EXAMINATION SET : A

Central Philippine UniversityCOLLEGE OF NURSING Iloilo City

MIDTERM Examinations in N-427bNursing Elective ReviewSecond Semester SY 2011-2012SUBJECT MATTER COMPETENCY: MENTAL HEALTH AND PSYCHIATRIC NURSING

DIRECTIONS for the STUDENTS:

FOLLOW THE INSTRUCTIONS GIVEN BY THE PROFESSOR ON HOW TO ACCOMPLISH THE ANSWER SHEET.MARK THE CORRECT ANSWERS IN YOUR ANSWER SHEET BY SHADING THE ENTIRE RECTANGLE IN THE LETTER CORRESPONDING TO YOUR CHOSEN ANSWER. ERASURES, RETRACING, OMISSIONS AND DOUBLE OR MULTIPLE ANSWERS IN THE ANSWER SHEET ARE ABSOLUTELY NOT ALLOWED: DO NOT MAKE ANY UNNECESSARY MARK IN YOUR ANSWER SHEET OR ELSE IT WILL INVALIDATE ALL YOUR ANSWERS AND EXAMINATION RESULTS: FOR STRICT COMPLIANCE: FIVE POINTS DEDUCTION FOR EVERY ERASURES DONE IN THE ANSWER SHEET. YOU MAY UTILIZE YOUR QUESTIONNAIRE FOR YOUR TEMPORARY ANSWER. USE BLACK BALLPOINT PEN TO WRITE YOUR EXAMINEE CODE AND SUBJECT MATTER AND USE PENCIL NO. 2 ONLY TO SHADE THE ENTIRE RECTANGLE.

CAUTION: DO NOT WRITE YOUR NAME IN YOUR ANSWER SHEET. WRITE ONLY YOUR EXAMINEE CODE WHICH CORRESPONDS TO YOUR STUDENT ID NUMBER. DO NOT FORGET TO SHADE THE BOX OF YOUR EXAMINATION SET.

DIRECTIONS for the PROCTOR:

Please do not entertain any student who asks for another copy of answer sheet. Let them finish with the first answer sheet that they have mutilated or tampered. Strictly no substitution of answer sheets. Please do not countersign any error, erasures or alterations committed by the student in the answer sheets. All the facts , questions and choices should be taken as is on the face of the questionnaires and any question raised by the students shall be addressed by the professor in the discussion of the test question in regular class hours. Thank you!

EXAMINATION PROPER:

EXAMINATION SET ASituation: In your professional nursing role, it is essential to establish a meaningful nurse-patient relationship. 1. A helping nurse-patient is characterized by which of the following?a. b. Recovery promotingc. Growth facilitating d. Mutual interactione. Health enhancing 2. 3. Demonstrating a helping relationship enables you to establish in the patient:a. b. Compliance to treatment c. Positive response to illnessd. Gratitude to your service e. Some sense of trust in you4. 5. Therapeutic communication begins with:a. b. Knowing the patient c. Trust d. Interacting with the patient e. Knowing yourself 6. 7. Which of the following approaches will most likely make your patient accept your help?a. Attending to all his needsb. Calling him by first name c. Demonstrating a relaxed and attending attitude d. Asking personal questions for health information 8. The client said, I am troubled that my son is starting to use drugs. The nurse replied, Its troubling and painful for you, I feel sorry about this. The nurses reply is an example of:a. b. Empathy c. Sympathy d. Telepathy e. Self-awareness9. 10. Preparation for termination of the nurse-patient relationship begins during the:a. b. Termination phase c. Working phase d. Pre-orientation phase e. Orientation phase 11. 12. The clients past reactions to ending relationships is withdrawal. The nurse assists her to practice better ways of coping termination by providing opportunities to:a. b. Test a new patterns of behavior c. Plan for alternatives d. Conceptualize her problem e. Value and find meaning in experience 13. 14. A male nurse reminds the client that it is already time for group activities. The client responded by yelling to the nurse You are always telling me what to do! Just like my father! This is an example of:a. b. Symbolization c. Transference d. Reaction formation e. Counter transference 15. 16. The longest and the most productive phase of the NPR is:a. b. Termination phase c. Working phase d. Pre-orientation phase e. Orientation phase17. The objective of the nurse-patient relationship is to provide an opportunity of the patient to:a. b. Clarify problem c. Develop insights d. Have a corrective emotional experience e. Develop interpersonal relationship

