s caregiver reports that the patient has wandered into the kitchen during the night and left the stove on several times over the past few weeks. Which of the following would be a priority nursing diagnosis for this patient?
a. Chronic confusion related to effects of dementia
b. Risk for injury related to increased wandering
c. Deficient knowledge related to effects of illness
d. Disturbed sleep pattern related to frequent nighttime
awakenings
98. A nurse is planning to implement complementary and alternative medicine therapies with a patient. In which
of the following would the nurse include energy biofield therapies?
a. Meditation
b. Visualization
c. Aromatherapy
d. Acupuncture
99. When applying the Power and Control Wheel to evaluate a victimizer’s behavior, which of the following would indicate intimidation?
a. Calling the victim names
b. Making the victim feel guilty
c. Destroying property
d. Controlling who the victim talks to
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100. A patient is diagnosed with schizophrenia, catatonic type.
Which of the following would the nurse expect to assess?
Select all that apply.
a. Stereotyped movements
b. Mutism
c. Absence of delusions
d. Echopraxia
e. Odd beliefs
101. A patient is brought to the emergency department by
a friend who states,“He’s been in a lot of pain and has
been using oxycodone quite a bit lately.”Which of the
following would lead the nurse to suspect that the patient
is experiencing intoxication?
a. Tachycardia
b. Pinpoint pupils
c. Rhinorrhea
d. Gooseflesh
102. A psychiatric-mental health nurse identifies a nursing diagnosis of defensive coping for a patient being treated for alcohol intoxication. Which statement would support this diagnosis?
a. “I really just drink when my life gets really stressful.”
b. “My employer said I might lose my job if things don’t
change.”
c. “I just can’t do anything right, I’m such a failure.”
d. “My family just seems to be falling apart lately.”
103. During the orientation phase of the nurse–patient relationship, the nurse focuses communication on which of the following?
a. Reason for the patient seeking help
b. The patient as a whole
c. Expected routines
d. Time frame for interaction
104. A nurse is preparing a presentation for a local senior citizen group about dementia and delirium. When describing delirium, which of the following would the nurse include?
a. It occurs gradually over a period of time.
b. It is usually due to an underlying medical condition.
c. It requires medication to slow its progression.
d. It remains fairly constant throughout the day.
105. A group of nurses in the emergency department (ED) are discussing a patient who has been admitted almost every holiday with suicide ideation. One of the nurses stated that the patient is not serious about hurting himself and should not be admitted the next time he comes in. Which response by the charge nurse would be most appropriate?
a. “Telling him we cannot see him may be the answer to stop this behavior.”
b. “Each episode must be individually evaluated and all options explored.”
c. “He obviously needs support that he is not getting elsewhere.”
d. “We should avoid showing any emotion to him the next time he comes in.”
106. A group of nursing students are reviewing the different classes of antidepressants. The students demonstrate understanding of the information when they identify sertraline as exerting its action on which neurotransmitter?
a. Serotonin
b. Dopamine
c. Gamma-aminobutyric acid (GABA)
d. Norepinephrine
107. When assessing a patient with dyspareunia, which of the following would the nurse expect the patient to report?
a. Inability to attain adequate lubrication in response to sexual excitement
b. Recurrent pain in the genital area with sexual intercourse
c. A deficient last of desire for sexual activity
d. An avoidance for engaging in sexual activity
108. A nursing instructor is preparing a teaching plan for a class about nursing theories. Which of the following would the instructor include when describing the Neuman Systems Model?
a. The person is an energy field continually interacting with the environment.
b. Each patient has a central core that includes survival factors common to all.
c. A proper environment is necessary to promote the patient’s reparative powers.
d. The nurse and patient engage in an interpersonal process to reach a desired goal.
