Wednesday, June 25, 2014


This is a 50-item practice test with answers and rationales:

1. Mental health is defined as:
a. The ability to distinguish what is real from what is not.
b. A state of well-being where a person can realize his own abilities can cope with normal stresses of life and work productively.
c. Is the promotion of mental health, prevention of mental disorders, nursing care of patients during illness and rehabilitation
d. Absence of mental illness
2. Which of the following describes the role of a technician?
a. Administers medications to a schizophrenic patient.
b. The nurse feeds and bathes a catatonic client
c. Coordinates diverse aspects of care rendered to the patient
d. Disseminates information about alcohol and its effects.
3. Letty says, “Give me 10 minutes to recall the name of our college professor who failed many students in our anatomy class.” She is operating on her:
a. Subconscious
b. Conscious
c. Unconscious
d. Ego
4. The superego is that part of the psyche that:
a. Uses defensive function for protection.
b. Is impulsive and without morals.
c. Determines the circumstances before making decisions.
d. The censoring portion of the mind.
5. Primary level of prevention is exemplified by:
a. Helping the client resume self care.
b. Ensuring the safety of a suicidal client in the institution.
c. Teaching the client stress management techniques
d. Case finding and surveillance in the community
6. Situation: In a home visit done by the nurse, she suspects that the wife and her child are victims of abuse. Which of the following is the most appropriate for the nurse to ask?
a. “Are you being threatened or hurt by your partner?
b. “Are you frightened of you partner”
c. “Is something bothering you?”
d. “What happens when you and your partner argue?”
7. The wife admits that she is a victim of abuse and opens up about her persistent distaste for sex. This sexual disorder is:
a. Sexual desire disorder
b. Sexual arousal disorder
c. Orgasm disorder
d. Sexual Pain Disorder
8. What would be the best approach for a wife who is still living with her abusive husband?
a. “Here’s the number of a crisis center that you can call for help .”
b. “Its best to leave your husband.”
c. “Did you discuss this with your family?”
d. “ Why do you allow yourself to be treated this way”
9. Which comment about a 3-year-old child if made by the parent may indicate child abuse?
a. “Once my child is toilet trained, I can still expect her to have some”
b. “When I tell my child to do something once, I don’t expect to have to tell”
c. “My child is expected to try to do things such as, dress and feed.”
d. “My 3-year-old loves to say NO.”
10. The primary nursing intervention for a victim of child abuse is:
a. Assess the scope of the problem
b. Analyze the family dynamics
c. Ensure the safety of the victim
d. Teach the victim coping skills
11. Situation: A 30-year-old male employee frequently complains of low back pain that leads to frequent absences from work. Consultation and tests reveal negative results. The client has which somatoform disorder?
a. Somatization Disorder
b. Hypochondriasis
c. Conversion Disorder
d. Somatoform Pain Disorder
12. Freud explains anxiety as:
a. Strives to gratify the needs for satisfaction and security
b. Conflict between id and superego
c. A hypothalamic-pituitary-adrenal reaction to stress
d. A conditioned response to stressors
13. The following are appropriate nursing diagnosis for the client EXCEPT:
a. Ineffective individual coping
b. Alteration in comfort, pain
c. Altered role performance
d. Impaired social interaction
14. The following statements describe somatoform disorders:
a. Physical symptoms are explained by organic causes
b. It is a voluntary expression of psychological conflicts
c. Expression of conflicts through bodily symptoms
d. Management entails a specific medical treatment
15. What would be the best response to the client’s repeated complaints of pain:
a. “I know the feeling is real tests revealed negative results.”
b. “I think you’re exaggerating things a little bit.”
c. “Try to forget this feeling and have activities to take it off your mind”
d. “So tell me more about the pain”
16. Situation: A nurse may encounter children with mental disorders. Her knowledge of these various disorders is vital. When planning school interventions for a child with a diagnosis of attention deficit hyperactivity disorder, a guide to remember is to:
a. provide as much structure as possible for the child
b. ignore the child’s overactivity.
c. encourage the child to engage in any play activity to dissipate energy
d. remove the child from the classroom when disruptive behavior occurs
17. The child with conduct disorder will likely demonstrate:
a. Easy distractibility to external stimuli.
b. Ritualistic behaviors
c. Preference for inanimate objects.
d. Serious violations of age related norms.
