PREBOARD-NURSING PRACTICE V

1. Which of the following responses by the nurse is the best example of clarifying?

a. “Tell me about what you were thinking before you went to talk to him.”
b. “When did you first notice these feelings.”
c. “Instead of talking about your mother, I want to know how you feel.”
d. “I’m having difficulty understanding. Could you explain that to me?”

2. An emergency psychiatric client presents with hyperthermia and unexplained loss of appetite.
The nurse concludes that these symptoms are consistent with trauma to which area of the brain?

a. Thalamus
b. Hypothalamus
c. Cerebrum
d. Cerebellum

3. A client who is unable to cope with the sudden loss of a job and who is feeling confused and
unable to make decisions is to be experiencing which of the following?

a. Adventitious crisis.
b. Maturational crisis
c. Situational crisis
d. Social crisis

4. In assessing a client in crisis, it is important for the nurse to first assist the client to identify:

a. The client’s feeling

b. The realistic nature of the event.
c. Others who might be affected by the event
d. An immediate action plan

5. When working with the client in crisis, which of the following is the most important?

a. Obtaining a complete assessment of the client’s past history

b. Remaining focused on the immediate problem
c. Determining whether the client may have had a part in the emergenceof the crisis.
d. Assisting the client to identify what is similar about crisis to other crises in the client’s life.

6. A 23-year-old client who’s life partner died recently from complications of AIDS has just found out
that he is HIV- positive. He has been referred to the outpatient crisis unit from his doctor’s office
because he “shut down “after finding out his HIV status. The nurse meets with the client, provides
comfort measures, and begins the assessment. An immediate priority is to evaluate if the client:

a. Is at risk for self-directed violence

b. Has an altered thought process
c. Has a psychiatric provider
d. Has a fear of dying

7. A 52-year-old client who was admitted to the hospital 5days ago with major depression and sui-
cidal ideations is now preparing for discharge. Which of the following statements for the client
demonstrates she has met one of her outcome/evaluation measures” “When I go home:

a. I’ll finally get some sleep

b. I’ll be able to take care of my plants again.”
c. I have a list of people that I can call if I start to feel poorly.”
d. I’ll cook for myself.”

8. A 3-year-old client has been diagnosed with attention deficit/ hyperactivity disorder (ADHD).
Which medication is most likely to be prescribed?

a. Amitriptyline (Elavil)
b. Paroxetene (paxil)
c. Methylphenidate (Ritalin)
d. Pemoline (Cyclert)
9. The client is being admitted to the inpatient psychiatric unit. You determine that which of
the following must be present in order to be diagnosed with major depression?

a. Suicidal thoughts or plans of suicide reported over at least the last 2 weeks
b. History of one depressive episode within the last 2 years
c. Loss of appetite for more than 3 days
d. Loss of interest in previously enjoyed activities.

10. The nurse should consider the irregularities in which of the following body systems before an
accurate diagnosis of mood disorder can be assigned?

a. Integumentary
b. Cardiovascular
c. Respiratory
d. Endocrine

11. During an assessment interview the client tells the nurse, “I can’t stop worrying about my
makeup. I can’t go anywhere or do anything unless my makeup is fresh and perfect. I wash my
face and put on fresh makeup at least once and sometimes twice an hour. “This behavior is most
likely a sign of a (n):

a. Acute stress disorder

b. Generalized anxiety disorder
c. Obsessive-compulsive disorder
d. Panic disorder

12. The spouse of a woman diagnosed with somatization disorder asks the nurse if this wife has so
many healthproblems on purpose. The best response is:

b. “Have you tried asking her? I think she’d tell you the truth.”
c. “Your wife is trying to gain your attention.”
d. “She doesn’t have the problem on purpose; however, this is probably difficult for both of you.”
e. “She has some significant emotional problems that she cannot admit.’

13. The most appropriate nursing diagnosis for a client with a somatoform disorder is:

a. Altered role performance

b. Knowledge deficit: medication.
c. High risk for violence, self-directed
d. Acute trauma reaction

14. A female client with a 15-year history of somatization disorder is to be discharged from her first
psychiatric hospitalization. Which statement would indicate that nursing care has been effective?

a. “I need to make sure that all of my medications are sent home with me.”
b. “I see now that when I get stressed, my ‘body speaks for me.”
c. “My family is good to me when I am sick like this.”
d. “There are so many illness that you nurses simply do not know about.”