Situation: Mental Retardation is an increasingly common childhood disorder that impairs learning. 18. Mental retardation is:a. A delay in normal growth and development caused by an inadequate environment b. A lack of development of sensory abilities c. A condition of sub-average intellectual functioning that originates during the developmental period and is associated with impairment in adaptive behavior d. A severe lag in neuromuscular development and motor abilities 19. An important principle for the nurse to follow in interacting with retarded children is:a. Seen that if the child appears contented , his needs are being met b. Provide an environment appropriate to their developmental task as scheduled c. Treat the child according to his chronological age d. Treat the child according to his developmental age 20. The child was classified as having an IQ of 55. This is said to be:a. b. Mild mental retardation c. Moderate mental retardation d. Severe mental retardation e. Profound mental retardation 21. 22. Which of the following is true with regards to Mild retardation?a. Trainable, can reach up to 2nd grade and can reach the maturity of a 7 year old b. Custodial and barely trainable c. Requires total care throughout life, mental age of a young infantd. Educable, can reach up to grade 6 and has a maturing of 12 year old 23. A child with an IQ of 35-49 is:a. b. Barely irritable c. Trainable d. Educable e. Requires total care

24. 25. Which of the following is true with regards to mental retardation?a. Mental retardation is always accompanies by physical featuresb. Hereditary and prenatal factors do not result to mental retardation c. Mental retardation is mental illness d. Hereditary and prenatal factors are known to result to impaired intellectual functioning 26. The onset of mental retardation is before the child reaches what particular age?a. b. 17c. 16d. 15e. 1827. 28. The possible nursing diagnosis for a mentally retarded child who is hyperactive is:a. b. Impaired physical mobility c. Potential for injury d. Impaired social adjustment e. Ineffective coping 29. 30. A tranquilizing agent can be given in calming a hyperactive mentally retarded is:a. b. Chlorpromazine (Thorazine)c. Haloperidol (Haldol)d. Imipramine (Tofranil)e. Diazepam (Valium)31. 32. This form of psychotherapy allows the child to experience and express or troubling emotion in safe environment with a caring individual:a. b. Play therapy c. Milieu therapy d. Behavior therapy e. Gestalt therapy

Situation: Margie has been diagnosed with Bipolar I disorder. The client demonstrates extreme psychomotor agitation, flight of ideas, loud and elated mood. 33. Which of the following is true about manic reaction?a. It is an expression of destructive impulseb. A means of coping with frustration and disappointmentsc. A means of ignoring reality d. An attempt to ward of feeling of underlying depression 34. Nursing care plan for a client with mania like Margie should give priority to:a. Discourage her from manipulating the staffb. Prevent her from assaulting other patient c. Protect her against suicidal attempts d. Provide adequate food and fluid intake 35. During a nurse-patient interaction, Marge jumps rapidly from one topic to another, this is known as:a. b. Flight of ideas c. Clang association d. Ideas of reference e. Neologism 36. 37. Which of the following is a suitable activity that a nurse should assign for a manic client?a. Delivering supply of linen to other rooms b. Conducting a drama workshop c. Engaging in activity therapy and group exercise d. Painting a mural with other patients 38. The doctor ordered lithium. You know that this is indicated in patients with:a. b. Depression c. Mania d. Schizophrenia e. Anxiety disorder 39. 40. Lithium has a narrow therapeutic range of:a. b. 0.1 to 1.0 mEq/Lc. 0.6 to 1.2 mEq/Ld. 10 to 50 mEq/Le. 50 to 100 mEq/L41. 42. Which of the following is a side effect of lithium toxicity?a. b. Anuria c. Oliguria d. Sudden burst of muscle strength e. Polyuria 43. 44. What specimen is taken from a client when checking the lithium toxicity?a. b. Blood c. Stool d. Urine e. Sweat 45. 46. Which of the following is not a drug use to augment lithium toxicity?a. b. Urea c. Mannitol d. Aminophylline e. Acetylcysteine