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109. After engaging in an argument with a friend at work, a person becomes angry. Moments later, on returning to his or her office, he punches the wall. The person is demonstrating which defense mechanism?
a. Suppression
b. Rationalization
c. Denial
d. Displacement
110. A group of students are reviewing information about the classification of addictive disorders. The students demonstrate understanding of the information when they identify which of the following as a substance use disorder?
a. Substance dependence
b. Substance-induced disorder
c. Susbstance intoxication
d. Substance withdrawal
111. The following are phases associated with a crisis. Which of the following occurs first?
a. Distress occurs as every method of coping fails.
b. Anxiety increases as past coping methods are
ineffective.
c. Exposure to a stressor leads to use of past coping
mechanisms.
d. New and different coping strategies are tried.
112. An elderly patient comes to the clinic complaining of difficulty sleeping, stating,“It just started about a week or so ago.”When obtaining the patient’s history, which of the following would the nurse identify as potentially contributing to the patient’s complaint?
a. Hypertensive agent added to his medications
b. History of arthritis
c. Dinner usually consumed at 5:30 p.m.
d. Routine bedtime at 11:00 p.m.
113. After teaching a group of students about risk and protective factors, the nursing instructor determines that additional teaching is needed when the students state which of the following about resilience?
a. “Everyone is born with resilience but not everybody uses it.”
b. “It is a protective factor that helps balance out the risk factors.”
c. “Individuals need time to develop resilience.”
d. “Resilience promotes better coping with trauma or
stress.”
114. A nurse is in the resolution phase of the interpersonal relationship with a patient. The nurse would also be engaged in which step of the nursing process?
a. Assessment
b. Planning
c. Implementation
d. Evaluation
115. An elderly patient is experiencing social loneliness. Which of the following most likely would be involved?
a. Loss of contact
b. Loss of intimacy
c. Loss of independence
d. Loss of support
116. A nurse breaches a patient’s confidentiality and shares this confidential information in writing. The nurse would most likely be charged with which of the following?
a. Slander
b. Medical battery
c. Libel
d. Assault
117. When engaging in critical thinking, which of the following would the nurse ask first?
a. “What would be the best course of action?”
b. “What is the issue at hand?”
c. “What could have been missed?”
d. “What factors might be affecting the patient?”
118. A group of nursing students is reviewing class information about the different types of personality disorders. The students demonstrate understanding of this information when they identify which of the following as a Cluster A personality disorder? Select all that apply.
a. Borderline personality disorder
b. Paranoid personality disorder
c. Avoidant personality disorder
d. Schizoid personality disorder
e. Narcissistic personality disorder
f. Antisocial personality disorder
119. An older adult patient is admitted to the acute care facility
for treatment of bacterial pneumonia for which the patient is
receiving oxygen therapy and antibiotics. When assessing the
patient, the nurse notes that the patient has suddenly become
confused and agitated and is having increasing difficulty
staying focused. The nurse suspects which of the following?
a. Depression b. Dementia c. Delirium
d. Generalized anxiety disorder
120. A patient with posttraumatic stress disorder (PTSD) is exhibiting hypervigilence. Which statement would the nurse interpret as indicating this?
a. “I’m having trouble sleeping at night.”
b. “I’ve been really irritable and angry.”
c. “I always have to watch my back.”
d. “I just can’t seem to relax.”
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121. A group of students are reviewing medications used to treat depression in the older adult. The students demonstrate a need for additional study when they identify which agent as approved for use in the elderly?
a. Escitalopram
b. Paroxetine
c. Duloxetine
d. Aripiprazole
122. A child is diagnosed with attention deficit hyperactivity disorder (ADHD). When reviewing the child’s history, which of the following would the nurse expect to find?
a. Exposure to a traumatic event
b. Difficulty engaging in quiet leisure activities
c. Frequent losses of temper
d. Previous diagnosis of oppositional defiant disorder
123. A group of nursing students is reviewing information about adjustment disorders in children. The students demonstrate a need for additional study when they identify which of the following as a possible stressor?
a. Witness to the death of a parent
b. Moving away of a close friend
c. Parental divorce
d. Bullying by a classmate
124. A group of students are reviewing information related
to the variables associated with the levels of ambulatory
behavioral care. The students demonstrate understanding
when they identify which of the following as a service
variable?
