REFRESHER PHASE

EVALUATIVE EXAMINATION
PSYCHIATRIC NURSING (ABNORMAL)
MAY 2025 Philippine Nurse Licensure Examination Review
1. What type of hallucination is most likely to be experienced 9. A patient with agoraphobia was suddenly brought
by a chronic alcoholic patient who has suddenly stopped to a mall, as part of their therapy. What behavioral
drinking? therapy supports this intervention?
A. Claims that they keep feeling something A. This is an example of systematic desensitization
B. Claims that they keep hearing something B. This intervention may or may not work and
C. Claims that they keep seeing something requires extensive consideration before doing such.
D. Claims that they keep tasting something C. This is an example of cognitive behavioral therapy
2. During the early stages of the previous patient’s illness, they D. This is an example of flooding
claim that his family has been supporting him faithfully which 10. Which of the following is not included in the criteria for
calms him. However, his family has given up on him this time diagnosing posttraumatic stress disorder?
and refuses to believe that something is wrong with the A. Increased arousal
patient. This caused an exacerbation of the patient’s B. Extreme attachment to support people
symptoms. Such is an example of: C. Flashbacks of the traumatic event
A. The loss of secondary gain as a relief of D. Irritability
anxiety 11. What physical symptom is most likely to be felt by a
B. Evidence of how loss of family support can impact patient with mild anxiety?
a patient’s illness A. GI butterflies
C. The importance of including the caregivers to the B. GI upset
care in order to avoid caregiver burden C. Nausea, vomiting, and diarrhea
D. The history is unrelated to the patient’s chief D. GI paralysis
complaint 12. You are assigned to a patient who claims that he has been
3. Which food is appropriate to serve to a patient with bipolar feeling abdominal pains with a score of 6/10 for the past 5
personality disorder in the manic phase? years. Upon assessment, you discover that this patient has
A. Chopsuey already consulted 5 hospitals and 3 clinics. You suspect this
B. Chicken popcorn patient to have which disorder?
C. Baked mac A. Functional neurologic deficit disorder
D. Carrot sticks B. Disease phobia
4. Which of the following is the initial intervention for a patient C. Somatic symptom disorder
who is panicking? D. Disease conviction
A. Administer PRN IM anxiolytics 13. What psychotherapy is indicated when activities such as
B. Redirect the patient’s attention to the environment art, music, or dance serve as outlets of the emotions
around them (especially anxiety, anger, and depressive feelings) of a patient
C. Take the patient in a small, quiet, non-stimulating with PTSD?
environment A. Defusing
D. Stay with the patient and ensure that their B. Debriefing
environment is safe C. Free association
5. Which of the following patients are considered to be D. Catharsis
demonstrating a soft symptom of schizophrenia? 14. What action by a nurse indicates that they are applying
A. The patient who can speak but chooses not grounding techniques for patients who are panicking or
to flashbacks in post-traumatic stress disorder?
B. The patient who is talking to the wall A. The nurse states: “I want you to tell me what you
C. The patient who is trying to build a fire using sticks are seeing and feeling right now.”
D. The patient who is using new words that only they B. The nurse touches the client to let them know that
can understand they are there for the patient
6. Who among the following patients have insight about their C. The nurse asks the client to reflect on how they
disorder? got through similar situations before
A. Patient with schizophrenia D. The nurse commands the client to look
B. Patient with anorexia nervosa around the room, feel the bed, and identify
C. Patient with bipolar disorder sounds they are hearing.
D. Patient with obsessive-compulsive disorder 15. A patient with depression was observed by the nurse to
7. What delusion is a patient experiencing when they claim seat at a table with two other clients. What is the best
that their Kpop crush loves them and is their partner? feedback the nurse could give?
A. Sexual delusion A. “It makes me happy to see you talking to other
B. Erotomanic delusion patients.”
C. Grandiose delusion B. “You must be feeling better now compared to when
D. Affectionate delusion we first met”
8. Which of the following activity characteristics is most C. “Tell me more about what you feel”
appropriate for a patient with bipolar disorder in the depressive D. “I saw that you sat with the others at lunch
phase? earlier”
A. Competitive, solitary
B. Noncompetitive, group
C. Competitive, group
D. Noncompetitive, solitary