18. Ritalin is the drug of choice for children with ADHD. The side effects of the following may be noted:
a. increased attention span and concentration
b. increase in appetite
c. sleepiness and lethargy
d. bradycardia and diarrhea
19. School phobia is usually treated by:
a. Returning the child to the school immediately with family support.
b. Calmly explaining why attendance in school is necessary
c. Allowing the child to enter the school before the other children
d. Allowing the parent to accompany the child in the classroom
20. A 10 year old child has very limited vocabulary and interaction skills. She has an I.Q. of 45. She is diagnosed to have Mental retardation of this classification:
a. Profound
b. Mild
c. Moderate
d. Severe
21. The nurse teaches the parents of a mentally retarded child regarding her care. The following guidelines may be taught except:
a. overprotection of the child
b. patience, routine and repetition
c. assisting the parents set realistic goals
d. giving reasonable compliments
22. The parents express apprehensions on their ability to care for their maladaptive child. The nurse identifies what nursing diagnosis:
a. hopelessness
b. altered parenting role
c. altered family process
d. ineffective coping
23. A 5 year old boy is diagnosed to have autistic disorder. Which of the following manifestations may be noted in a client with autistic disorder?
a. argumentativeness, disobedience, angry outburst
b. intolerance to change, disturbed relatedness, stereotypes
c. distractibility, impulsiveness and overactivity
d. aggression, truancy, stealing, lying
24. The therapeutic approach in the care of an autistic child include the following EXCEPT:
a. Engage in diversionary activities when acting -out
b. Provide an atmosphere of acceptance
c. Provide safety measures
d. Rearrange the environment to activate the child
25. According to Piaget a 5 year old is in what stage of development:
a. Sensorimotor stage
b. Concrete operations
c. Pre-operational
d. Formal operation
26. Situation : The nurse assigned in the detoxification unit attends to various patients with substance-related disorders. A 45 years old male revealed that he experienced a marked increase in his intake of alcohol to achieve the desired effect This indicates:
a. withdrawal
b. tolerance
c. intoxication
d. psychological dependence
27. The client admitted for alcohol detoxification develops increased tremors, irritability, hypertension and fever. The nurse should be alert for impending:
a. delirium tremens
b. Korsakoff’s syndrome
c. esophageal varices
d. Wernicke’s syndrome
28. The care for the client places priority to which of the following:
a. Monitoring his vital signs every hour
b. Providing a quiet, dim room
c. Encouraging adequate fluids and nutritious foods
d. Administering Librium as ordered
29. Another client is brought to the emergency room by friends who state that he took something an hour ago. He is actively hallucinating, agitated, with irritated nasal septum.
a. Heroin
b. cocaine
c. LSD
d. marijuana
30. A client is admitted with needle tracts on his arm, stuporous and with pin point pupil will likely be managed with:
a. Naltrexone (Revia)
b. Narcan (Naloxone)
c. Disulfiram (Antabuse)
d. Methadone (Dolophine)
31. Situation: An old woman was brought for evaluation due to the hospital for evaluation due to increasing forgetfulness and limitations in daily function. The daughter revealed that the client used her toothbrush to comb her hair. She is manifesting:
a. apraxia
b. aphasia
c. agnosia
d. amnesia
32. She tearfully tells the nurse “I can’t take it when she accuses me of stealing her things.” Which response by the nurse will be most therapeutic?
a. ”Don’t take it personally. Your mother does not mean it.”
b. “Have you tried discussing this with your mother?”
c. “This must be difficult for you and your mother.”
d. “Next time ask your mother where her things were last seen.”
