PSYCH WORKBOOK d.

Heredity
5. Ysabelle, a newly registered nurse, is
Situation: The psychiatric nurse should be well pursuing her career as a psychiatric
versed in the legal issues commonly nurse. In which of the following settings
encountered in the psych unit. would she expect to work with people
with psychiatric needs?
1. Which of the following rights can be a. Special education centers
suspended with a good cause? b. DSWD shelters
a. Choice of providers c. Half-way houses
b. Confidentiality d. All of these
c. Treatment
d. Non discrimination 6. While caring for the client with a mental
illness, which action by the
2. The nurse employed in a mental health psychiatric–mental health nurse best
clinic is greeted by a neighbor in a local indicates the use of Hildegard Peplau’s
grocery store. The neighbor says to the nursing theory?
nurse, “How is Carol doing? She is my a. Assessing client’s interactions
best friend and is seen at your clinic with their environment
every week.” Which is the most b. Intervening to enhance the
appropriate nursing response? client’s abilities to perform
a. “I cannot discuss any client self-care
situation with you.” c. Establishing a therapeutic
b. “If you want to know about Carol, nurse-client relationship
you need to ask her yourself.” d. Evaluating the effectiveness of
c. “Only because you’re worried the client’s coping and adaptation
about a friend, I’ll tell you that she skills
is improving.
d. “Being her friend, you know she 7. Brad has been diagnosed to have Major
is having a difficult time and Depression. He is now being
deserves her privacy.” discriminated against by the community
and is labeled as “Baliw” because of his
3. A voluntary client in a facility decides to illness. This is an example of?
leave the unit before treatment is a. Defined burden
complete. To detain the client, you b. Undefined burden
refuse to return the client's personal c. Hidden burden
effects. Nurse Mark will tell you that you d. Future burden
are committing?
a. False imprisonment Situation: The mechanism for establishing,
b. Limit setting maintaining, and improving human contacts is
c. Slander interpersonal communication. Communication
d. Violation of confidentiality is a very special process and the most
significant of human behaviors. Moreover, it is
Situation: No single, universal definition of the main method for implementing the nursing
mental health exists. Generally a person’s process. As psychiatric–mental health nurses,
behavior can provide clues to his or her we help clients tell their stories, explore the
mental health. Because each person can have circumstances of their lives, and move in a
a different view or interpretation of behavior more satisfying and mentally healthier
(depending on his or her values and beliefs), direction.
the determination of mental health may be
difficult. As such, the psychiatric nurse must 8. The use of facial expressions and
be knowledgeable about mental health and the gestures communicates:
scope of this specialty field. a. Personality traits.
b. Interest in, and attraction to,
4. A major environmental factor that may another person.
influence the development of mental c. Emotions.
illness is: d. Rejection.
a. Having 3 nurse siblings
b. Poverty 9. A client in group therapy is restless. His
c. Political confusion face is flushed and he makes sarcastic
 remarks to group members. The nurse a. Professional identification of own
responds by saying, "You look angry." emotional difficulties
The nurse is using which of the b. There is mutual trust between
following techniques? the nurse and the patient
a. A broad opening statement c. Patient’s self-esteem needs are
b. Reassurance satisfied
c. Clarifying d. Patient is diagnosed a wellness
d. Making observations diagnosis

10. A client asks the nurse, "Do you think I 14. The primary task of the nurse in the
should leave my husband?" The nurse resolution phase of the nurse-patient
responds, "You aren't sure if you should relationship is:
leave your husband?" The nurse is a. Assist patient to review what
using which therapeutic technique? he has learned
a. Restating b. Planning therapeutic
b. Reframing interventions
c. Reflecting c. Nursing diagnosis formulation
d. Offering a general lead d. Assisting the client in expression
of thoughts and feelings
Situation: The therapeutic nurse–client
relationship, also called the one–to–one 15. A productive therapeutic relationship
relationship, is one in which the nurse uses between a nurse and a client begins
theoretical understandings, personal with the nurse’s:
attributes, and appropriate clinical techniques a. Passion to help clients who
to provide the opportunity for a corrective cannot cope
emotional experience for clients. b. Unconditional positive regard for
others
11. Which of the following client statements c. Self-awareness and
does NOT reflect a characteristic of the understanding
functional one to-one relationship? d. Psychiatric nursing expertise
a. “We agreed to meet twice
monthly for a year in her office at Situation: Nurse Linda is a young promising
the clinic.” nurse who chose to start a professional career
b. “My nurse wants to focus on as a mental health psychiatric nurse. Part of
anger management her orientation and training as a beginning
techniques, and I want to professional nurse is enhancing facilitative
examine my early childhood.” personal characteristics.
c. “When I move in December, our
relationship will end. My nurse 16. The nurse should introduce information
plans to refer me to a clinic near about the end of the nurse-patient
my new home. I will miss her, relationship:
because I will not see her again.” a. As the goals of the relationship
d. “The nurse and I decided to are reached
address physical safety issues b. During the orientation phase
first, and then focus on sources c. At least one or two sessions
of social support.” before the last meeting
d. When the patient states that he is
12. The nurse who encourages her client to ready
express her feelings and concerns
performs one of the following tasks: 17. Establishing a therapeutic contract is the
a. Parent surrogate goal of which phase of the nurse-patient
b. Counselor relationship?
c. Socializing agent a. Orientation phase
d. Ward Manager b. Working phase
c. Pre-orientation phase
13. Psychiatric nurses are well aware that a d. Middle phase
therapeutic relationship is only possible
and effective after: Situation: Clinicians are often said to be
eclectic, that is, they choose one or a
combination of nursing and human behavior by her children with the diagnosis of
sciences. Dementia. In order to test her ability to
think abstractly, you would ask which of
18. The nurse knows that Erikson identified the following?
the developmental tasks of the a. “Can you repeat the following
school-age child from 6 to 12 years as: numbers: 8, 2, 4, 6, 10”
a. Initiative vs guilt b. “How are radio and television
b. Breaking away vs staying at alike?”
home c. “What would you do if you fell
c. Industry vs inferiority and hurt yourself?”
d. Psychosexual impulses vs d. “Can you give me today’s
psychosexual development complete date?”

