MCQ

1. A client tells the nurse that his co-workers are sabotaging the computer. When
the nurse asks questions, the client becomes argumentative. What is the most
appropriate intervention for the nurse to implement?
a). Encourage the client to vent his anger about his computer
B). Tell the client that his co-workers haven’t touched his computer
c). Use clear and consistent speech when talking to the client
d). Tell the client to go to his room and stay there until he calms down

2. A nurse is distinguishing characteristics of schizotypal personality disorder from

schizoid personality disorder. What is the most appropriate statement by the
nurse?
a). Schizotypal are characterized by emotional detachment
B). Schizotypal are characterized by disinterest in close relationships
c). Schizotypal are indifferent to praise or criticism
d). Schizotypal have magical thinking or perceptual distortions

3. Which of the following nursing diagnoses would be most appropriate for a client
with schizotypal personality disorder?
a). Ineffective coping related to repetitive behaviour such as hand washing
B). Risk for self-mutilation related to social anxiety
c). Risk for violence toward others related to lack of remorse for behaviours
d). Impaired thought processes related to ideas of reference and
magical thinking

4. A client with paranoid personality disorder is discussing current problems with a

nurse. What is the most important intervention for the nurse to implement?
a). Have the client look at sources of frustration
B). Have the client focus on ways to interact with others
c). Have the client discuss the use of defence mechanisms
d). Have the client clarify thoughts and belief about an event

5. A client with a paranoid personality disorder makes an inappropriate and

unreasonable report to a nurse. What is the most appropriate intervention by the
nurse?
a). Use logic to address the client’s concern
B). Confront the client about the stated misperception
c). Use nonverbal communication to address the issue
d). Tell the client too matter-of-factly that you don’t share his interpretation.
 6. What is the most appropriate short-term goal for a client with paranoid personality
disorder and impaired social skills?
a). Obtain feedback from other people
B). Discuss anxiety-provoking situations
c). Address positive and negative feelings about self-mutilation
d). Identify personal feelings that hinder social interaction

1. A patient who was admitted yesterday with an adjustment disorder and depressed mood has not left his or her
room. The psychiatric-mental health nurse's most appropriate approach at meal time today is to respond:

 "I will bring your tray to your room, if it will make you more comfortable."
 "I will walk with you to the dining room and sit with you while you eat."
 "Where would you like to eat your meal this noon?"
 "You will feel better if you go to the dining room and eat with the others."

2. A 17-year-old, female patient with anorexia nervosa has just been released from the hospital. To facilitate
recovery at home, the psychiatric-mental health nurse instructs the family to:

 discourage the patient from sneaking food between meals, by unobtrusively reducing her access to the
kitchen.
 encourage the patient's interest in menu planning, food magazines, and cooking lessons, by leaving
information and materials around the house.
 permit the patient to eat her meals privately in her bedroom to discourage family preoccupation with meals.
 recommend that the patient joins in routine family meals and clears the dishes after dinner, even if
she does not eat.

3. A supervisor observes inconsistency in the psychiatric-mental health nurse's behavior toward a patient; the
nurse is unreasonably concerned, overly kind, or irrationally hostile. The most appropriate explanation is that the
nurse is displaying:

 countertransference.
 empathic resonance.
 splitting behavior.
 transference.

4. The first step in the treatment of incest is to:

  believe the child who reports the activity.
 notify the proper authorities.
 objectively confront the accused family member.
 remove the child from the home.

5. A couple in counseling reports fighting with their son when they are angry with each other. This behavior
typifies:

 coalition.
 indirect communication.
 transference.
 triangulation.

6. The severe feeling of restlessness produced by some psychotropic medications, which is often misinterpreted
by patients as anxiety or a recurrence of psychiatric symptoms, is known as:

 akathisia.
 akinesia.
 bradykinesia.
 dystonia.

7. During an initial patient interview, the psychiatric and mental health nurse begins by asking the patient to
describe his or her:

 current situation.
 feelings about the current situation.
 personal history.
 thoughts about the current situation.

8. A female patient reports an intense, overwhelming fear of driving a car. The fear has disrupted all elements of
the patient's life. The patient does not go to the grocery store unless someone transports her, has relinquished
her job, and has few social contacts. The patient's treatment plan includes:

 assertiveness training.
 biofeedback.
 stress management assistance.
 systematic desensitization.
9. A short-term goal for a patient with Alzheimer's disease is:

 improved functioning in the least restrictive environment.

 improved problem solving in activities of daily living.
 increased self-esteem and improved self-concept.
 regained sensory perception and cognitive function.

10. Older adults have reached Erikson's developmental stage of ego integrity when they:

 acknowledge that one cannot get everything one wants in life.

 assess their lives and identify actions that had value and purpose.
 express a wish that life could be relived differently.
 feel that they are being punished for things they did not do.

11. A patient states that unit staff members have been avoiding him or her since an attempt to self-mutilate. The
psychiatric-mental health nurse's most appropriate response is to:

 apologize for the staff's behavior.

 explain that feelings of rejection are typical after self-mutilation.
 listen, redirect the patient to his or her feelings, and explore the issue with the staff.
 report the matter to the nurse manager.