33. The primary nursing intervention in working with a client with moderate stage dementia is ensuring that the client:
a. receives adequate nutrition and hydration
b. will reminisce to decrease isolation
c. remains in a safe and secure environment
d. independently performs self care
34. She says to the nurse who offers her breakfast, “Oh no, I will wait for my husband. We will eat together” The therapeutic response by the nurse is:
a. “Your husband is dead. Let me serve you your breakfast.”
b. “I’ve told you several times that he is dead. It’s time to eat.”
c. “You’re going to have to wait a long time.”
d. “What made you say that your husband is alive?
35. Dementia unlike delirium is characterized by:
a. slurred speech
b. insidious onset
c. clouding of consciousness
d. sensory perceptual change
36. Situation: A 17-year-old gymnast is admitted to the hospital due to weight loss and dehydration secondary to starvation. Which of the following nursing diagnoses will be given priority for the client?
a. altered self-image
b. fluid volume deficit
c. altered nutrition less than body requirements
d. altered family process
37. What is the best intervention to teach the client when she feels the need to starve?
a. Allow her to starve to relieve her anxiety
b. Do a short term exercise until the urge passes
c. Approach the nurse and talk out her feelings
d. Call her mother on the phone and tell her how she feels
38. The client with anorexia nervosa is improving if:
a. She eats meals in the dining room.
b. Weight gain
c. She attends ward activities.
d. She has a more realistic self concept.
39. The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is that bulimic individuals
a. have episodic binge eating and purging
b. have repeated attempts to stabilize their weight
c. have peculiar food handling patterns
d. have threatened self-esteem
40. A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating habits. The goal for this problem is:
a. Patient will learn problem solving skills
b. Patient will have decreased symptoms of anxiety.
c. Patient will perform self care activities daily.
d. Patient will verbalize how to set limits on others.
41. In the management of bulimic patients, the following nursing interventions will promote a therapeutic relationship EXCEPT:
a. Establish an atmosphere of trust
b. Discuss their eating behavior.
c. Help patients identify feelings associated with binge-purge behavior
d. Teach patient about bulimia nervosa
42. Situation: A 35 year old male has intense fear of riding an elevator. He claims “ As if I will die inside.” This has affected his studies The client is suffering from:
a. agoraphobia
b. social phobia
c. Claustrophobia
d. xenophobia
43. Initial intervention for the client should be to:
a. Encourage to verbalize his fears as much as he wants.
b. Assist him to find meaning to his feelings in relation to his past.
c. Establish trust through a consistent approach.
d. Accept her fears without criticizing.
44. The nurse develops a countertransference reaction. This is evidenced by:
a. Revealing personal information to the client
b. Focusing on the feelings of the client.
c. Confronting the client about discrepancies in verbal or non-verbal behavior
d. The client feels angry towards the nurse who resembles his mother.
45. Which is the desired outcome in conducting desensitization:
a. The client verbalize his fears about the situation
b. The client will voluntarily attend group therapy in the social hall.
c. The client will socialize with others willingly
d. The client will be able to overcome his disabling fear.
46. Which of the following should be included in the health teachings among clients receiving Valium:
a. Avoid taking CNS depressant like alcohol.
b. There are no restrictions in activities.
c. Limit fluid intake.
d. Any beverage like coffee may be taken
47. Situation: A 20 year old college student is admitted to the medical ward because of sudden onset of paralysis of both legs. Extensive examination revealed no physical basis for the complaint. The nurse plans intervention based on which correct statement about conversion disorder?
a. The symptoms are conscious effort to control anxiety
b. The client will experience high level of anxiety in response to the paralysis.
c. The conversion symptom has symbolic meaning to the client
d. A confrontational approach will be beneficial for the client.
48. Nikki reveals that the boyfriend has been pressuring her to engage in premarital sex. The most therapeutic response by the nurse is:
a. “I can refer you to a spiritual counselor if you like.”
b. “You shouldn’t allow anyone to pressure you into sex.”
c. “It sounds like this problem is related to your paralysis.”
d. “How do you feel about being pressured into sex by your boyfriend?”