a. Risk/dangerousness
b. Social system support
c. Level of functioning
d. Milieu
125. The following are phases identified by the model proposed by the anti-violence movement in Oregon. Place them in the proper sequence from beginning to end.
a. Setup
b. Fantasy
c. Planning
d. Abuse
e. Rationalize
f. Guilt
g. Normal
126. Which of the following patients would be least likely to require involuntary commitment?
a. Patient convicted of substance abuse required to undergo treatment
b. Patient who is actively experiencing suicidal ideation c. Patient with depression who is in need of treatment d. Patient deteriorating from a severe, persistent mental
illness
127. The following are examples of therapy that may be used with a patient experiencing a psychiatric-mental health problem. Place the treatments in the proper order based on the concept of the least restrictive environment.
a. Talk therapy
b. Involuntary medication administration
c. Behavioral therapy
d. Seclusion
128. A nurse is interviewing a patient who came to the area after she fled her home country, during a political revolution. When assessing the patient, the nurse notes that the
patient has adopted several of the local customs of the area. The nurse identifies this as which of the following?
a. Ethnicity
b. Enculturation
c. Spirituality
d. Religiosity
129. A patient comes to the clinic for a routine checkup and is to have laboratory testing completed. During the assessment, the patient reveals that he is afraid of needles and begins to hyperventilate. The patient also becomes diaphoretic and complains of a lump in his throat. The nurse would suspect which of the following?
a. Generalized anxiety disorder b. Posttraumatic stress disorder c. Acute stress disorder
d. Specific phobia
130. Applying Freud’s theory, which of the following stages would occur first in the development of personality?
a. Oral
b. Phallic
c. Latency
d. Anal
131. A patient is experiencing heroin withdrawal and develops hypertension. Which of the following would the nurse expect to administer?
a. Phenobarbital
b. Diazepam
c. Clonidine
d. Acamprosate
132. A nurse is working in the community and is preparing a presentation for a local group of parents about child abuse. Which of the following would the nurse most likely include in this presentation?
a. Physicians are the individuals responsible for reporting suspected child abuse.
b. Child abuse primarily involves emotional and sexual abuse.
c. The perpetrator is commonly someone the child knows.
d. When children do reveal abuse, they experience
revictimization.
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133. The three primary concerns targeted by health care reform are:
a. Source, prevention, and waste
b. Quality, access, and value
c. Limitation, categorization, and chronicity
d. Ageism, comprehensiveness, and expense
134. When applying the therapeutic use of self during assessment, which of the following would be important for the nurse to demonstrate? Select all that apply.
a. Genuineness
b. Respect
c. Empathy
d. Adherence to rigid rules
e. Honesty
135. A group of students are reviewing information about the numerous issues that impact the mental health of physically ill patients. The students demonstrate a need for additional study when they identify which of the following?
a. Unhealthy lifestyle practices as an adult can be traced to negative events in childhood.
b. Grief is an abnormal response that interferes with a person’s ability to heal.
c. Neuropeptides and their actions are addressed with psychoneuroimmunology.
d. Pain causes increased secretion of cortisol, which disrupts the immune system.
136. The roots of theory building and policy generation are very similar because:
a. Both can be a very politically influenced.
b. There are multiple levels, each with a different
implication.
c. Neither can ever be proven as fact.
d. Both start with observation of repeated instances of
things that are puzzling or processes that seem to be
wrong or in need of repair.
137. The nurse is assessing a patient and determines that the patient is experiencing a normal grief response based on which of the following?
a. Openly expresses anger
b. Nonintact reality testing
c. Persistent sleeping problems
d. Consistently dysphoric
138. A psychiatric-mental health nurse (PMHN) is preparing a presentation for a group of student nurses about psychiatric-mental health nursing. Which statement would the nurse include in the presentation about this specialty?
a. A PMHN needs to obtain a graduate level degree for practice.
b. Advanced practice PMHNs can engage in psychotherapy.
c. Basic level PMHNs mainly focus on the patient’s ability to function.
d. PMHNs primarily work in acute in-patient settings.