15. The best initial approach to take with a self- accusatory, guilt ridden client would be to:
a. Contradict the client’s persecutory delusions
b. Accept the client’s statements as the client’s beliefs.
c. Medicate the client when these thoughts are expressed.
d. Redirect the client whenever a negative topic is mentioned

16. A client treated for hypochondriasis has an upsetting phone conversation with her husband and
subsequently requests an analgesic. “My head is killing me, and I know there is a tumor in there
somewhere or it wouldn’t hurt like this. “The nurse’s best response is:

a. “You have no brain tumor. It is just your anger towards your husband.”
b. “I’ll get your vital signs and then call your doctor if they are abnormal.”
c. “You must try not to rely on the pain pills so much since they are addictive.”
d. “I’ll get your medication and then let’s talk about what just happened.”

17. A client with a somatization disorder has been attending group therapy. Which statement
indicates that care has been effective?
 a. “I think I’d better get some pain pills. My back hurts from sitting in group.”
b. “The other women in the group have mental problems!”
c. “I haven’t said much, but I get a lot out of listening.”
d. “I feel better physically just from getting a chance to talk.”

18. The client, although oriented to person, place and time, cannot remember being extracted from
his burning automobile the day before. His inability to remember events surrounding the accident
is best described as:

a. Denial
a. Localized amnesia
b. Confabulation
c. continuous amnesia

19. A client recently released from prison for embezzlement has a history of blaming others for his
problems and becoming defensive and angry when criticized. He has expressed no remorse
for his actions nor any response to his conviction. He claims his actions were justified since his
employer did not treat him fairly. He is displaying characteristics of which personality disorder?

a. Narcissistic
a. Histrionic
b. Antisocial
c. Borderline

20. A 35-year-old client is being interviewed by the nurse. The client’s history indicates that she has
few friends, fears criticism and rejection from others, and withholds information about her
thoughts and feelings because she anticipates a negative reaction. Based on the data, the
nurse suspects that the client may have which of the following personality disorder?

a. Schizotypal
b. Paranoid
c. Avoidant
d. Schizoid

21. Which nursing diagnosis may be a priority of care at the time of admission for a client
diagnosed with antisocial personality disorder?

a. Personal identity disturbance

b. Fear
c. Risk for violence directed at others
d. Social isolation

22. The client diagnosed with borderline personality disorder tends to label certain persons on the
staff as being good or bad. This behavior is an example of:

a. Secondary gain
b. Acting out
c. Passive aggression
c. Dichotomous thinking

23. In evaluating the progress of the client whose interpersonal relationships are based on
manipulation, the most important criteria are the client’s:

a. Plans
b. Promises
c. Actions
d. Words

24. A client with a diagnosis of schizophrenia is speaking in a group by putting rhyming words that
have no meaning together. This speech pattern is known as:

a. Echopraxia
a. Echolalia
b. Clang association
c. Neologism
25. The nurse administering atypical antipsychotic medication is aware that they have been defined
as having which of the following characteristics?

a. High risk for tardive dyskinesia

b. Minimal to no risk for extrapyramidal effects
c. Effective in treating only positive symptoms of schizophrenia
d. Effective in treating only negative symptoms of schizophrenia.

26. A client taking antipsychotic medications for treatment of schizophrenia complains to the nurse of
feeling nervous. The nurse notices that the client is pacing the long hallway and is unable to
remain still even when other clients are talking with him. This client is most likely experiencing:

a. Akathisia
b. Akinesia
c. Dystonia
d. Tardive dyskinesia

27. What nursing diagnosis is most likely to be associated with a client diagnosed as
having schizophrenia, disorganized type?
a. Impaired verbal communication
a. Sleep pattern disturbance
b. Social isolation
c. Self-care deficit

28. Which of the following is considered to be a positive symptom associated with schizophrenia?

a. Alogia
b. Avolition
c. Social withdrawal
d. Loose association

29. Family members have noticed that during the bath, a client tries to chew on a bar of soap. Which
term best describes this behavior?