19. Under the psychoanalytic model of 23. The nurse must assess a client's
Freud, the ego functions includes all of judgment to determine mental status. To
the following except: best accomplish this, the nurse should
a. Store up experiences in memory have the client:
b. Operate on the pleasure principle a. interpret proverbs.
to reduce tension or discomfort b. spell words backward.
c. Control and regulate c. count by serial sevens.
instinctual drives d. discuss hypothetical situations
d. Use defense mechanism to
protect self 24. During the mental status examination, a
client may be asked to explain such
20. The negative attitude of parents towards proverbs as "Birds of the same feather
infantile masturbation like threatening a flock together." The purpose is to
boy with the loss of his penis may lead evaluate the client's ability to think:
to: a. rationally.
a. Electra complex b. concretely.
b. Inferiority complex c. abstractly.
c. Oedipal complex d. tangentially.
d. Castration complex
Situation: As a nurse you will encounter clients
21. A defense mechanism used by patient with anxiety disorders in every clinical practice
with borderline personality disorder is setting including primary care and general
reaction formation which is described in hospital settings, not just mental health
one of the following statements: facilities, but also in your own community. You
a. Blaming someone else for one’s must be ready to apply your knowledge on
difficulties anxiety disorders to any area in which you
b. A conscious behavior that is choose to work.
the exact opposite of an
unconscious feeling 25. During client assessment, the nurse
c. Doing something to counteract or finds that the client is experiencing
make up for a wrongdoing in the tunnel vision in his crisis. The nurse
past should conclude that this client is
d. Unconscious and involuntary experiencing which level of anxiety?
forgetting of painful ideas, events a. Mild
and conflicts b. Moderate
c. Severe
Situation: In psychiatric and mental health d. Panic
nursing, psychosocial assessment is
conducted to construct a picture of the client’s 26. When assessing an apparently anxious
current emotional state, mental capacity, and client, the nurse ensures that questions
behavioral function. This assessment serves related to the client’s anxiety are:
as the basis for developing a plan of care to a. Abstract and nonthreatening
meet the client’s needs. b. Avoided until the anxiety
disappears
22. Lola Basyang is your 70-year old retired c. Avoided until the client brings up
librarian who was brought to the hospital the subject
 d. Specific and direct d. The ASD client with the
dissociative symptoms does have
27. A physician has just told a client that problems coping.
surgery will be required to treat a health
problem. After the physician leaves, the Situation: To be able to design care plans to
client reports feeling angry, tense and help those with personality disorders, the nurse
shaky.The nurse notes that the client’s must be familiar with the various types of PDs
palms are sweaty and the pupils are and the major characteristics of each.
dilated. The nurse interprets this to
mean that the client is experiencing 31. A dependent personality is
symptoms consistent with which level of characterized by:
the general adaptation syndrome a. Mistrust of the significant others
(GAS)? b. Incessant demands for
a. Alarm attention and support from
b. Exhaustion others
c. Generalized anxiety c. Inability to postpone gratification
d. Resistance d. Lack of enthusiasm for the
ordinary activities of life
28. A client states, “I am always late for
everything because I can’t leave my 32. The nurse caring for a client with
room without checking every drawer and antisocial personality disorder would
door to make sure they are locked. If I place highest priority on which nursing
don’t do that, I get so worried that I have diagnosis?
to go back. I can’t seem to stop my a. Disturbed personal identity
behavior.” The nurse should take which b. Fear
action at this time? c. Risk for violence directed at
a. Allow the client adequate time others
to carry out the ritual d. Social isolation
b. Explore childhood experiences
that may have led to the behavior 33. A client arrives for her mental health
c. Encourage the client to remain in appointment wearing a cocktail dress
the room until the urge to recheck and theatrical makeup. She announces
has decreased dramatically and flirtatiously that she
d. Remind the client that the staff needs to be seen immediately because
will not allow others to enter the she is experiencing overwhelming
room. psychological distress. The nurse
should recognize behaviors suggestive
29. The nurse is caring for a client who was of which axis II diagnosis?
serving in the military during a bombing a. Borderline personality disorder
of an American embassy. Which finding b. Narcissistic personality disorder
can suggest PTSD? c. Histrionic personality disorder
a. Seizures, headache, d. Antisocial personality disorder
hypertension
b. Goosebumps, memory loss of 34. A client has been diagnosed with
the trauma, flashbacks borderline personality disorder. The
c. Anger, depression, flashbacks client is impulsive, shows labile affect,
d. Unexplained paralysis, sweating, displays frequent angry outbursts and
elation has difficulty tolerating angry feelings
without self-injury. The nurse selects
30. PTSD and ASD have many similarities. which of the following as the priority
Which of the following characteristics nursing diagnosis for this client?
differentiates the two disorders? a. Anxiety
a. ASD has a longer duration than b. Risk for self-mutilation
PTSD. c. Risk for violence toward others
b. The interval from trauma to d. Ineffective coping