139. The nurse is implementing validation therapy with a patient diagnosed with dementia of the Alzheimer’s type. Which of the following would the nurse do?
a. Confirm the patient’s version of reality
b. Place cards on the bathroom and bedroom doors
c. Repeatedly tell the patient what day it is
d. Have the patient discuss past events
140. A patient with addiction is undergoing treatment that focuses on redirecting dysfunctional thought processes. The patient is involved in which of the following?
a. Motivational enhancement therapy
b. Cognitive behavioral therapy
c. Mindfulnesss
d. Community reinforcement
141. A group of students are reviewing information
about eating disorders. The students demonstrate an
understanding of the topic when they identify which of the
following as being associated with bulimia nervosa?
a. Greater occurrence in males
b. Use of severe fasting rituals
c. More common in women in their 20s and 30s
d. High correlation with overweight and obesity
142. The nurse is assessing a female adolescent who engages in self-harming behavior. Which of the following would the nurse identify as a possible trigger? Select all that apply.
a. Rejection by friends
b. Substance misuse
c. Feelings of power
d. Worthlessness
e. Parental divorce
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143. When developing the plan of care for a patient who has attempted suicide, an understanding of which of the following would be most critical for the nurse to integrate into the plan?
a. Patients who attempt suicide and fail will not try again.
b. The more specific the plan, the greater the risk of suicide.
c. People who talk about suicide rarely go ahead and attempt it.
d. People who attempt suicide and fail do not really want to die.
144. A nurse who will be providing care to a psychiatric- mental health patient is in the orientation phase of the relationship. The nurse would most likely assume which role?
a. Counselor
b. Teacher
c. Stranger
d. Surrogate
145. A group of nursing students are reviewing information on boundaries, boundary crossings, and boundary violations. The students demonstrate understanding of the information when they state which of the following?
a. “Most times, a boundary crossing will lead to a boundary violation.”
b. “Boundary violations can be therapeutic in some instances.”
c. “Boundaries are unnecessary if the patient and nurse view each other as equals.”
d. “Boundary crossings can result in a return to established boundaries.”
146. A nurse is thinking about working in a correctional facility.
Which characteristic would be important for the nurse to
have?
a. Self-awareness
b. Prejudice
c. Cultural bias
d. Inflexibility
147. A nurse is establishing boundaries with a patient who is coming to a community mental health center for treatment. Which of the following would be least appropriate to do during the orientation phase?
a. Give the patient some information about the nurse’s personal life.
b. Explain to the patient the reason for the nurse being there.
c. Describe what it is that the nurse can provide for the patient.
d. Discuss the time, place, and frequency for the meetings.
148. A group of nursing students is reviewing information about anxiety disorders. The students demonstrate a
need for additional study when they identify which of the following as a compulsion?
a. Hearing voices that tell a person he is the king
b. Repeatedly washing hands
c. Touching the door knob three times before leaving
d. Walking in a specific pattern when entering a room
149. A nurse is engaged in assessing a male patient and has determined that it is appropriate to move on to assessing the patient’s sexual history. Which of the following would be most important for the nurse to do first?
a. Make sure that the nurse and patient are alone
b. Ask the patient about whether or not he is sexually
active
c. Question the patient about any history of sexual
abuse
d. Obtain the patient’s permission to ask him questions
about this area
150. A nurse is interviewing a child diagnosed with a conduct disorder. Which of the following would the nurse expect to assess?
a. Repetitive, stereotypical behaviors
b. Difficulty organizing tasks
c. Lack of follow-through with directions
d. Bullying behaviors
151. A patient with antisocial personality disorder is observed taking an other patient’s belongings. Which initial nursing intervention would be most appropriate?
a. Tell the patient’s primary nurse what happened b. Obtain an order for an antipsychotic medication c. Confront the patient about his behavior
d. Encourage the patient to discuss his angry feelings
152. A psychiatric-mental health nurse is engaged in a therapeutic dialogue with a patient. The patient states,“I’ve been feeling
so down lately.”Which of the following would the nurse identify as being congruent with the patient’s statement?