49. Malingering is different from somatoform disorder because the former:
a. Has evidence of an organic basis.
b. It is a deliberate effort to handle upsetting events
c. Gratification from the environment are obtained.
d. Stress is expressed through physical symptoms.
50. Unlike psychophysiologic disorder Linda may be best managed with:
a. medical regimen
b. milieu therapy
c. stress management techniques
d. psychotherapy

Answers and Rationale

1. Answer: (B) A state of well-being where a person can realize his own abilities can cope with normal stresses of life and work productively.
Mental health is a state of emotional and psychosocial well being. A mentally healthy individual is self aware and self directive, has the ability to solve problems, can cope with crisis without assistance beyond the support of family and friends fulfill the capacity to love and work and sets goals and realistic limits. A. This describes the ego function reality testing. C. This is the definition of Mental Health and Psychiatric Nursing. D. Mental health is not just the absence of mental illness.
2. Answer: (A) Administers medications to a schizophrenic patient.
Administration of medications and treatments, assessment, documentation are the activities of the nurse as a technician. B. Activities as a parent surrogate. C. Refers to the ward manager role. D. Role as a teacher.
3. Answer: (A) Subconscious
Subconscious refers to the materials that are partly remembered partly forgotten but these can be recalled spontaneously and voluntarily. B. This functions when one is awake. One is aware of his thoughts, feelings actions and what is going on in the environment. C. The largest potion of the mind that contains the memories of one’s past particularly the unpleasant. It is difficult to recall the unconscious content. D. The conscious self that deals and tests reality.
4. Answer: (D) The censoring portion of the mind.
The critical censoring portion of one’s personality; the conscience. A. This refers to the ego function that protects itself from anything that threatens it.. B. The Id is composed of the untamed, primitive drives and impulses. C. This refers to the ego that acts as the moderator of the struggle between the id and the superego.
5. Answer: (C) Teaching the client stress management techniques
Primary level of prevention refers to the promotion of mental health and prevention of mental illness. This can be achieved by rendering health teachings such as modifying ones responses to stress. A. This is tertiary level of prevention that deals with rehabilitation. B and D. Secondary level of prevention which involves reduction of actual illness through early detection and treatment of illness.
6. Answer: (A) “Are you being threatened or hurt by your partner?
The nurse validates her observation by asking simple, direct question. This also shows empathy. B, C, and D are indirect questions which may not lead to the discussion of abuse.
7. Answer: (A) Sexual desire disorder
Has little or no sexual desire or has distaste for sex. B. Failure to maintain the physiologic requirements for sexual intercourse. C. Persistent and recurrent inability to achieve an orgasm. D. Also called dyspareunia. Individuals with this disorder suffer genital pain before, during and after sexual intercourse.
8. Answer: (A) “Here’s the number of a crisis center that you can call for help .”
Protection is a priority concern in abuse. Help the victim to develop a plan to ensure safety. B. Do not give advice to leave the abuser. Making decisions for the victim further erodes her esteem. However discuss options available. C. The victim tends to isolate from friends and family. D. This is judgmental. Avoid in anyway implying that she is at fault.
9. Answer: (B) “When I tell my child to do something once, I don’t expect to have to tell”
Abusive parents tend to have unrealistic expectations on the child. A,B and C are realistic expectations on a 3 year old.
10. Answer: (C) Ensure the safety of the victim
The priority consideration is the safety of the victim. Attend to the physical injuries to ensure the physiologic safety and integrity of the child. Reporting suspected case of abuse may deter recurrence of abuse. A,B and D may be addressed later.
11. Answer: (D) Somatoform Pain Disorder
This is characterized by severe and prolonged pain that causes significant distress. A. This is a chronic syndrome of somatic symptoms that cannot be explained medically and is associated with psychosocial distress. B. This is an unrealistic preoccupation with a fear of having a serious illness. C. Characterized by alteration or loss in sensory or motor function resulting from a psychological conflict.