symptoms is of shorter
duration for ASD. 35. The mental health nurse is reviewing a
c. The client with ASD has at least 35 year old client’s history before
one dissociated manifestation. conducting an interview. The client’s
 history indicates fear of criticism and 39. The nurse suspects a client is
rejection from others, having few friends experiencing delirium. A specific
and withholding information about assessment information that would
thoughts and feelings in anticipation of support this suspicion includes:
rejection by others. Based on the data, a. Slow onset of confusion and
the nurse suspects that the client may agitation.
have a personality disorder? b. Onset is insidious and relentless.
a. Schizotypal c. Sudden onset of confusion.
b. Paranoid d. The symptoms last for 1 month or
c. Avoidant longer.
d. Schizoid
40. She is observed to be repeating the
36. A patient is having difficulties in same word over and over again. This
establishing and maintaining symptom is known as:
relationships with others; he does not a. Palilalia
exhibit psychotic symptoms. The b. Confabulation
psychiatrist is considering a diagnosis of c. Aphasia
personality disorder. Based on the d. Apraxia
above symptoms and her knowledge of
the disorder, the nurse would suspect 41. Discharge plan is being prepared. The
the patient to have what type of family should be instructed to place
personality disorder? highest priority to this need in caring for
a. Schizoid Aling Mrs. Cruz:
b. Schizotypal a. Nutrition
c. Borderline b. Safety
d. Dependent c. Hygiene
d. Comfort
Situation: Nurse Bob is taking care of different
patients having dementia of varied types. She 42. Psychiatric nurses may describe a
is concerned with the sequelae of the disorder psychopathological condition as:
to his patient’s physical, mental and social a. a state of emotional balance
health. b. a disturbance in the person's
thoughts, feelings and
37. On a 24-hour assessment, Nurse Bob behavior
documents that Lola Johana, a client c. always hereditary
diagnosed with Alzheimer’s disease d. not treatable
presents with aphasia. Which client
behavior supports this finding? Situation: Society and culture have a great deal
a. Lola Johana is sad and has no of influence on eating behaviors and
ability to experience pleasure. perceptions of ideal weight. Eating patterns
b. Lola Johana is extremely are developed based on attempts to meet
emaciated and appears to be these societal norms.
wasting away.
c. Lola Johana is no longer able to 43. The nurse is teaching a group of young
speak. adolescents about eating disorders. The
d. Lola Johana is having difficulty nurse consider the sessions effective if
forming words. the participants state that anorexia
nervosa is best as an eating disorder
38. In planning her treatment plan, which that occurs:
intervention would be most important in a. Only in young girls who are
managing Lola Johana’s condition? depressed
a. Avoid the use of touch b. Mainly in young girls who
b. Provide a stimulating perceive themselves to be
environment grossly overweight
c. Provide a safe environment c. Primarily in young gays who live
d. Use restraints whenever in chaotic families
necessary d. In young boys and girls alike
44. The nurse is conducting an in-service a. Ensuring daily consumption of
education session about the relationship 1000 mL of liquid.
between anxiety and bulimia nervosa. b. Weighing the client after each
The nurse best describes the meal.
relationship by saying, “When the client c. Monitoring the client for at
has bulimia nervosa, an increase in the least 1 hour after meals.
anxiety level will generally result in: d. Monitoring body temperature
a. Rigidly controlling what he or she every 4 hours.
eats.
b. Binging and purging Situation: It is now well documented that a
c. Overeating large proportion of clients in general medical
d. Consuming alcohol outpatient clinics and private medical offices
do not have organic disease requiring medical
45. A characteristic that would suggest to treatment. It is likely that many of these clients
the nurse that an adolescent may have have somatic symptom disorders, but they do
bulimia would be not perceive themselves as having a
a. Redness on knuckles psychiatric problem and thus do not seek
b. A positive body image treatment from psychiatrists. The psychiatric
c. A previous history of gastritis nurse must be able to identify certain clients
d. Frequent regurgitation and with the above mentioned condition.
re-swallowing of food
50. The nurse finds, during the initial
46. The following are the characteristics of assessment of the star player on the
anorexia nervosa, except: basketball team, that he is not
a. Preoccupied with weight loss concerned about the sudden paralysis
b. Thinks she’s fat of his “shooting arm.” This behavior is
c. Afraid of gaining weight known as.
d. Aware of her eating problem a. Secondary gain.
b. La belle indifference.
47. The nurse traces the history of the client c. Malingering.
to identify the probable cause of her d. Hypochondriasis.
condition. You know that families of
anorexia nervosa clients: 51. A female client with a 15-year history of
a. Tends to be chaotic and place somatic symptom disorder is to be
high value on achievement discharged from the first psychiatric
b. Often have a history of substance hospitalization. Which client statement
abuse indicates that nursing care has been
c. Are usually closed systems that effective?
discourage outside relationship a. I need to make sure that all of my
d. Have an inability to collaborate medications are sent home with
with others me
b. I see now that when I get
48. When taking care of a client diagnosed stressed, my ‘body’ speaks for
with bulimia nervosa, the least me