12. When planning inpatient psychotherapeutic activities for a patient who has antisocial personality disorder, the
psychiatric-mental health nurse:

 focuses on group, rather than individual, therapy.

 provides a permissive atmosphere, so the patient feels a sense of control.
 provides an organized, structured environment.
 recognizes that the disorder is characterized by social withdrawal.

13. Accompanied by many family members, a 16-year-old Chinese-American female patient is admitted to the
unit with reports of sadness and suicidal ideation. The patient and her family emigrated from mainland China five
years ago. Regarding the family, the psychiatric and mental health nurse:

 encourages the patient to communicate her need for privacy to her family.
 gently asks the family members to leave the room.
 privately asks the mother for her assistance in clearing the room.
  provides care for the patient while the family members are present.

14. According to family systems theory, removing the "identified patient" from the environment most likely causes
the:

 patient to decompensate, due to the loss of his or her support system.

 patient to significantly improve, often with minimal or no additional therapy.
 remaining family members to decompensate, as evidenced by new dysfunctional behavior.
 remaining family members to lose motivation and withdraw from therapy.

15. A psychiatric-mental health nurse, who is teaching a couple how to use positive reinforcement techniques
with their child, recommends:

 agreeing with the child's statements, whether negative or positive, and simply restating the child's
statements without other comment.
 controlling the child's behavior, so there is no chance of negative behavior.
 removing adverse consequences to produce positive results.
 rewarding positive behaviors to promote their recurrence.

16. A common nursing diagnosis for a patient with antisocial personality disorder is:

 chronic low self-esteem, related to poor self-image and excessive fear of failure.
 disturbed thought processes, related to sensory-perceptual alterations.
 impaired social interaction, related to manipulative behaviors.
 social isolation, related to anxiety in social situations.

17. A patient who is admitted to the psychiatric unit with a diagnosis of obsessive-compulsive disorder spends a
significant amount of time during the day and night washing his or her hands. On the third hospital day, the
patient reports feeling better and more comfortable with the staff and other patients. The psychiatric-mental
health nurse knows that the most appropriate nursing intervention is to:

 acknowledge the ritualistic behavior each time and point out that it is inappropriate.
 allow the patient to carry out the ritualistic behavior, since it is helping him or her.
 collaborate with the patient to reduce the amount of time he or she engages in ritualistic behavior.
 ignore the ritualistic behaviors, and the behaviors will be eliminated due to lack of reinforcement.

18. A selective serotonin reuptake inhibitor targets which part of the brain?
  Basal ganglia.
 Frontal cortex.
 Hippocampus.
 Putamen.

19. To evaluate whether patient teaching for coping skills has been effective, the psychiatric-mental health nurse
asks an adolescent patient to:

 consider the outcomes objectively.

 keep a written journal.
 perform a return demonstration.
 set measurable goals.

20. The psychiatric-mental health nurse knows that the patient's spouse clearly understands the side effects of
lithium carbonate (Eskalith), when he or she says:

 "I should call the doctor if my spouse shakes badly."

 "I should make sure my spouse drinks as much water as she or he can."
 "My spouse must remain on a salt-free diet."
 "When the lithium level is 1.6 mEq/L, my spouse can go back to work."

21. A school-aged patient with attention-deficit/hyperactivity disorder is displaying disruptive behaviors at home.
The psychiatric-mental health nurse modifies the treatment plan for the social domain, by advising the patient's
parents to:

 establish eye contact before giving directions.

 initiate a point system, to reward the patient for appropriate behavior.
 instruct the patient to work on one homework assignment at a time.
 maintain a predictable environment in the home.

22. After taking an antidepressant for about a week, a patient reports constipation and blurred vision, with no
improvement in mood. The psychiatric-mental health nurse informs the patient:

 "It takes approximately two to four weeks for depression to lessen, and side effects usually diminish
over time."
 "Stop the medication immediately and contact your primary care physician."
 "You should contact your doctor. The doctor may need to change your medication."
  "You should schedule an appointment with your ophthalmologist."

23. A patient is being discharged after spending six days in the hospital, due to depression with suicidal ideation.
The psychiatric-mental health nurse knows that an important outcome has been met when the patient states:

 "I can't wait to get home and forget that this ever happened."
 "I feel so much better. If I continue to feel this way, I can probably stop taking my medications soon."
 "I have a list of support groups and a crisis line that I can call, if I feel suicidal."
 "I have to leave here soon, if I want to make it to the shelter before they run out of beds."

24. When screening families for post-traumatic stress disorder following a major natural disaster, psychiatric-
mental health nurses are practicing which type of disease prevention?

 Primary.
 Secondary.
 Tertiary.
 Universal.

25. When a research study is based on a small sample size, the findings may:

 be statistically significant, but will be less generalizable than if the sample size had been larger.
 be statistically significant, but will not be clinically significant.
 not be statistically significant, because the research design was quasi-experimental, instead of
experimental.
 not be statistically significant, because the research was poorly conducted.