47. The nurse has a standing order to Lithium for Margie. If the Lithium is 1.5mEq/L, the nurse knows that she should:a. Administer the next dose and continue monitoring the clientb. Report this to physician c. Recheck the lithium level and validate first before doing any actiond. Withhold the next dose and notify the physician

Situation: Celina, age 25, a ramp model, suddenly became blind after her boyfriend broke off with her. A thorough work up did not reveal any pathological findings. 48. The loss or alteration of physical functioning without organic cause but is an expression of a psychological needs known as:a. b. Somatization c. Depersonalization d. Hypochondriasis e. Conversion 49. 50. Initially, the relevant nursing diagnosis the nurse includes in her care plan is:f. a. Self-esteem disturbance b. Impaired adjustment c. Ineffective individual coping d. Ineffective denial

51. 52. The defense mechanism commonly used by these clients are:e. a. Projection b. Conversion c. Repression d. Sublimation 53. 54. An appropriate nursing intervention which can help Celina is:e. a. Establishing a trusting relationship b. Encourage her to verbalize her feelings c. Reinforce reality d. Accept her limitation as a person 55. 56. An effective modality of treatment for Celina would be:e. a. Milieu therapy b. Systematic desensitization c. Cognitive-behavioral therapy d. Psychopharmacology

Situation Daisy, nurse at psyche ward, was assigned as one of the crisis intervenors for the victims and survivors of the flash floods that swept the provinces in the northern region.36. The tool used by crisis intervenors is to assist victims of disaster deal positively with emotional impact of the event.A. PsychotherapyC. CounselingB. Stress managementD. Stress debriefing37. Many have lost members of their families and properties in that tragedy. What can be normally experienced following loss of loved ones?A. HopelessnessC. HelplessnessB. AngerD. Grief38. The reaction of children to crisis is compared to adults is:A. LongerC. SlowerB. The sameD. faster39. What is the effect of resilience among children during crisis?A. BeneficialC. severeB. TraumaticD. no effect40. Because of the enormous impact of the crisis to the victims it is important that the crisis intervenor be:A. B. EnergeticC. Well trainedD. Patient and understandingE. Firm but kind

Situation 5 Joanne, a 50 years old widow, sought admission for inability to sleep, loss of zest for life and nervousness ever since her only daughter got married 3 months ago.41. As a nurse, at what level of anxiety is Joanne experiencing?A. PanicC. ModerateB. MildD. Severe42. During the orientation phase of relationship, what is the topic most appropriate?A. Finding out clients coping mechanisms.B. Teaching clients other modes of coping.C. Finding out clients perception why she needs hospitalizationD. Teaching client to control her feelings.43. The behavioral theory of anxiety is viewed asA. B. Arising from physiological abnormalitiesC. Product of unconscious psychic conflictD. Learned responses resulting from frustrationE. Resulting from early childhood experiences

44. Whenever Joanns daughter is mentioned, she burst into tears mumbling. The nurse best response:A. B. Do you feel uncomfortable?C. Are you saying something?D. Is something bothering you?E. You dont like to hear the name of your daughter?

