NCLEX Sample Questions for Psychiatric Nursing 3

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       1.     Which is the best indicator of success in the long term management of the client?

a.       His symptoms are replaced by indifference to his feelings

b.       He participates in diversionary activities.

c.       He learns to verbalize his feelings and concerns

d.       He states that his behavior is irrational.

       2.     Situation: A young woman is brought to the emergency room appearing depressed. The nurse learned that her child died a year ago due to an accident.  The initial nursing diagnosis is dysfunctional grieving. The statement of the woman that supports this diagnosis is:

a.       “I feel envious of mothers who have toddlers”

b.       “I haven’t been able to open the door and go into my baby’s room “

c.       “I watch other toddlers and think about their play activities and I cry.”

d.       “I often find myself thinking of how I could have prevented the death.

       3.     The client said “I can’t even take care of my baby. I’m good for nothing.” Which is the appropriate nursing diagnosis?

a.       Ineffective individual coping related to loss.

b.       Impaired verbal communication related to inadequate social skills.

c.       Low esteem related to failure in role performance

d.       Impaired social interaction related to repressed anger.

       4.     The following medications will likely be prescribed for the client EXCEPT:

a.       Prozac

b.       Tofranil

c.       Parnate

d.       Zyprexa

       5.     Which is the highest priority in the post ECT care?

a.       Observe for confusion

b.       Monitor respiratory status

c.       Reorient to time, place and person

d.       Document the client’s response to the treatment

       6.     Situation: A 27 year old writer is admitted for the second time accompanied by his wife. He is demanding, arrogant talked fast and hyperactive. Initially the nurse should plan this for a manic client:

a.       set realistic limits to the client’s behavior

b.       repeat verbal instructions as often as needed

c.       allow the client to get out feelings to relieve tension

d.       assign a staff to be with the client at all times to help maintain control

       7.     An activity appropriate for the client is:

a.       table tennis

b.       painting

c.       chess

d.       cleaning

       8.     The client is arrogant and manipulative. In ensuring a therapeutic milieu, the nurse does one of the following:

a.       Agree on a consistent approach among the staff assigned to the client.

b.       Suggest that the client take a leading role in the social activities

c.       Provide the client with extra time for one on one sessions

d.       Allow the client to negotiate the plan of care

       9.     The nurse exemplifies awareness of the rights of a client whose anger is escalating by:

a.       Taking a directive role in verbalizing feelings

b.       Using an authoritarian, confrontational approach

c.       Putting the client in a seclusion room

d.       Applying mechanical restraints

    10.     A client on Lithium has diarrhea and vomiting. What should the nurse do first:

a.       Recognize this as a drug interaction

b.       Give the client Cogentin

c.       Reassure the client that these are common side effects of lithium therapy

d.       Hold the next dose and obtain an order for a stat serum lithium level

    11.     Situation: A widow age 28, whose husband died one year ago due to AIDS, has just been told that she has AIDS.  Pamela says to the nurse, “Why me? How could God do this to me?” This reaction is one of:

a.       Depression

b.       Denial

c.       anger

d.       bargaining

    12.     The nurse’s therapeutic response is:

a.       “I will refer you to a clergy who can help you understand what is happening to you.”

b.       “ It isn’t fair that an innocent like you will suffer from AIDS.”

c.       “That is a negative attitude.”

d.       ”It must really be frustrating for you. How can I best help you?”

    13.     One morning the nurse sees the client in a depressed mood. The nurse asks her “What are you thinking about?” This communication technique is:

a.       focusing

b.       validating

c.       reflecting

d.       giving broad opening

    14.     The client says to the nurse ” Pray for me” and entrusts her wedding ring to the nurse. The nurse knows that this may signal which of the following:

a.       anxiety

b.       suicidal ideation

c.       Major depression

d.       Hopelessness

    15.     Which of the following interventions should be prioritized in the care of the suicidal client?

a.       Remove all potentially harmful items from the client’s room.

b.       Allow the client to express feelings of hopelessness.

c.       Note the client’s capabilities to increase self esteem.

d.       Set a “no suicide” contract with the client.

    16.     Situation: A 14 year old male was admitted to a medical ward due to bronchial asthma after learning that his mother was leaving soon for U.K. to work as nurse. The client has which of the following developmental focus:

a.       Establishing relationship with the opposite sex and career planning.

b.       Parental and societal responsibilities.

c.       Establishing ones sense of competence in school.

d.       Developing initial commitments and collaboration in work

    17.     The personality type of Ryan is:

a.       conforming

b.       dependent

c.       perfectionist

d.       masochistic

    18.     The nurse ensures a therapeutic environment for the client. Which of the following best describes a therapeutic milieu?

a.       A therapy that rewards adaptive behavior

b.       A cognitive approach to change behavior

c.       A living, learning or working environment.

d.       A permissive and congenial environment

    19.     Included as priority of care for the client will be:

a.       Encourage verbalization of concerns instead of demonstrating them through the body

b.       Divert attention to ward activities

c.       Place in semi-fowlers position and render O2 inhalation as ordered

d.       Help her recognize that her physical condition has an emotional component

    20.     The client is concerned about his coming discharge, manifested by being unusually sad. Which is the most therapeutic approach by the nurse? 

a.       “You are much better than when you were admitted so there’s no reason to worry.”

b.       “What would you like to do now that you’re about to go home?”

c.       “You seem to have concerns about going home.”

d.       “Aren’t you glad that you’re going home soon?”

    21.     Situation: The nurse may encounter clients with concerns on sexuality. The most basic factor in the intervention with clients in the area of sexuality is:

a.       Knowledge about sexuality.

b.       Experience in dealing with clients with sexual problems

c.       Comfort with one’s sexuality

d.       Ability to communicate effectively

    22.     Which of the following statements is true for gender identity disorder?

a.       It is the sexual pleasure derived from inanimate objects.

b.       It is the pleasure derived from being humiliated and made to suffer

c.       It is the pleasure of shocking the victim with exposure of the genitalia

d.       It is the desire to live or involve in reactions of the opposite sex

    23.     The sexual response cycle in which the sexual interest continues to build:

a.       Sexual Desire

b.       Sexual arousal

c.       Orgasm

d.       Resolution

    24.     The inability to maintain the physiologic requirements in sexual intercourse is:

a.       Sexual Desire Disorder

b.       Sexual Arousal Disorder

c.       Orgasm Disorder

d.       Sexual Pain disorder

    25.     The nurse asks a client to roll up his sleeves so she can take his blood pressure. The client replies “If you want I can go naked for you.” The most therapeutic response by the nurse is:

a.       “You’re attractive but I’m not interested.”

b.       “You wouldn’t be the first that I will see naked.”

c.       “I will report you to the guard if you don’t control yourself.”

d.       “I only need access to your arm. Putting up your sleeve is fine.”

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