16. Your patient with somatic symptom illness disorder

mentioned that their abdominal pain is back which is why they

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do not want to get out of the bed. After determining that there A. The patient being born as a male
are no other symptoms, what is a therapeutic response to this B. The patient’s age being 18 years old
patient? C. The patient who just experienced the loss of a
A. “Tell me about what you feel and I’ll listen partner
before we go to our walk” D. The patient whose father has been
B. “We already talked about this before. You must be diagnosed with major depressive disorder
aware now that this is not real.” 26. One of the complaints of your patient is that they feel like
C. “I’ll give you your scheduled pain medications” the newscaster on the TV is talking about him during a report
D. “Getting up to walk will distract you from your of a victim of a man hunting incident. You know that this is
pain” called as:
17. When interviewing your patient, she states that she feels A. Ideas of reference
excited in a monotonous tone and while maintaining a blank, B. Thought broadcasting
mask-like face. You document this affect as: C. Persecutory delusion
A. Blunt affect D. None of the above
B. Flat affect 27. While talking to a patient experiencing psychosis, you
C. Restrictive affect noticed that they keep looking at the side and reacting to the
D. Inappropriate affect wall. What is your appropriate response?
18. What therapy will a patient with paranoid personality A. “I would appreciate it if you focus on our
disorder most benefit from? discussion”
A. Acting out how to act in social situations B. “You seem distracted. Is something
B. Taking psychiatric medications on time distracting you at your side?”
C. Setting limits on inappropriate behavior C. “How often do you do that when talking to other
D. Increasing self-esteem and self-worth people?”
19. Which of the following behaviors of a nurse is non D. Ignore the behavior as it may go away.
therapeutic for a patient who is paranoid? 28. What is an appropriate intervention for a client whose
A. Maintaining a businesslike and formal attitude manic phase is triggered?
when interacting with the patient A. Bring the client to the garden where it is
B. Two nurses who are planning about another quiet
patient’s care at the patient’s door B. Allow the client to verbalize their feelings
C. Using simple, direct, and concise words C. Sit with the client even if they do not recognize
D. Maintaining a friendly, yet passive attitude your presence
20. Which of the following neurotransmitters are altered in D. Restrain the client.
patients with mood disorders? 29. In the emergency room, a patient entered complaining of
A. Norepinephrine and dopamine a 10/10 headache and severe chest pain. Upon assessing the
B. Dopamine and serotonin client’s history, you determined that they were admitted to the
C. Norepinephrine and serotonin psychiatric ward for somatic symptom illnesses with the same
D. Dopamine and acetylcholine chief complaint. What is your immediate nursing intervention?
21. In applying restraints, what is an action by the nurse that A. Assess the client’s symptoms further
will indicate that you, as the head nurse, need to provide B. Bring the client to the psychiatric ward.
further education? C. Refer the client to the cardiologist
A. The nurse monitors the client’s radial and dorsalis D. Refer the client to the psychiatrist
pedis pulse after applying restraints. 30. Your patient states: “I feel great. Rate my pain. I feel
B. The nurse ensures the restraints are tightly sane. I want to drive in my lane.” As a psychiatric nurse, you
applied to the footboard. are aware that this is a manifestation of:
C. The nurse does not wait for the doctor’s orders A. Verbigeration
when they applied restraints B. Stilted language
D. The nurse monitors the client every 15 minutes, or C. Perseveration
as needed. D. Clang association
22. You observe that your patient isolates herself from other 31. Which of the following is true about schizophrenia?
patients in the ward. They are not participative and mentions A. Schizophrenia is a chronic illness requiring
“I do not care about anything.” What will you include in your long-term management
plan of care for this patient? B. A patient with schizophrenia may experience some
A. Implement a kind and firm approach during your involvement of their social integration to the
interactions community
B. Offer your time with the client in a C. Medications for schizophrenia are called
consistent and non-demanding manner antipsychotics and is discontinued once symptoms of
C. Sign the client up for the community basketball schizophrenia are cured
league D. A common and accredited tool and nursing care
D. Ask other clients who are friends with the patient plan is available to be used for all patients with
for guidance schizophrenia, regardless of severity.
23. Which sign or symptom indicates that your patient is 32. What speech disturbance is characteristic of a patient
experiencing panic? during the acute phase of mania?
A. Suicidal behavior A. Perseveration
B. Sleeplessness B. Word salad
C. High pitched voice C. Looseness of association
D. Pounding heart and chest pain D. Flight of ideas
24. Which of the following statements by a student nurse 33. When reading your patient’s charts, they are characterized
indicate that they do not need any additional teaching to have the following behavior: (1) wears seductive and
regarding patients who are suicidal? colorful clothes, (2) acts close to all people even if they just
A. It is important to not talk about suicide to avoid met, and (3) is emotionally expressive and agrees with anyone
encouraging the patient to think about it to get attention. These are signs and symptoms of which
B. A patient who has acted on their suicidal personality disorder?
ideation is at risk for suicide for two years A. Narcissistic personality disorder
C. If a person talks openly about suicide, it is less B. Obsessive-compulsive personality disorder
likely that they will hurt themselves C. Borderline personality disorder
D. Once a patient is at risk for suicide, they are D. Histrionic personality disorder
always at risk for such 34. A patient with schizophrenia is currently experiencing
25. Which of the following patient data puts them at the delusions of grandiosity. What is an initial response to their
highest intrinsic risk for major depressive disorder?