45. To better understand Joann, the nurse must be aware that she is at what stage of Eriksons personality development?A. B. Generativity vs. StagnationC. Initiative vs. GuiltD. Intimacy vs. IsolationE. Trust vs. Mistrust

Situation This is a journal club in a psychiatric unit conducted by the head nurse focusing on Disorders before the event of Adulthood.46. The IQ assessment of a child is between 55 and 68. This degree of intellectual improvement would be considered.A. ModerateC. mildB. ProfoundD. severe47. The parents of a child who is mentally retarded insist to enroll him in a regular school. The parents are exhibiting:A. CompensationC. intellectualizationB. DenialD. rationalization48. Hyperactive children particularly those with attention deficit disorder are prone to accidents. Nursing actions should focus on personal safety like:A. Encouraging the child to ask others about safety rulesB. Give specific instructions one at a timeC. Let somebody accompany the child all the timeD. Instructing the child ways to protect himself49. The probability of an autistic child to lead a productive life is:A. B. Facilitated by parental guidanceC. Influenced by the childs over-all temperamentD. Guarded because of many interlocking factorsE. Dependent on early and accurate diagnosis

Situation Esther, 28 years old, was admitted in the emergency unit of the hospital. Esther picks up whatever material she can hold in the unit and throws it to the nurses and medical staff. She is hyperactive, shouts profanities, and screams loudly. She is diagnosed with Bipolar I Disorder.50. The nursing diagnosis for clients with Bipolar I Disorder like Esther is:A. B. Risk for other-directed violenceC. Risk for InjuryD. Defensive CopingE. Risk for self-directed violence

51. Esther received Chlorpromazine (Thorazine) and Lithium. Chlopromazine (Thorazine) is given because:A. It minimizes the negative symptoms of bipolar disorder.B. It has an immediate calming effect on Esthers hyperactivityC. It balances the sedating effect of LithiumD. It prevents development of fine hand tremors due to Lithium.52. As Esther takes Lithium, which of Esthers statement about Lithium will require further teaching from the nurse?A. B. I will report nausea, vomiting and diarrhea.C. I will experience dry mouth.D. I will need to decrease my sodium intake.E. I will have to blood check regularly.

53. Esther tells the nurse after 2 weeks of Lithium therapy, I realized I hurt when I pushed you in the emergency unit during admission.A. B. And what made you say that?C. How sincere are you about that?D. You feel sorry for what happened two weeks ago?E. How are things going today?

54. As Esther is being discharged, the nurse is aware that the important teaching isA. B. Report fine hand tremorsC. Drug complianceD. Have RBC checked regularlyE. Join community groups

Situation Jinky, a 28 year old, suffered from uremia and suddenly experienced sleep disturbances, memory deficits, altered sensory perception, disorientation to time and place.55. The nurse suspects which of the following?A. B. Generalized anxiety disorderC. DeliriumD. DementiaE. Systemic disorder

56. Delirium is similar to dementia in terms of:A. B. DurationC. Short-term memory lossD. Level of consciousnessE. onset

57. Jinky points to the bed while shouting, cockroaches, there are cockroaches, even though there are no cockroaches on the bed. The BEST nursing response is:A. B. I dont see any cockroaches on your bed.C. Ok, leave the room this very minute.D. Ignore the cockroaches, they wont bite you.E. Ill spray them with a repellant.

58. The nursing diagnosis for Jinky is:A. B. Imbalanced nutritionC. Disturbed thought processD. Disturbed sensory perceptionE. Risk for self-directed violence

59. The nurse is aware that the most important consideration for the care of the delirious client is:A. B. Eating patternC. SafetyD. Risk for lonelinessE. Elimination pattern

Situation Melton is 5 years old. He has been diagnosed as autistic since he was 2 years old.60. The psychosocial task according to Erickson for this age group is:A. B. Identify vs. DiffusionC. Initiative vs. GuiltD. Industry vs. InferiorityE. Trust vs. Mistrust

61. Which among the following is NOT typical of autistic clients?

A. EcholaliaB. No eye contactC. Ritualistic behaviorD. Responsiveness to parents

62. Meltons mother said Its fathers fault!. The nurse initial response is:

A. You must not say that.B. Nobody is at fault here.C. You seem upset by this.D. Why dont you blame yourself?

63. Since Melton fails to develop interpersonal skills, an appropriate nursing diagnosis is:A. B. Impaired Social InteractionC. Self-multilation D. Disturbed Sensory PerceptionE. Impaired Verbal Communication