12. Answer: (B) Conflict between id and superego
Freud explains anxiety as due to opposing action drives between the id and the superego. A. Sullivan identified 2 types of needs, satisfaction and security. Failure to gratify these needs may result in anxiety. C. Biomedical perspective of anxiety. D. Explanation of anxiety using the behavioral model.
13. Answer: (D) Impaired social interaction
The client may not have difficulty in social exchange. The cues do not support this diagnosis. A. The client maladaptively uses body symptoms to manage anxiety. B. The client will have discomfort due to pain. C. The client may fail to meet environmental expectations due to pain.
14. Answer: (C) Expression of conflicts through bodily symptoms
Bodily symptoms are used to handle conflicts. A. Manifestations do not have an organic basis. B. This occurs unconsciously. D. Medical treatment is not used because the disorder does not have a structural or organic basis.
15. Answer: (A) “I know the feeling is real tests revealed negative results.”
Shows empathy and offers information. B. This is a demeaning statement. C. This belittles the client’s feelings. D. Giving undue attention to the physical symptom reinforces the complaint.
16. Answer: (A) provide as much structure as possible for the child
Decrease stimuli for behavior control thru an environment that is free of distractions, a calm non –confrontational approach and setting limit to time allotted for activities. B. The child will not benefit from a lenient approach. C. Dissipate energy through safe activities. D. This indicates that the classroom environment lacks structure.
17. Answer: (D) Serious violations of age related norms.
This is a disruptive disorder among children characterized by more serious violations of social standards such as aggression, vandalism, stealing, lying and truancy. A. This is characteristic of attention deficit disorder. B and C. These are noted among children with autistic disorder.
18. Answer: (A) increased attention span and concentration
The medication has a paradoxic effect that decrease hyperactivity and impulsivity among children with ADHD. B, C, D. Side effects of Ritalin include anorexia, insomnia, diarrhea and irritability.
19. Answer: (A) Returning the child to the school immediately with family support.
Exposure to the feared situation can help in overcoming anxiety. A. This will not help in relieving the anxiety due separation from a significant other. C. and C. Anxiety in school phobia is not due to being in school but due to separation from parents/caregivers so these interventions are not applicable. D. Thiswill not help the child overcome the fear
20. Answer: (C) Moderate
The child with moderate mental retardation has an I.Q. of 35-50 Profound Mental retardation has an I.Q. of below 20; Mild mental retardation 50-70 and Severe mental retardation has an I.Q. of 20-35.
21. Answer: (A) overprotection of the child
The child with mental retardation should not be overprotected but need protection from injury and the teasing of other children. B,C, and D Children with mental retardation have learning difficulty. They should be taught with patience and repetition, start from simple to complex, use visuals and compliment them for motivation. Realistic expectations should be set and optimize their capability.
22. Answer: (B) altered parenting role
Altered parenting role refers to the inability to create an environment that promotes optimum growth and development of the child. This is reflected in the parent’s inability to care for the child. A. This refers to lack of choices or inability to mobilize one’s resources. C. Refers to change in family relationship and function. D. Ineffective coping is the inability to form valid appraisal of the stressor or inability to use available resources
23. Answer: (B) intolerance to change, disturbed relatedness, stereotypes
These are manifestations of autistic disorder. A. These manifestations are noted in Oppositional Defiant Disorder, a disruptive disorder among children. C. These are manifestations of Attention Deficit Disorder D. These are the manifestations of Conduct Disorder
24. Answer: (D) Rearrange the environment to activate the child
The child with autistic disorder does not want change. Maintaining a consistent environment is therapeutic. A. Angry outburst can be rechannelled through safe activities. B. Acceptance enhances a trusting relationship. C. Ensure safety from self-destructive behaviors like head banging and hair pulling.