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statement: “I need to go home. My attendants are waiting for 44. What is the appropriate intervention of a nurse to a
me and my fans are expecting my return to showbusiness.” patient admitted who does not want to interact with other
A. I see that you believe that you really have fans people, including their nurse-in-charge?
awaiting you. A. “It’s okay if you do not want to talk. I will come
B. What makes you think that people are waiting for back before my shift ends”
your return? B. “I will have to terminate my contract if you do not
C. Do you feel like you have something or speak with me”
someone important to attend to outside? C. “I will stay here for 15 minutes. You can
D. No one is waiting outside for you. choose to talk or not to talk to me”
35. What is true of obsessive-compulsive disorder? D. “Please answer. We need your input so that we can
A. Obsessions are uncontrollable impulses take care of you”
B. Compulsions are uncontrollable thoughts 45. The nurse observes that a client with bipolar disorder is
C. Obsessions are uncontrollable thoughts pacing in the hall, talking loudly and rapidly, and using
D. None of the above elaborate hand gestures. The nurse concludes that the client is
36. When asked about how the patient is feeling, they demonstrating which
responded: “I feel forlorn for I have just been a witness of the A. Aggression
demise of my dearly beloved offspring. It brings me absolute B. Anger
melancholy that I witness their burial way ahead of me.” This C. Anxiety
is an example of which speech disturbance? D. Psychomotor agitation
A. Schizophasia 46. This is a schizophrenia-related disorder in which the patient
B. Stilted language manifests one or more psychotic behavior for at least month
C. Neologism but less than 6 months, usually with no impairment to social or
D. Verbigeration occupational functioning.
37. Your patient who is up for discharge teaching is showing A. Brief psychotic disorder
signs and symptoms of mild anxiety. What intervention must B. Catatonic schizophrenia
be done by the nurse? C. Schizophreniform
A. Redirect the client to the teaching session D. Shared psychotic disorder
B. Proceed with the planned health teaching 47. Which of the following interventions for a patient with
session bulimia nervosa should change in their care plan?
C. Assist the client to a quiet, non-stimulating room A. Encourage the patient to eat meals with other
D. Stay with the client and address their symptoms people such as friends or family
38. What intervention written by the nurse in the care plan B. Ensure that food stored at the kitchen, room,
indicates that they have a correct understanding in managing a and their car are all nutritious
patient who turns all lights in their house on and off for 25 C. Identify food eaten during binge episodes and
times before leaving? avoid buying them
A. Prohibits the client their behavior of turning the D. Plan with the patient a nutritious food plan
lights on and off. 48. What is the ego defense mechanism that is expected to be
B. Allow the client to do the behavior for 25 times used by a patient with OCD?
today, 10 times tomorrow, 15 times the day after. A. Acting upon negative feelings regarding a
C. Provide the client a safe space to verbalize threatening object to a less threatening object
their feelings behind their behavior. B. Performing acceptable behaviors in response
D. Make sure to give scheduled antidepressants on to negative behaviors
time. C. Acting the opposite of what one thinks or feels
39. A patient who presents with sudden shifts of emotion from D. Blaming oneself
being ecstatic and joyful to sad and depressive in a short 49. What is an appropriate intervention for a client who is
amount of time is presenting with what affect? experiencing GI upset, muscle tension, frequent urination, and
A. Bipolar disorder cannot seem to concentrate unless directed?
B. Broad affect A. Acknowledge the client’s experience and promote
C. Labile affect verbalization
D. Inappropriate affect B. Refocus the client to the current situation
40. What is an important intervention for a patient with and promote use of relaxation techniques
anorexia nervosa after meals? C. Use a soothing, calm voice and provide
A. Stop them from performing ritualistic food intramuscular anxiolytics
behaviors D. Take control of the client and assist them to a
B. Provide the client with supplemental food private room
C. Write down in their journal their experience of 50. Which of the following patients, upon your assessment, will
eating you document as the least likely to commit suicide?
D. Monitor the client closely A. A patient who has a list of people who they want
41. What is the thought disturbance that is the delusional to say sorry to at the bedside
belief that other people are taking the client’s thoughts away B. A patient who is offering to the nurse the only
and the client is powerless to stop it? award they received from their school
A. Thought blocking C. A patient whose affect has improved to smiling and
B. Thought broadcasting joyful as compared to being depressive during
C. Thought insertion admission
D. Thought withdrawal D. A patient who is persistently alone and does
42. What neurotransmitter levels are altered in schizophrenia? not want to talk to anyone since admission
A. Dopamine and serotonin
B. Norepinephrine and serotonin
C. GABA and dopamine
D. Acetylcholine and norepinephrine
43. When a patient responds to a question in full detail but is
unable to answer the question at hand, the nurse documents
this manifestation as:
A. Flight of ideas
B. Looseness of association
C. Tangentiality
D. Circumstantiality 3

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