64. Approximately 50% of autistic children have an IQ below 50. What is the level of mental retardation of client with IQ of 45?A. ProfoundC. ModerateB. SevereD. MildSituation - Aizheimer disease believed to be the fourth leading cause of death of persons beyond 65 years of age. It is very difficult to diagnose and it is necessary for the nurse to know predominant characteristics of Aizheimer disease.65. When a elderly client has inability to learn new information or recall previously learned information. This isA. B. AgnosiaC. AphasiaD. ApraxiaE. Amnesia66. 67. Agnosia in a patient with Aizheimer means that heA. B. Has language disturbanceC. Can not hold on to objectsD. Is forgetfulE. Can not recognize and identify68. 69. Inability to plan a menu, managing medication schedule, abstracting isA. B. Memory dysfunctionC. Impaired judgmentD. Disturbance in executive functionE. Impaired occupational functioning70. 71. During the terminal phase of illness, patients are totally bed-bound requiring constant care. Focus attention must beA. B. Freedom from harmC. Spiritually of the patientD. Emotional careE. Persona care and nutrition72. 73. Taking care of AD patients at home is described as the toughest job in this world. The best strategy for coping with irritating situations.A. B. Be informedC. Enough restD. Sharing common concernsE. Nutritious diet

SITUATION: The nurse is envisioning a career path in Mental Health Psychiatric Nursing. As a Beginning Professional Nurse, She is guided with Basic Beliefs about the practice.70. Which of the following statement reflects the scope of mental health psychiatric nursing?A. It include nursing actions aimed at returning the patient to his highest potential of productivityB. It is an integral aspect of all nursing a specialty service to people affected by mental illnessC. It includes nursing actions to reduce the rate of new cases of mental disorder in populationD. It consists of early recognition and treatment of mental disorders to reduce severity and duration of mental illness71. The beginning professional nurse can do mental health counseling with the following clients EXCEPT:

A. Actively psychotic patients B. Out of school adolescentsC. Parents with child rearing concernsD. School children with behavioral problems

72. A professional responsibility of the mental health psychiatric nurse is to provide a safe therapeutic environment. This is BEST reflected in:A. Restraining patients who violates policies and do not follow schedule of activitiesB. Maintaining a closed door policy to prevent patients from abscondingC. Keeping a restrictive environment to prevent patients from becoming assaultive and hostileD. Ensuring physical safety and maintain therapeutic attitudes towards the patient73. The foundation of the therapeutic process is the therapeutic relationship. What is the essential component that the nurse must bring to the relationship?

A. Humor B. EmpathyC. ReframingD. Confrontation

74. Which of these people, the highest in population groups that would need priority mental health therapy?

A. Adults going through active skillsB. Single elderly with no social supportC. Young Professionals entering the workplaceD. Women preparing for overseas employment

Situation: Some Activity therapies are organized and conducted in groups where nurses may participate in.75. A mental health nurse may not be a member of this self help group because help given to members comes from members themselves.

A. Re motivation GroupB. Alcoholics AnonymousC. Activity Therapy GroupD. Art Therapy Group

76. Which of the following determines the success of client government groups?A. Willingness of psychiatric professionals to be open and receptive to clients ideas and SuggestionsB. A way of permitting clients provide themselves with a more creative and wholesome lifeC. Means to acquire a variety of social skillsD. Opportunity to learn democratic living77. Which of the following situation appropriately illustrate horticulture therapy?A. The therapist brings bongos, tambourine, and bells and encourages client participationB. Tommy, Karen, Jon and Pia play scrabble every night after supperC. Every afternoon, Vic goes in the garden where he work with plants, seedlings, tree planting and watering themD. Paul finds sketching relaxing and rewarding78. Eva is a member of a group who exhibits endless talking. Her role is that of a/an:

A. BlockerB. Self-confessorC. Recognition seekerD. Monopolizer

79. Community meetings are held as part of milieu therapy on an in-patient psychiatric unit. The purpose of these meetings would be:A. to focus on issue arising from group livingB. To encourage expression on topics of interestC. To provide direction from the treatment learnD. To encourage expression of intra psyche conflicts

Situation: The patient who is depressed will undergo electroconvulsive therapy80. The preparation of a patient for ECT ideally is MOST similar to preparation of a patient for:

A. ElectroencephalogramB. X-RayC. General anesthesiaD. Electrocardiogram

81. Which of the following is a possible side effect which you will discuss with the patient for:

A. Hemorrhage with the brainB. Robot-like stiffnessC. EncephalitisD. Confusion, disorientation and short term memory loss

82. Informed consent is necessary for the treatment for involuntary clients. When this cannot be obtained, permission may be taken from the:

A. Social workerB. DoctorC. Next of kin or guardianD. Chief nurse

83. After ECT, the nurse should do this action before giving the client fluids, food or medication:A. B. Assess the gag reflexC. Assess the sensorium D. Take vital signsE. Check O2Sat with a pulse oximeter

Situation: THE COMMUNITY HEALTH NURSE ENCOUNTERS SPECIAL CHILDREN IN THE COMMUNITY84. An individual with antisocial personality disorder lacks remorse, shame and guilt in going against the norms of society. Psycho dynamically, this defect in the personality reflects a disturbance of the:A. B. EgoC. Super egoD. Ego IdealE. Id

85.The nurse teaches parents about childrens beginning concepts of right and wrong by emphasizing child rearing attitude and practices during the:A. B. School ageC. Toddler stageD. Infancy periodE. Latency period

86.It is BEST for parents to teach healthy interpersonal relationships to their children by:A. Modeling to their childrenB. Encouraging their children to attend secondary schoolC. Encouraging their children are home to behave properlyD. Teaching their children good manners and right conduct87. An important principle for the nurse to follow in interacting with retarded children is:A. Seen that if the child appears contented, his needs are being metB. Provide and environment appropriate to their developmental task as scheduleC. Treat the child according to his chronological ageD. Treat the child according to his developmental level88. Mental retardation is:A. A delay in normal growth and development caused by an inadequate environmentB. A lack of development of sensory abilitiesC. A condition of sub average intellectual functioning that originates during the developmental period and is associated with impairment in adaptive behaviorD. A severe lag in nueromuscular development and motor abilities

SITUAITON: BERNIE AND JOHN IN THEIR LATE 40S HAVE BEEN MARRIED FOR 20 YEARS AND ARE AT THE PEAK OF THEIR CAREERS.SUDDENLY, BERNIE DISCOVERED THAT HER HUSBAND WAS FAILING IN LOVE WITH ANOTHER WOMAN. SHAKEN BY THIS SITUATION, SHE STARTED TO HAVE PROBLEMS SLEEPING AND COULD NOT FUNCTION WELL AT WORK AND AT THE RISK OF LOSING HER JOB. JOHN ASKED FORGIVENESS AND REGRET VERY MUCH THE HURT WIFE WAS GOING THROUGH AND SUFFERED GUILT FEELINGS:89. Bernie and John are going through a:A. B. Situational crisisC. Developmental crisisD. Anticipated crisisE. Both developmental and situational crisis

90. All of these are characteristics of crisis EXCEPT:A. A hazardous or threatening even t occursB. It has a growth promoting potentialC. Usual problem solving methods and coping mechanisms produce a solutionD. Anxiety and depression continue to increase91. The nurse employs this approach in crisis intervention:A. B. Problem solvingC. Behavior modificationD. Role playingE. Nurse-patient relationship

92. Assessment data of the nurse include all of the following EXCEPT:A. B. Coping mechanismsC. Situational supportD. Perception of the eventE. Repressed problems