appropriate action of a nurse is: c. My family is so good to me when
a. Promoting an accepting I am sick like this
non-judgmental atmosphere d. There are so many illnesses that
b. Encouraging participation in you nurses simply do not know
self-help groups about
c. Allowing greater degree of
independence when eating 52. Which among the following statements
d. Encouraging verbalizations about made by the patient would lead the
stressful issues nurse to suspect that her client has body
Dysmorphic Disorder (Dysmorphobia)?
49. The nursing diagnosis for a client with a. “Most people say that I look all
bulimia is Fluid Volume Deficit. Nursing right but I am disgusted with
interventions specific to the fluid volume how ugly nose and lips are.”
deficit include: b. “This cough is terrible, I know I
have pneumonia.”
 c. “I can’t possibly go to work with b. Pedophilia
all this pain.” c. Gender identity Disorder
d. “I don’t know why I’m so sick d. Zoophilia
when I’m so young.”
56. Gender identity can best be described
Situation: The psychiatric nurse is also as:
responsible for providing safe and effective a. The role a person is expected to
electroconvulsive therapy for psychiatric perform as a result of being male
patients. Nurse Calma is working at the or female.
Mariveles Mental Hospital. One of her b. The degree of flexibility a person
responsibilities is to provide safe and effective has regarding gender-stereotypic
electroshock therapy for the psychiatric behaviors.
patients. c. A contradiction between
chromosomal gender and
53. Zeny is undergoing ECT for the first external genital appearance.
time. Which of the following instructions d. An individual’s personal or
is appropriate for the nurse to teach private sense of identity as
Zeny? male or female.
a. Shampooing the hair before and
after treatment to remove 57. A holistic approach to nursing care of
electrode gel used in ect the client with sexual disorders requires
b. One session of ECT will cure the the nurse generalist to have which of the
disorder following?
c. Refraining from food and fluids a. Extensive experience in caring
for at least 8 hours before for clients with sexual disorders
treatment b. The ability to diagnose sexual
d. Patient can continue taking disorders
diazepam. c. A basic understanding of the
nursing process
54. The nurse is administering Methohexital d. Proficiency in the use of the
Brevital to a client about to undergo nursing process and ability to
electroconvulsive therapy (ECT). Which assess the client’s sexual
assessment indicates that the health
medication is effective?
a. The client’s heart rate is 110 Situation: Dissociative disorders are defined by
beats/minute. a disturbance of or alteration in the usually
b. The client appears calm and integrated functions of consciousness,
relaxed. memory, and identity. Dissociative responses
c. The client cannot breathe occur when anxiety becomes overwhelming
d. The client states that his mouth is and the personality becomes disorganized.
dry.
58. The nurse is caring for a client who
Situation: Sexual health care is a relatively reports feeling “estranged and
new area of involvement for psychiatric – separated from himself.” How would the
mental health nurses. Until recently, sexuality nurse describe such symptoms?
has not been viewed as falling within their a. Intoxication
scope of practice. Currently, sexuality is b. Disorientation
increasingly recognized as an important c. Derealization
component of a holistic approach to overall d. Depersonalization
health status. Sexual health care is a
legitimate and appropriate nursing concern. 59. A family asks you why their loved one
dissociates in response to trauma.
55. Benjamin, a 43 y/o, a former teacher at Which of the following is your most
a public elementary school, has sexual accurate response?
urges to children far younger than his a. “Dissociation helps decrease
age. He was also convicted for anxiety by isolating the
molesting a 9 y/o boy in his hometown. thoughts from the feelings
Benjamin’s behavior is an example of: about the experience and
a. Incest
 keeps the person from being avoid taking one of the following drugs
completely overwhelmed.” for it will potentiate the symptoms of
b. “It provides the individual with a schizophrenia:
‘witness’ experience rather than a a. Amphetamines
’victim’ experience, and it is less b. Narcotics
traumatic for the individual to c. Benzodiazepines
witness trauma than it is to d. Barbiturates
experience it oneself.”
c. “It is not clearly understood, but it 64. Benjie is using Marijuana. Which of the
seems to have a definite following behaviors would be observed?
biochemical basis.” a. Watery eyes, rhinitis, sneezing,
d. “When we find out what yawning
happened in the months she b. Appears drunk with staggering
cannot remember, we will have gait
an explanation about why she c. Uses dark glasses to conceal
dissociates.” bloodshot eyes
d. Appears alert and confident with
Situation: Television and newspapers report dilated pupils
that drug abuse is a serious social, economic
and political problem in our society. Nurses are 65. Geisler, an alcoholic, was admitted to
continually challenged to play a role in abetting the detoxification unit of the hospital.
this problem in the community. He was prescribed disulfiram
(Antabuse) as part of aversion therapy.
60. A college student client states that his The nurse should instruct him to avoid
addiction to morphine is due to a which of the following?
chemical imbalance. The nurse a. Caffeine
understands that researches that point b. Wheat bread
to biochemical theory of addiction c. Mouthwash
support that those drugs of abuse have d. Preserved foods
in common, stimulation of which of the