25. Answer: (C) Pre-operational
Pre-operational stage (2-7 years) is the stage when the use of language, the use of symbols and the concept of time occur. A. Sensory-motor stage (0-2 years) is the stage when the child uses the senses in learning about the self and the environment through exploration. B. Concrete operations (7-12 years) when inductive reasoning develops. D. Formal operations (2 till adulthood) is when abstract thinking and deductive reasoning develop.
26. Answer: (B) tolerance
tolerance refers to the increase in the amount of the substance to achieve the same effects. A. Withdrawal refers to the physical signs and symptoms that occur when the addictive substance is reduced or withheld. B. Intoxication refers to the behavioral changes that occur upon recent ingestion of a substance. D. Psychological dependence refers to the intake of the substance to prevent the onset of withdrawal symptoms.
27. Answer: (A) delirium tremens
Delirium Tremens is the most extreme central nervous system irritability due to withdrawal from alcohol B. This refers to an amnestic syndrome associated with chronic alcoholism due to a deficiency in Vit. B C. This is a complication of liver cirrhosis which may be secondary to alcoholism . D. This is a complication of alcoholism characterized by irregularities of eye movements and lack of coordination.
28. Answer: (A) Monitoring his vital signs every hour
Pulse and blood pressure are usually elevated during withdrawal, Elevation may indicate impending delirium tremens B. Client needs quiet, well lighted, consistent and secure environment. Excessive stimulation can aggravate anxiety and cause illusions and hallucinations. C. Adequate nutrition with sulpplement of Vit. B should be ensured. D. Sedatives are used to relieve anxiety.
29. Answer: (B) cocaine
The manifestations indicate intoxication with cocaine, a CNS stimulant. A. Intoxication with heroine is manifested by euphoria then impairment in judgment, attention and the presence of papillary constriction. C. Intoxication with hallucinogen like LSD is manifested by grandiosity, hallucinations, synesthesia and increase in vital signs D. Intoxication with Marijuana, a cannabinoid is manifested by sensation of slowed time, conjunctival redness, social withdrawal, impaired judgment and hallucinations.
30. Answer: (B) Narcan (Naloxone)
Narcan is a narcotic antagonist used to manage the CNS depression due to overdose with heroin. A. This is an opiate receptor blocker used to relieve the craving for heroin C. Disulfiram is used as a deterrent in the use of alcohol. D. Methadone is used as a substitute in the withdrawal from heroine
31. Answer: (C) agnosia
This is the inability to recognize objects. A. Apraxia is the inability to execute motor activities despite intact comprehension. B. Aphasia is the loss of ability to use or understand words. D. Amnesia is loss of memory.
32. Answer: (C) “This must be difficult for you and your mother.”
This reflecting the feeling of the daughter that shows empathy. A and D. Giving advise does not encourage verbalization. B. This response does not encourage verbalization of feelings.
33. Answer: (C) remains in a safe and secure environment
Safety is a priority consideration as the client’s cognitive ability deteriorates.. A is appropriate interventions because the client’s cognitive impairment can affect the client’s ability to attend to his nutritional needs, but it is not the priority B. Patient is allowed to reminisce but it is not the priority. D. The client in the moderate stage of Alzheimer’s disease will have difficulty in performing activities independently
34. Answer: (A) “Your husband is dead. Let me serve you your breakfast.”
The client should be reoriented to reality and be focused on the here and now.. B. This is not a helpful approach because of the short term memory of the client. C. This indicates a pompous response. D. The cognitive limitation of the client makes the client incapable of giving explanation.
35. Answer: (B) insidious onset
Dementia has a gradual onset and progressive deterioration. It causes pronounced memory and cognitive disturbances. A,C and D are all characteristics of delirium.
36. Answer: (B) fluid volume deficit
Fluid volume deficit is the priority over altered nutrition (A) since the situation indicates that the client is dehydrated. A and D are psychosocial needs of a client with anorexia nervosa but they are not the priority.