93. The duration of crisis usually lasts several days and usually:A. B. 2-4 weeksC. 1-2 weeksD. 1-2 monthsE. 4-6 weeks

SITUATION: FELISA HAS A RITUALISTIC PATTERN OF CONSTANTLY WASHING HER HANDS WITH SOAP AND WATER FOLLOWED BY RUBBING ALCOHOL94. This behavior is categorized as:A. B. DelusionalC. NormalD. NeuroticE. Psychotic

95. A Therapeutic intervention in this situation is:A. Avoid limits on her behavior to release her anxietyB. Call attention to her ritualistic patternC. Provide alternative behaviors to deal with increased anxietyD. Ignore her behavior totally96. The anxiety of Felisa is disabling and interferes with her job performance, interpersonal relationships and other activities of daily living. To minimize such problems, she is likely to be given:A. B. Diazepam (Valium)C. Haloperidol (Haldol)D. Imipramine hcl (Tofranil)E. Chlorpromazine (Thorazine)

97. Felisa understands the effects of her medicine when expresses:A. I should watch out for signs of sore lips or sore throatB. I might have constipationC. I might feel changes in my body temperatureD. I should not drive or operate machines98. The level of anxiety that Felisa is experiencing is:A. B. PanicC. SevereD. MildE. Moderate

SITUATION: AS A PROFESSIONAL, IT IS IMPERATIVE THAT THE NURSE IS ACCOUNTABLE TO ONESELF HENCE THE IMPORTANCE OF PERSONAL AND PROFESSIONAL DEVELOPMENT99. Nurse: I feel personally involved with my clients problems demonstrates:A. B. Counter transferenceC. EmpathyD. TransferenceE. Sympathy

100. The nurse has achieved self awareness in which of the following verbalizations?A. Every time people around me yell, I feel upset and withdrawnB. When the patient yelled at me I became speechlessC. With the patients tone of voice and stare, I got reminded of how my father would be so angry and this made me anxiousD. I thought it was rude for the patient to yell hence I kept quiet

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Good Luck and God Bless You!!!

GOD is far more concerned with the inner space of your heart than the outer space of the great universe

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101. An accepting attitude requires being:A. Aware of ones biasesB. Tolerant of the faults of othersC. Non judgmentalD. In control of tendency to blame39. Self-awareness knowledge and understanding of human behavior and communication skills define what is essential in caring for every nurse to be able to demonstrate which is:A. Positive self-projectionB. AssertivenessC. Therapeutic Use of selfD. Self - mastery40. Considering that man is by nature social, it is BEST for the nurse to gain self-awareness by:A. Participating in intensive group experiencesB. Individual psychotherapyC. HypnotherapyD. Writing and autobiography for self introspection

-----Situation 1 The nurse patient relationship is a modality through which the nurse meets the clients needs.1. The nurses most unique tool in working with the emotionally ill client is his/her:A. Personality make upB. Theoretical knowledgeC. Emotional reactionsD. Communication skills

2. The psychiatric nurse who is alert to both the physical and emotional needs of clients is working from the philosophical framework that states:A. All behavior is meaningful, communicating a message or a needB. Human beings are systems of interdependent and interrelated partsC. There is a basic similarity among all human beingsD. Each individual has the potential for growth and change in the direction of positive mental health

3. One way to increase objectivity in dealing with ones fears and anxieties is through the process of:A. ValidationC. interventionB. ObservationD. collaboration4. All of the following responses are non therapeutic. Which is the MOST direct violation of the concept, congruence of behavior?A. Tolerating all behavior in the clientB. Rejecting the client as a unique human beingC. Responding in a punitive manner to the clientD. Communicating ambivalent messages to the client

5. The mentally ill person responds positively to the nurse who is warm and caring. This is a demonstration of the nurses role as:A. Mother surrogateC. therapistB. CounselorD. socializing agent

Situation 2 It is common that clients ask the nurse personal questions.6. Anticipation of personal questions is given adequate attention during which phase of the nurse patient relationship?A. Termination phaseC. Orientation phaseB. Working phaseD. Pre-interaction phase

7. If the client asks for the nurses telephone number, which of these responses is NOT appropriate?A. Are you asking for an official number of the hospital/clinic for your reference?B. What would you do with my number if I give it to you?C. If I say No to your request, what are your thoughts about this?D. It is confidential. I just dont give it to anyone.