following neurotransmitters? Situation: Nurses have a variety of important
a. Norepinephrine roles in child psychiatry. Our unique
b. Serotonin perspective of both mental and physical health
c. Acetylcholine allows us to assess psychological and physical
d. Dopamine symptoms in children, explain laboratory tests
to children and their families, administer
61. Before his hospitalization, a client medications that require strict and systematic
needed an increasingly larger dose of monitoring, and work with children having a
barbiturates to achieve the same medical and psychiatric diagnosis.
euphoric effect he initially realized from
their use. From this information, the 66. The parent of a child recently diagnosed
nurse develops a plan of care that takes with oppositional defiant disorder (ODD)
into account that the client is most likely asks the nurse to explain what
suffering from which of the following? behaviors are associated with the
a. Tolerance condition. Which information should the
b. Addiction nurse include in an answer?
c. Abuse a. Cruelty
d. Dependence b. Stealing
c. Argumentations
62. What should be done before d. Arson
rehabilitation of a patient who is
dependent on narcotics? 67. At the mental health unit, Nurse Lance
a. Detoxify is meeting Boy Abun, a 7-year old boy
b. Reprimand with Tourette syndrome. Which of the
c. Isolate the patient following should the nurse expect to
d. Restrain the patient assess?
a. Multiple motor and verbal tics
63. Before discharge, the family should be b. Primarily motor tics
instructed that Mrs. Tolento, should c. Isolated verbal tics
 d. Alternating simple and complex Situation: Maria, 67 years old, has a history of
motor tics mental illness in her middle age and treatment
for “early menopause.” Medications were given
Situation: Mr. Williams, a 42-year old for depression that brought her into remission.
businessman and father of three, was admitted She functioned fairly well but was prone to
at the psychiatric unit with a diagnosis of paranoid ideation, social isolation, and
depression. During the intake interview, the became severely anxious when stressed. She
nurse noted that the patient exhibits symptoms was brought to the hospital due to profound
of suicidal ideation when he made statements depression with mood changes manifested by
like “I am worthless. My family will be better off little sleep, high energy, hysterical laughter,
without me.” At home, he was observed to and bizarre behavior.
have lost weight and have diminished interest
in practically all his daily activities. 72. Lithium was initiated. The nurse was
effective in her health teaching when the
68. The nursing diagnosis for Mr. Williams is client remarked.
risk for violence, self-directed. The initial a. I need to lessen my calorie and
desired outcome would be, the client salt intake but have enough fluids
will: b. I need to have regular sodium
a. Be safe from self-harm and harm and fluid intake
to others c. I should restrict my salt and fluids
b. Verbalize higher quality of life d. I should sweat a lot with exercise
c. Extinguish suicidal ideation to reduce my body fluids
d. Participate in ward activities
73. Maria claimed she had been hearing
69. Patients with severe depression, uses frightening motorcycle noises, angry
this defense mechanism: voices, and sounds of rushing floor
a. projection water. The priority need at this point is:
b. repression a. Trust
c. introjection b. Love and belongingness
d. suppression c. Self-esteem
d. Safety and security
70. The client diagnosed with dysthymia
asks the nurse to explain what the 74. The nurse watches for early lithium
diagnosis means. When responding to toxicity. Which of the following must be
the client, the nurse should state that part of health teaching?
before dysthymia can be diagnosed, a. Seizures and anuria
depressed mood needs to be present b. Coarse hand tremors, nausea,
for at least: vomiting, and diarrhea
a. 2 weeks c. High fever and tachycardia
b. 4 weeks d. Shuffling gait and restlessness
c. 1 year
d. 2 years 75. The nurse is concerned about the lack
of food and fluid intake of Maria. Which
71. The nurse needs to teach a client about of the following foods should the nurse
newly prescribed sertraline (Zoloft). select that would best meet the client’s
Which information is essential to include nutritional needs?
in the teaching? a. Carrots, celery, raisins, apple
a. Constipation is a sign of toxicity b. Slices of pizza and sports drink
from sertraline c. Steak and baked potato
b. Fever and flu like symptoms are d. Beef stew and non-diet soda
bothersome but not dangerous
side effects of sertraline. 76. An extremely hyperactive client
c. Clients taking sertraline will exhibiting manic behavior is admitted to
usually recognize improvement the hospital. In view of the client’s elated
within one week state, the nurse should arrange for the
d. It is possible that sexual side client to be in a room:
effects will occur. a. With another client who is very
quiet
 b. That will provide a great deal of a. Possible child abuse
stimuli b. Immature parenting
c. That has had most of the c. Normal findings in an 18 month
furniture removed old
d. With another client exhibiting d. Indications of tissue fragility
similar behavior
Situation: Wilfredo, 37 years old, separated
77. The client has bipolar I disorder. Lithium from his wife and children for six years. He has
carbonate (Lithium) 300mg four times been in and out of the hospital for the last ten
daily has been prescribed. After 3 days years for his illness. This latest hospitalization
of Lithium therapy, the client says’ was precipitated by an exacerbation of auditory
“What’s wrong? My hands are shaking a hallucination when he states that “I hear