a. Wide facial grin
b. Low tone of voice
c. Fidgeting
d. Erect posture
153. A group of students are reviewing information about the various types of sexual disorders and dysfunctions. The students demonstrate understanding of this topic when they identify which of the following as examples of sexual disorders? Select all that apply.
a. Vaginismus
b. Exhibitionism
c. Pedophilia
d. Premature ejaculation
e. Male erectile disorder
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154. A group of nursing students are reviewing information related to the development of psychiatric-mental nursing. The students demonstrate understanding of the information when they identify which person as emphasizing the use of the interpersonal process?
a. Florence Nightingale
b. Linda Richards
c. Dorothea Dix
d. Hildegard Peplau
155. While working with a patient diagnosed with an antisocial personality disorder, the nurse notes that the patient is beginning to exhibit signs that he is losing emotional control. The nurse assists the patient in moving to a safe, quiet area to regain his control. The nurse is using which of the following?
a. Time out
b. Limit setting
c. Confrontation
d. Cognitive restructuring
156. The nurse is working with group of patients who have immigrated to the United States from several Latin American and South American countries and is reviewing the situation for possible barriers to accessing mental health services. Which of the following would the nurse identify as an environmental barrier?
a. No translator on staff at the facilities
b. Knowledge about the mental health problems
c. Availability of family support
d. Beliefs of mental illness caused by demon
157. When engaging in therapeutic communication for the initial encounter with the patient, which of the following would be most appropriate for the nurse to use?
a. Silence
b. “What would you like to discuss?”
c. “Are you having any problems with anxiety?”
d. “Why do you think you came here today?”
158. When implementing secondary prevention strategies, which of the following would the psychiatric-mental health nurse do first?
a. Conduct community screening b. Identify existence of risk factors c. Teach about coping skills
d. Make referrals for immediate treatment
159. The nurse is developing a plan of care for a patient diagnosed with a schizotypal personality disorder. Which of the following would be most appropriate to include in the plan?
a. Setting specific boundaries for behavior
b. Teaching problem-solving techniques
c. Fostering decision-making skills
d. Implementing social skills training
160. A woman is brought by her husband to the emergency department. The woman has significant swelling surrounding her right eye and bruising over the right side of her face. She is also holding her right upper arm that is covering a large bruised area. The nurse suspects
intimate partner violence. When interviewing the woman, which statement would indicate that the woman is in the honeymoon phase of the cycle of violence?
a. “I feel like I’m walking on eggshells.”
b. “He said he was sorry and wouldn’t do it again.”
c. “I need to make sure I don’t make him angry.”
d. “It was my fault because I didn’t have dinner ready
on time.”
161. Which statement would the nurse expect a newly admitted married patient with mania to make?“I can:
a. not do anything right anymore.”
b. manage our finances better than any accountant.”
c. understand why my spouse is so upset that I spend
so much money.”
d. not understand where all our money goes.”
162. A nurse is preparing a presentation for a local community group about adolescence and mental health problems. Which of the following would the nurse expect to include?
a. Time typically heals any problems that adolescents experience.
b. Problems in adolescence can continue into adulthood if not addressed.
c. Adolescents primarily experience disorders that are uncommon in adults.
d. The stigma associated with mental disorders is seen less frequently with adolescents.
163. Deinstitutionalization occurred as a result of which of the following?
a. Mental Retardation Facilities and Community Mental
Health Centers Act
b. National Mental Health Act
c. Omnibus Budget Reconciliation Act (OBRA)
d. The Surgeon General’s Report on Mental Health
164. While interviewing a middle-aged woman who has
come to the mental health care facility, the woman states,
“My oldest son just left for college last week. I’m so lost
without him. The house seems so empty.”The nurse would
interpret the woman’s statement as suggesting which type
of crisis?
a. Maturational
b. Situational
c. Social
d. Adventitious
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