8. It is 10 oclock on your watch. The client asks, What time is it? The nurses appropriate response is:A. Guess, what time is it?B. Are you getting bored?C. It is 10 oclock.D. Why do you ask?9. When the client asks about the family of the nurse, the MOST appropriate response is:A. Why dont we talk about your family instead?B. Avoid the situation and redirect the clients attentionC. Introduce another topic like the clients interestsD. Give a brief and simple response and focus on the client

10. When the nurse is asked a personal question, which of these reactions indicate a need for him/her to introspect?A. The client is simply curious.B. Some patients are like children in seeking recognition from the nurse.C. His/her right to privacy is being intruded.D. The client knows no other way to begin a conversation.

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SITUATION 10- Nicanor was discharged from the hospital and recovered from a manic episode of Bipolar Disorder. Nicanor was readmitted with an entirely different behavior. He was very depressed.

46. The defense mechanism utilized by manic patients to cover up depression is:A. Reaction formationB. CompensationC. Displacement D. Denial

47. The psychodymics of depression is:A. Lax supper-egoB. Weak super-egoC. Internalized hostility feelingsD. Narcissistic personality

48. Which of these drugs is likely to indicated for Nicanor?A. Serenance (Haloperidol)B. Valium (Diazepam)C. Tofranil (Imipramine HCI)D. Trilafon (Pherphenazine)

SITUATION 16 Annie has a morbid fear of heights. She asks the nurse what desensitization therapy is:

76. The accurate information of the nurse of the goal of desensitization is:A. To help the clients relax and progressively work up a list of anxiety provoking situations through imagery.B. To provide corrective emotional experiences through a one-to-one intensive relationshipC. To help clients in a group therapy setting to take on specific roles and reenact D. To help clients cope with their problems by learning behaviors that are more functional and be better equipped to face reality and make decisions

77. It is essential in desensitization for the patient to:A. Have rapport with the therapistB. Use deep breathing or another relaxation techniqueC. Assess ones self for the need of an anxiolytic drugD. Work through unresolved unconscious conflicts

78. In this level of anxiety, cognitive capacity diminishes. Focus becomes limited and client experiences tunnel vision. Physical signs of anxiety become more pronounced.A. Severe anxiety B. Panic C. Mild anxiety D. Moderate anxiety

79. Anti-anxiety medications should be used with extreme caution because long term use can lead to:A. Parkinsonian like syndromeB. Hypertensive crisisC. Hepatic failureD. Risk of addiction

80. The nursing management or anxiety related with post traumatic stress disorder includes all of the following EXCEPT:A. Encourage participation in recreation or sports activitiesB. Reassure clients safety while touching clientC. Speak in a calm soothing voiceD. Remain

SITUATION 20- Jim, age 25, recalled that his problem began around age 15 or 16. He would count pencils in a mug over and over with the thought that stopping could result in something bad happening.

96. There are many things Jim seems he has to do keep himself from feeling:A. Confused B. Suspicious C. Excited D. Anxious

97. He has to change clothes 20 times before work, chew each bite he eats 24 times and go up and town the stairs four to five times before it feels right. He is demonstrating:A. Ideas of reference B. Denial and projectionC. Obsession and compulsionD. Rationalization and over reaction

98. The objective of nursing care for Jim is to develop or increase feelings of:A. Self-masteryB. Self worth C. Self-actualizationD. Self-determination

99. All of these are therapeutic interventions EXCEPT:A. Impose limits every time the behavior becomes repetitive B. Establish a routine for himC. Assign task that can be done repetitively D. Facilitate self-expression

100. Jim is aware of his behavior, yet realizes that it is very disturbing to him. This is a pattern of:A. Personality disorder C. Neurosis B. Psychosis D. Habitual Disorder