little.” The best response of the nurse voices, usually a woman’s tormenting me.”
is: Diagnosis: Schizophrenia
a. Minor hand trembling often
happens for a few days after 80. WIlfredo repeatedly says to the nurse,
lithium is started. It usually stops “No conbromomation a stellacaustic
in 1 to 2 weeks. listorl!” is an example of:
b. There’s no reason to worry about a. Echolalia
that. We won’t, unless it lasts b. Concretism
longer than a couple of weeks. c. Neologism
c. Just in case your blood level is d. Paleologic thinking
too high, I am not going to give
you your next dose of Lithium. 81. The family relates that one day Wilfredo
d. I wouldn’t worry about it if I were looked at a linen sheet on a clothesline
you. It’s a small tremor that and thought it was a ghost. The nurse
doesn’t interfere with your recognizes that this was:
functioning. a. An illusion
b. A delusion
78. The client who has a diagnosis of c. A confabulation
bipolar I disorder has a new order for d. A hallucination
carbamazepine (Tegretol). Before
beginning to administer the medication, Situation: Criselda has been admitted to the
the nurse checks to see which psychiatric unit. She is diagnosed with
laboratory results are in the client’s schizophrenia, catatonic type. The companion
record. volunteered information that she hardly moves.
a. Blood glucose
b. Liver function studies 82. When the nurse moved the client’s leg,
c. Bleeding and clotting time the client did not return the extremity to
d. Thyroid profile its initial position. This is called:
a. Negativism
Situation: Kate is 9 years old. Horribly sexually b. Waxy flexibility
abused by her father, she had developed a c. Stupor
way of behaving: she strips naked, urinates on d. Lethargy
the floor and vomits. For some reason, she
thinks it is all right for her to strip, urinate on 83. Criselda was not able to take a bath and
the floor and kick or hit the staff, and then asks dress up. The most appropriate nursing
sweetly for a hug. She is one of the kids in the diagnosis is:
Child and Adolescent unit of the hospital. a. Altered thought processes
b. Impaired hygiene and grooming
79. An 18 month old client is scheduled for c. Ineffective individual coping
a minor surgical procedure. The client d. Self-care deficit
has numerous large bruises of different
stages over the back and buttocks. The 84. When taking an antipsychotic, the client
mother states that the child must have suddenly experienced muscle rigidity,
fallen down while playing alone outside tremors, impaired ventilation and a
but cannot provide specific information temperature of 108 °F (42.2 °C).
about these incidents. The nurse a. Tardive dyskinesia
evaluates this as:
 b. Neuroleptic malignant d. Offering a general lead
syndrome
c. Akinesia 91. Nurse Kelly knows that they are already
d. Akathisia in the resolution phase. Which of the
following should be the focus of their
85. The nurse noticed that the patient's relationship at this moment:
eyeballs appear to roll back in a fixed a. Assist patient to review what
position. This is known as: he has learned
a. Neuroleptic malignant syndrome b. Planning therapeutic
b. Oculogyric crisis interventions
c. Tardive dyskinesia c. Nursing diagnosis formulation
d. Opisthotonus d. Assisting the client in expression
of thoughts and feelings
86. You are currently on an ethics
committee. Which of the following rights 92. Under the psychoanalytic model of
can be suspended with a good cause? Freud, the ego functions includes all of
a. Choice of providers the following except:
b. Confidentiality a. Store up experiences in memory
c. Treatment b. Operate on the pleasure principle
d. Non discrimination to reduce tension or discomfort
c. Control and regulate
87. Psychiatric nurses may describe a instinctual drives
psychopathological condition as: d. Use defense mechanism to
a. a state of emotional balance protect self
b. a disturbance in the person's
thoughts, feelings and 93. A defense mechanism used by patient
behavior with borderline personality disorder is
c. always hereditary reaction formation which is described in
d. not treatable one of the following statements:
a. Blaming someone else for one’s
88. Ysabelle, a newly registered nurse, is difficulties
pursuing her career as a psychiatric b. A conscious behavior that is
nurse. In which of the following settings the exact opposite of an
would she expect to work with people unconscious feeling
with psychiatric needs? c. Doing something to counteract or
a. Special education centers make up for a wrongdoing in the
b. DSWD shelters past
c. Half-way houses d. Unconscious and involuntary
d. All of these forgetting of painful ideas, events
and conflicts
89. Mario in group therapy is restless. His
face is pale and does not respond to 94. A patient is having difficulties in
queries.The nurse responds by saying, establishing and maintaining
"You look anxious." The nurse is using relationships with others; he does not
which of the following techniques? exhibit psychotic symptoms. The
a. A broad opening statement psychiatrist is considering a diagnosis of
b. Reassurance personality disorder. Based on the
c. Clarifying above symptoms and her knowledge of
d. Making observations the disorder, the nurse would suspect
the patient to have what type of
90. Maria, a client in the psychiatric ward, personality disorder?
asks the nurse, “Do you think I should a. Schizoid
leave my husband?” The nurse b. Schizotypal
responds, “You aren’t sure if you should c. Borderline
leave your husband?” The nurse is d. Dependent
using which therapeutic technique?
a. Restating 95. She is observed to be repeating the
b. Reframing same word over and over again. This
c. Reflecting symptom is known as:
 a. Palilalia
b. Confabulation
c. Aphasia
d. Apraxia