a. Hyperactivity
a. Hyperamorphosis
b. Hyperorality
c. Hyperemesis

30. The nurse administering which of the following medications to a client realizes that it
increases the availability of acetylcholine in the synapse and leads to the recovery of some
mental functioning for the clients with dementia?

a. Fluoxetine (Prozac)
b. Trazodone (Desyrel)
c. Haloperidol (Haldol)
d. Donepezil (Aricept)

31. Client who is fighting against his restraints and shouting incoherently is brought by ambulance to
the Emergency Department, accompanied by his girlfriend. She reports that he seemed fine until
he took some pills that he had purchased that afternoon, but an hour later “he went crazy.” Which
of the following actions should the nurse take first?

a. Take his vital signs

b. Check his orientation
c. Start intravenous (IV) fluids
d. Administer sedative medication.

32. When working with a client suspected of having Alzheimer’s disease, the nurse needs to be alert
for increasing agitation that worsen at night, known as:

a. Pseudodementia
b. Pseudodelirium
c. Catastrophic reaction
d. Sundown syndrome
 33. A nurse explains to a mental health care technician that the client’s obsessive-compulsive
behaviors are related to unconscious conflict between id impulses and the superego (or
conscience). On which of the following theories does the nurse base this statement?

a. Behavioral theory
b. Cognitive theory
c. Interpersonal theory
d. Psychoanalytic theory

34. A client comes to day treatment intoxicated but says he is not. The nurse’s evaluation of his
symptomatology reveals:

a. Denial
b. Reaction formation
c. Transference
d. Countertransference

35. The nurse working in obstetrics is reinforcing the physician health teaching about the risks of
using substances during pregnancy. The client states that she only drinks a little beer and wine
and would never use any dangerous drugs. The nurse then assess for use of which drug that
causes the most physical, cognitive, and growth and developmental problems to the fetus?

a. Benzodiazepines
b. Hallucinogens
c. Alcohol
d. Cocaine

36. A young female presents for her school checkup. She denies any medical problem or taking any
medications, but she does acknowledge daily laxative use. As the school nurse, what other
symptoms or problems would you expect to find?

a. Headaches
b. Altered sleep patterns
c. Abnormal eating patterns
d. Intermittent chest pain.
37. A nursing educator is teaching a group of community health nurses on moderating alcohol use.
The nurse educator evaluates the group’s understanding of “harm reduction” if the group is able
to identify which group is not appropriate for “harm reduction”?

a. Individuals with tolerance

b. Individuals with alcohol skills
c. Individuals unable to control use
d. Individuals with high-dose use

38. Some adolescent clients relapse because they feel pressured by their peers. Which skill training
could the nurse plan for adolescents in order to assist them in relapse prevention?

a. Vocational skills
b. Drinking refusal skills
c. Problem-solving skills
d. Communication skills

39. A mother tells the nurse during an admission interview that her 2-year-old, who has numerous
bruises, has fallen down stairs frequently. The mother is able to provide few details. The
nurse evaluates this as:

a. Possible child abuse

b. Knowledge deficit pertaining to home safety
c. Normal behavior for a 2-year-old
d. Possible attention deficit disorder.

40. A nurse is teaching a class on domestic violence to high school students. Which of the following
statements by a student would indicate to the nurse that further teaching is needed?
a. “Violence often begins in a dating relationship.”
b. “The abuser will often apologize and promise to stop.”
c. “If you are educated and have money, abuse does not happen.”
d. “Abusers are often excessively jealous and possessive.”
41. A 15-year-old female student comes into the school nurse’s office asking to be tested for
[pregnancy. She confides to the nurse that her boyfriend forced her to have sex against her will.
The most appropriate intervention by the nurse would be:

a. Administer a pregnancy test.

b. Do teaching on safe sex.
c. Do teaching on birth control method.
d. Identify the student’s immediate concerns.

