REFRESHER PHASE

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

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

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

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