96. The following are the characteristics of

anorexia nervosa, except:
a. Preoccupied with weight loss
b. Thinks she’s fat
c. Afraid of gaining weight
d. Aware of her eating problem

97. Gender identity can best be described

as:
a. The role a person is expected to
perform as a result of being male
or female.
b. The degree of flexibility a person
has regarding gender-stereotypic
behaviors.
c. A contradiction between
chromosomal gender and
external genital appearance.
d. An individual’s personal or
private sense of identity as
male or female.

98. Nurse Harry is caring for Marc, a patient

with schizophrenia, who reports feeling
“estranged and separated from himself.”
How would the nurse describe such
symptoms?
a. Intoxication
b. Disorientation
c. Derealization
d. Depersonalization

99. Ched is using Marijuana. Which of the

following behaviors would be observed?
a. Watery eyes, rhinitis, sneezing,
yawning
b. Appears drunk with staggering
gait
c. Uses dark glasses to conceal
bloodshot eyes
d. Appears alert and confident with
dilated pupils

100. Joan was diagnosed with dysthymia

recently. She asks the nurse to explain
what the diagnosis means. When
responding to the client, the nurse
should state that before dysthymia can
be diagnosed, depressed mood needs
to be present for at least:
a. 2 weeks
b. 4 weeks
c. 1 year
d. 2 years
 PHARMA WORKBOOK b. Flush between drugs with 10 ml
of sterile water
1. The nurse is preparing to administer c. Administer one drug with 30 ml
insulin to a client with diabetes mellitus of water
for which of the following purposes? d. Maintain the client in an upright
a. Relief of disease manifestations position for 15 minutes following
b. Preventive drug administration
c. Health maintenance
d. Curative 6. Which of the following principles of
parenteral drug administration is a
2. The nurse is collecting a medication priority for the nurse to consider before
history. Which of the following questions administering a parenteral injection to a
would elicit the most accurate 2-year-old child?
information? Select all that apply: a. Apply EMLA (lidocaine 2.5% and
1. “Do you take any herbal prilocaine 2.5%) to the injection
supplements?” site 1 hour before administering
2. “What time of day do you go to bed?” the injection
3. “What is the highest level of b. Lightly tap the injection site
education you completed?” before administering the injection
4. “Do you have a vision or hearing c. Administer up to 1 ml of the
impairment?” prescribed drug to the injection
5. “Where do you eat most of your site
meals?” d. Select the vastus lateralis for
6. “Do you have drug insurance the administration of the drug
coverage?”
a. 1, 3, 6 7. The nurse selects which of the following
b. 2, 4, 5 isotonic intravenous solutions for the
c. 1, 3, 4, 6 primary purpose of promoting
d. 2, 3, 4, 5 rehydration and elimination, while
providing a good vehicle for potassium
3. Which of the following should the nurse replacement?
include in the oral drug administration a. Sodium chloride 0.45%
procedure? b. Dextrose 5% in water
a. Administer a drug to a 3-year-old c. Dextrose 5% in 0.45% saline
child as a capsule d. Ringer’s lactate
b. Administer two drugs at a time to
an older adult client 8. The nurse is preparing the client
c. Administer a carbonated assignments for the day. Which of the
beverage over ice following a following assignments would be
drug appropriate for the registered nurse
d. Administer a sustained action (RN) to assign to a licensed practical
buccal drug under the tongue nurse (LPN)?
a. Administer a drug to a client who
4. The nurse should assess which of the has an implantable intravenous
following body systems while infusion port
administering intravenous cimetidine b. Insert an angiocath into the
(Tagamet) to a client? medial antebrachial vein of a
a. Urinary client going to surgery
b. Immune c. Instruct a client on the
c. Respiratory advantages of an autologous
d. Cardiovascular blood transfusion
d. Discontinue a client’s
5. Which of the following should the nurse peripheral IV site
include when administering drugs by a
nasogastric tube? 9. The nurse prepares to hang which of the
a. Crush the drug before following for a client with
administering through a feeding thrombocytopenia?
tube a. Whole blood
b. Packed red blood cells
 c. Platelets d. open the mouth to facilitate
d. Albumin breathing.