42. An adult survivor of child abuse state, “Why couldn’t I make him stop the abuse? If I were a
stronger person, I would have been able to make him stop. Maybe it was my fault he abused me.”
Based on this data, which would be the most appropriate nursing diagnosis?

a. Ineffective family coping

b. Social isolation
c. Chronic low self-esteem
d. Anxiety

43. The nurse is assessing a normal appearing 6-year-old brought to the Emergency Department by
the mother, who reports that the child vomits every time she eats. The child’s history reveals no
positive findings as well as several previous similar visits. The mother is very concerned and
insists that the child be admitted for a full GI workup. The nurse reports this as possible:

a. Anxiety disorder
b. Bulimia nervosa
c. Munchausen’s syndrome by proxy.
d. Severe food allergies.

44. In counseling parents who have recently lost a child to death, it is important for the nurse to have
already dealt with personal feelings about death, grief, and loss in children. This self-awareness
would:

a. Assist the nurse in helping the parents to express their grief fully.
b. Prevent the nurse from being personally affected by the loss
c. Prevent the nurse from sharing any personal feelings with the parents.
d. Assist the nurse in avoiding discussion of unpleasant feelings with the parents.

45. An African-American family gathered around their dying grandmother’s bed refuses to allow a
feeding tube to be removed and to stop feeding her, even after the healthcare team has stated
that there was nothing else to be done. The nurse understands the family’s resistance to removal
of the feeding tube is most likely caused by:

a. The refusal to accept the finality of death

b. Their need to try every possible solution
c. Their spiritual and cultural beliefs
d. Their distrust of the healthcare system

46. Outcome criteria for successful counseling for the loss of a client’s spouse would include
the client’s ability to:

a. Avoid feelings about the spouse’s death

b. Immediately memorialize the spouse
c. Attend grief support groups
d. Avoid sharing loss with significant others.

47. The nurse working with terminally ill clients understands that culture influences a client
and family’s reaction to grief, loss, and death by:

a. Ignoring inappropriate grieving behaviors

b. Tolerating any expression of grief or loss
c. Establishing symbolic rituals
d. Supporting all individual responses.

48. When questioned by a client about what an advance directive or living will is, the nurse should
respond that it states:
a. What treatment should be provided or omitted if the client becomes incapacitated
b. The practitioners who are allowed to provide care at the end of life
 c. The caregiver’s role in providing care at the end of life
d. The inheritance requirements for those relatives who are living.

49. When planning care for the client diagnosed with a chronic medical illness, the nurse can
anticipate the client needing assistance with issues related to what area?

a. Anger
b. Anorexia
c. Apathy
d. Euphoria

50. What is an expected outcome related to increasing the level of social support for the terminally ill
client?

a. Increased number of friends

b. Increased independence
c. Expression of emotion
d. Expression of hope

51. A client expressed feelings of hopelessness and helplessness about her husband’s illness and
her inability to care for him. Of the following issues, which would be the best for the client to focus
on first?

a. Her husbands present illness

b. Her past losses of significant others
c. Her loneliness and isolation in her new surroundings
d. Her future loss of her husband

52. While assessing the defense mechanisms used by the client, the nurse recognizes the client’s
use of defense mechanisms as adaptive when the:

a. Mechanism used decreases anxiety

b. Client seeks isolation to avoid stress.
c. Anxiety is expressed in behaviors
d. Client can identify the stressor

53. A nurse who practices subtle stereotyping or countertransference can expect the cultur-
al assessment to:

a. Be sensitive to the unmet needs of the culture

b. Be open and honest, reflecting the client’s concerns
c. Reinforce the nurse’s prejudices about the culture
d. Facilitate the treatment process.

54. The nurse should do which of the following as a primary nursing strategy for dealing effectively
with the spiritual needs of clients?

[Link] clients to appropriate clergy

[Link] own spiritual beliefs and values
c. Use a spiritual assessment tool.
d. Discuss own religiosity with the client.