37. Answer: (C) Approach the nurse and talk out her feelings
The client with anorexia nervosa uses starvation as a way of managing anxiety. Talking out feelings with the nurse is an adaptive coping. A. Starvation should not be encouraged. Physical safety is a priority. Without adequate nutrition, a life threatening situation exists. B. The client with anorexia nervosa is preoccupied with losing weight due to disturbed body image. Limits should be set on attempts to lose more weight. D. The client may have a domineering mother which causes the client to feel ambivalent. The client will not discuss her feelings with her mother.
38. Answer: (B) Weight gain
Weight gain is the best indication of the client’s improvement. The goal is for the client to gain 1-2 pounds per week. (A)The client may purge after eating. (C) Attending an activity does not indicate improvement in nutritional state. (D) Body image is a factor in anorexia nervosa but it is not an indicator for improvement.
39. Answer: (A) have episodic binge eating and purging
Bulimia is characterized by binge eating which is characterized by taking in a large amount of food over a short period of time. B and C are characteristics of a client with anorexia nervosa D. Low esteem is noted in both eating disorders
40. Answer: (A) Patient will learn problem solving skills
if the client learns problem solving skills she will gain a sense of control over her life. (B) Anxiety is caused by powerlessness. (C) Performing self care activities will not decrease ones powerlessness (D) Setting limits to control imposed by others is a necessary skill but problem solving skill is the priority.
41. Answer: (B) Discuss their eating behavior.
The client is often ashamed of her eating behavior. Discussion should focus on feelings. A,C and D promote a therapeutic relationship
42. Answer: (C) Claustrophobia
Claustrophobia is fear of closed space. A. Agoraphobia is fear of open space or being a situation where escape is difficult. B. Social phobia is fear of performing in the presence of others in a way that will be humiliating or embarrassing. D. Xenophobia is fear of strangers.
43. Answer: (D) Accept her fears without criticizing.
The client cannot control her fears although the client knows its silly and can joke about it. A. Allow expression of the client’s fears but he should focus on other productive activities as well. B and C. These are not the initial interventions.
44. Answer: (A) Revealing personal information to the client
A. Countertransference is an emotional reaction of the nurse on the client based on her unconscious needs and conflicts. B and C. These are therapeutic approaches. D. This is transference reaction where a client has an emotional reaction towards the nurse based on her past.
45. Answer: (D) The client will be able to overcome his disabling fear.
The client will overcome his disabling fear by gradual exposure to the feared object. A,B and C are not the desired outcome of desensitization.
46. Answer: (A) Avoid taking CNS depressant like alcohol.
Valium is a CNS depressant. Taking it with other CNS depressants like alcohol; potentiates its effect. B. The client should be taught to avoid activities that require alertness. C. Valium causes dry mouth so the client must increase her fluid intake. D. Stimulants must not be taken by the client because it can decrease the effect of Valium.
47. Answer: (C) The conversion symptom has symbolic meaning to the client
the client uses body symptoms to relieve anxiety. A. The condition occurs unconsciously. B. The client is not distressed by the lost or altered body function. D. The client should not be confronted by the underlying cause of his condition because this can aggravate the client’s anxiety.
48. Answer: (D) “How do you feel about being pressured into sex by your boyfriend?”
Focusing on expression of feelings is therapeutic. The central force of the client’s condition is anxiety. A. This is not therapeutic because the nurse passes the responsibility to the counselor. B. Giving advice is not therapeutic. C. This is not therapeutic because it confronts the underlying cause.
49. Answer: (B) It is a deliberate effort to handle upsetting events
Malingering is a conscious simulation of an illness while somatoform disorder occurs unconscious. A. Both disorders do not have an organic or structural basis. C. Both have primary gains. D. This is a characteristic of somatoform disorder.
50. Answer: (C) stress management techniques
Stree management techniques is the best management of somatoform disorder because the disorder is related to stress and it does not have a medical basis. A. This disorder is not supported by organic pathology so no medical regimen is required. B and D. Milieu therapy and psychotherapy may be used a therapeutic modalities but these are not the best.


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