55. Among the following symptoms reported by a grieving older adult, which should concern the
nurse the most?

a. Occasional shortness of breath

b. Expressed thoughts of being better off dead
c. Guilt about what was done at the time of a loved one’s death
d. A morbid preoccupation with worthlessness

56. Primary nursing interventions effective for the impulsive, egocentric, and aggressive behaviors of
children with conduct disorders are:

a. Limit setting and consistency

b. Open communication and flexible approach
c. Open expression of feeling
d. Assertiveness training
57. The nurse assesses for which of the following common anxiety disorders among children?

a. Obsessive-compulsive disorder
b. Simple phobia
c. Separation anxiety disorder
d. Post-traumatic stress disorder (PTSD)

58. In planning the care for a young child with oppositional defiant disorder, the psychiatric
nurse would include:

a. Reminiscence therapy
b. Emotive therapy
c. Behavior modification
d. Cognitive retraining

59. One of the outcomes of play therapy is to enable the children to:

a. Act out feelings in a constructive manner

b. Learn to talk openly about themselves
c. Learn how to give and receive feedback
d. Learn problem-solving skills.

60. The school nurse who is planning a community education program would include information that
one childhood psychiatric disorder that appears to be genetically transmitted is:

a. Anxiety
b. Sleepwalking
c. Enuresis
d. Mania

61. When assessing an apparently anxious client, questions about anxiety should be:

a. Abstract and non-threatening

b. Avoided until the anxiety disappears
c. Avoided until the client brings up the subject
d. Specific and direct

62. Which of the following nursing diagnoses has the highest priority for an anxious client?

a. Defensive coping
b. Ineffective denial
c. Risk for loneliness
d. Risk for self-directed violence

63. The best goal for a client learning a relaxation technique is that the client will:

a. Confront the source of the anxiety

b. Experience anxiety without feeling overwhelmed
c. Keep a journal as a self-monitoring technique
d. Suppress anxious feelings

64. The long-term goal, “The client will learn new ways of coping with anxiety,” is most appropriate at
which level of anxiety?

a. Mild
b. Moderate
c. Severe
d. Panic

65. Which of the following would be the best nursing action for client who is having a panic attack?

a. Remain with the client

b. Teach the client to recognize signs of a panic attack
c. Instruct the client to remain alone until the symptoms subside
d. Involve the client in a physical activity
66. A client with Dissociative Identity Disorder (DID) is admitted after an overdose of alcohol
and benzodiazepines, claiming that another alter “did it.” The priority nursing diagnosis is:

a. Post-trauma response
b. Risk for self-directed violence
c. Personal identity disturbance
d. Anxiety

67. A client is brought to the emergency room after a brutal physical assault. Although oriented and
coherent, she cannot remember the assault or events surrounding it. The priority intervention is to
provide:

a. Frequent reality orientation

b. Physical comfort an safety
c. Thoughtful questioning for the police report
d. Referral to a community support group

68. A client with Dissociative Identity Disorder (DID) suddenly begins to speak with a child’s
vocabulary and voice. Which of the following is the most therapeutic response by the nurse?

a. “You must be feeling very needy.”

b. “Here are some toys you might enjoy.”
c. “Can you tell me what is happening?”
d. “This behavior keeps you from working on your problems.”

69. The priority nursing diagnosis for a client experiencing amnesia is:

a. High risk for self-directed violence

b. Powerlessness
c. Ineffective individual coping
d. Sensory/perceptual alteration

70. A client reports episodic depersonalization experiences. Which of the following is an appro-
priate goal of care?

a. The client will describe three stress management techniques by day 2.

b. The client will report no suicidal thoughts by week 1
c. The client will create a chart of all personalities by week 1
d. The client will state five personal strengths by day 2.

71. A nurse employed in managed care system collaboration with the treatment team in monitoring a
client’s progress from psychiatric inpatient care to a community-assisted living program. The role
of the nurse can best be described as:

a. Advanced practice nurse

b. Case manager
c. Nurse manager
d. Staff nurse

72. When a nurse establishes a therapeutic relationship with a client, which of the following is the
primary focus for the client’s care?

a. The medical diagnosis

b. The client’s needs and problems
c. The nursing diagnosis
d. The client’s social interaction skills

73. Which of the following is the overall purpose of therapeutic communication?

a. To analyze client problems

b. To elicit client cooperation
c. To facilitate a helping relationship
d. To provide emotional support

74. A nurse is interacting with a client from a different cultural background. Which of the following
implementations would the nurse use to provide sensitive care?
 a. Confronting issues of noncompliance
b. Use of therapeutic silence
c. Use of therapeutic touch
d. Validation of communication

75. Shortly after a voluntary admission to a psychiatric inpatient unit, a client tells the nurse, “I don’t
know if I should be here. What will my family think?” Using reflection, which of the following is
the most appropriate response from the nurse?

a. “Your family can visit you here, and they will see that this is a helpful place.”
b. “You think your family will be upset because you have a psychiatric problem?”
c. “There is still a stigma associated with mental illness. Hopefully your family won’t feel this
way.”
d. “You are wondering if you made the best decision, and you are concerned about your family
reaction.”

76. A nurse is intervening with a client who experienced a crisis following the sudden death of a loved
one. Which of the following actions would the nurse take after establishing initial rapport?

a. The nurse would ask the client to describe his social support system
b. The nurse would call the client’s family to discuss the problem
c. The nurse would encourage the client to describe in detail what happened.
d. The nurse would refer the client to a bereavement support group.

77. The nurse would select which of the following approaches in order to best respond to a client in
crisis?

a. Behavior approach
b. Behavior approach
c. Problem-solving approach
d. Supportive approach

78. Which of the following best describes the role of the nurse as a member of a crisis interven-
tion team?

a. Assistive role
b. Collaborative role
c. Educative role
d. Managerial role

79. Which of the following symptoms common in individuals experiencing a crisis would a nurse
expect to assess?

a. Feeling of depersonalization, loose association, flat affect

b. Lack of regard to social norms, apathy, hallucinations
c. Mood swings, feeling of boundless energy, grandiose beliefs
d. Somatic complaints, difficulty performing roles in life, poor concentration

80. When a client is experiencing a crisis, what is the best rationale for the nurse identifying client’s
strength?

a. It allows the nurse to better determine the nursing diagnosis

b. It helps the nurse understand the client’s unique personality
c. The nurse can better educate on assessment of strengths
d. Reinforcing the client’s strengths will aid in coping.

81. When evaluating an imminent suicide risk, which of the following information given by the client
would be most significant?

a. At least a 2-yaer history of feeling depressed more days than not

b. Divorced from spouse 6 months ago
c. Feeling loss of energy and appetite
d. Reference to suicide as best solution to identified problems

82. A client in an acute psychiatric hospital unit tells a nurse about his plans for suicide. The priority
nursing intervention is to :
 a. Allow the client time alone for reflection
b. Encourage client to use problem solving
c. Follow agency protocol for suicide precautions
d. Stimulate the client’s interest in activities

83. The community nurse is speaking to a group of new mothers as part of a primary prevention
program. Which of the following self-care measures would be most helpful as a strategy to
decrease occurrence of mood disorder?

a. Keeping busy, so as not confront problem areas

b. Medication with antidepressant
c. Use of crisis intervention services
d. Verbalizing rather than internalizing feelings.

84. The husband of a client who has recently lost her job tells the clinic nurse that the client’s moods
are constantly changing from extremely crying. As past of an immediate assessment of the family
situation, the nurse should question the husband and wife about which of the following?

a. The client’s academic and work history

b. The specific history of psychopathology in client’s family
c. The client’s specific symptoms, the duration of the symptoms, and the impact of the
symptoms on the family
d. The quality of couple’s marital relationship.

85. During a daily community meeting, a client with bipolar disorder, manic type, begins pacing
around the room and talking in aloud voice with a rapid speech. Which of the following is the most
appropriate nursing intervention?

a. Asking the client to accompany you and moving to a quieter room

b. Allowing the community group to handle the client’s behavior
c. Ending the community meeting at this type
d. Offering antianxiety medication to the client

86. The school guidance counselor refers family with an 8-yaer –old child to the mental health clinic
because of the child’s frequent fighting in school and truancy. Which of the following data would
be a priority to the nurse doing the initial family assessment?

a. The child’s performance in school

b. Family education and work history
c. Family perception of current problem
d. The teacher’s attempts to solve problem

87. When interacting with a mother and father who are divorcing, the nurse notes that the major
theme of parental disagreement is the behavior of their 13-year-old daughter is irresponsible and
lacks respect for his authority, whereas the mother cites the belief that a strict, authoritarian
father rules the daughter. Which of the following family systems concepts is this situation an
example of?

a. Differentiation of child
b. Enmeshed relationship of parents
c. Skewed relationship of parents
d. Triangulation of child

88. The parents of a client with schizophrenia express feelings of responsibility and blame for the
client’s problem. Which of the following would the nurse providing family education do?

a. Acknowledge parents’ responsibility

b. Explain the biologic nature of schizophrenia
c. Provide referral to a support group
d. Teach the parents various ways they must change.

89. The school nurse is conducting a class on parent-child relationships to encourage functional
family development. Which of the following things would the nurse teach the class about
family resolution of conflict situations?
a. Children need to be encouraged to accept parental advice
b. Conflict generally does not arise in functional families’
c. Discussion of conflict in a clear, direct way is important
d. Solutions to conflicts should be provided by a neutral party.
90. A 19-year-old client admitted to a psychiatric inpatient facility for treatment of major depression.
The nurse learns that the client’s father has been on total disability for 3 months since an accident
and that the mother has recently experienced relapse of a chronic alcohol problem. The nursing
diagnosis established is Family coping: ineffective- compromised related to situation stressors.
Which of the following is the most appropriate goal (outcome criterion) for intervention?

a. Establish independence of the client from the family system

b. Ensure the mother’s compliance with alcohol treatment
c. Identify ownership of problem as belonging to parents.
d. Use family and external resources to cope with problems.

91. A client with benign essential hypertension has been referred for biofeedback training. Which of
the following criteria would the nurse use to evaluate the client’s success with this method?

a. The client states that his stress level is under control.

b. The client’s blood pressure is normal while on a decreased dose of antihypertens-
ive medication
c. The client uses relaxation methods on a regular basis.
d. The client follows recommended diet and medication plan without deviation.

92. A nurse is teaching a class on stress management. The nurse is questioned about the use of al-
ternative treatments, such as herbal therapy and therapeutic touch. The nurse explains that the
advantage of these methods would include all of the following except

a. That they can be congruent with many cultural belief systems

b. That they encourage the consumer to take an active role in health management
c. That they promote interrelationships between mind-body-spirit
d. That they usually work better than traditional medical practice

93. A client hospitalized on an eating disorder unit is monitored by the nurse for one hour after eating.
The rationale for this intervention is

a. To develop trusting relationship

b. To maintain focus on importance of nutrition
c. To prevent purging behaviors
d. To reinforce behavioral contact

94. The initial treatment priority for a client hospitalized for anorexia nervosa on a special eating
disorder unit is

a. To determine current body image

b. To identify family interaction pattern
c. To initiate refeeding program
d. To promote client independence

95. Which of the following attitudes from a nurse would hinder a discussion with an adolescent client
about sexuality?

a. Accepting
b. Matter-of-fact
c. Moralistic
d. Nonjudgmental

96. A young client, who is a mother for the first time is very anxious about her new parenting role.
With the nurse’s encouragement, she has joined the new mother’s support group at the local “Y”.
This part of the plan is an example of:

a. Tertiary Prevention
b. Primary Prevention
c. Secondary Prevention
d. Therapeutic Prevention
 97. During an interview with the parents of an adolescent female, the nurse notices that her father
continually defends and makes excuses for all his daughter’s actions whereas her mother
seems to feel her daughter is just lazy and that there is nothing wrong with her that she couldn’t
change with some effort. The nurse recognizes that the dynamic used by the family is known as:

a. Coalition
b. Resignation
c. Scapegoating
d. Reaction Formation

98. The nurse is aware that according to Erickson, a young child’s increased vulnerability to anxiety
in response to separations or pending separations from significant others results from failure to
complete the developmental task called:

a. Trust
b. Identity
c. Initiative
d. Autonomy

99. The psychotherapeutic theory that uses hypnosis, dream interpretation, and free association as
methods to release repressed feelings is the:

a. Behaviorist Model
b. Psychoanalytic Model
c. Psychobiologic Model
d. Social – Interpersonal Model

100. The best initial approach to take with a self- accusatory, guilt ridden client would be to:

a. Contradict the client’s persecutory delusions

b. Accept the client’s statements as the client’s beliefs.
c. Medicate the client when these thoughts are expressed.
d. Redirect the client whenever a negative topic is mentioned