10. The nurse is caring for a client who 16. The nurse is assigned to administer
admits to a 15-year history of gastric eyedrops to a client being prepared for
ulcers. The nurse instructs this client to cataract surgery. Which of the following
take which of the following drugs for types of eyedrop does the nurse expect
minor aches and pains? to administer?
a. Acetaminophen (Tylenol) a. An osmotic diuretic
b. Buffered aspirin b. A miotic agent
c. Plain aspirin c. A mydriatic agent
d. Ibuprofen (Motrin) d. A thiazide diuretic

11. The nurse should question which of the 17. A client is experiencing peptic ulcer
following drugs for use in a client who disease caused by H. pylori. The nurse
has glaucoma? should plan to administer which of the
a. Acetazolamide (Diamox) following oral drug combinations?
b. Pilocarpine Clarithromycin (Biaxin) with
c. Atropine sulfate a. tetracycline (Achromycin) with
d. Mannitol sodium bicarbonate (baking
soda).
12. The nurse is administering an b. metronidazole (Flagyl) and
adrenergic blocking agent, such as a aluminum hydroxide (Amphogel).
beta blocker, to a client with glaucoma. c. amoxicillin (Amoxil) and
Which of the following would the nurse omeprazole (Prilosec).
interpret as indicative of a serious d. penicillin (Pen-G) and nizatidine
adverse reaction? (Axid).
a. Photophobia
b. Blurred vision 18. A client with Ménière’s disease asks the
c. Drop in blood pressure nurse why meclizine hydrochloride
d. Exacerbation of asthma (Antivert) is being administered. The
most appropriate response by the nurse
13. The nurse administers which of the is which of the following?
following drugs to a client who has a. “It will control the vertigo.”
keratitis? b. “It will help you sleep.”
a. Acyclovir (Zovirax) c. “It will decrease your pain.”
b. Acetazolamide (Diamox) d. “It will alleviate your nausea.”
c. Scopolamine (Isopto Hyoscine)
d. Idoxuridine (Stoxil) 19. The nurse is collecting a medication
history from a client with herpes simplex
14. The nurse is to administer timolol 1 of the eye. The nurse should ask the
(Timoptic) 1 drop in each eye. Which of client if which of the following drugs are
the following comments by the client taken?
indicates the need for further teaching? a. Trifluridine (Viroptic)
a. “I must wash my hands before b. Cromolyn
putting in my drops.” c. Idoxuridine (Stoxil)
b. “This drug will decrease the fluid d. Acetazolamide (Diamox)
in my eye.”
c. “I’ll need to take this until my 20. The nurse should understand that a
eye pressure is normal.” client is to receive which of the following
d. “Adverse reactions include drugs to paralyze the ciliary body
dizziness and double vision.” muscles?
a. Phenylephrine HCl
15. The nurse instructs the client that the (Neo-Synephrine)
best position for instilling nose spray is b. Homatropine
to c. Hydroxyamphetamine-hydrobrom
a. bend the head forward. ide (Paredrine)
b. push one nare to the side. d. Cromolyn
c. tilt the head backward.
21. A client has been receiving intravenous use cromolyn sodium (Intal) and is in
theophylline and the physician writes need of further instructions?
new orders to discontinue the IV a. “If I don’t feel better in 2 to 3
medication and begin an weeks, I should stop taking the
immediate-release oral form of the medication.”
medication. When should the nurse b. “I will call my doctor if this
schedule the first dose of the oral medication causes severe
medication to be administered? coughing.”
a. Immediately after stopping the c. “I have to take this medication
intravenous infusion of routinely, even when I feel good.”
theophylline d. “I do not stop my other
b. Begin 4 to 6 hours after medications just because I’m
stopping the intravenous taking this one.”
infusion of theophylline
c. Begin the initial dose at bedtime 26. When instructing a client to use a
d. Start the oral dose with the metered dose inhaler, it would be
morning medications and essential for the nurse to include which
breakfast of the following aspects? Instruct the
client to
22. A client with acute asthma is treated for a. hold the breath for 3 seconds
inspiratory and expiratory wheezes and after using the inhaler.
a decreased forced expiratory volume. b. take a quick deep breath after
Which class of prescribed drugs should activating the canister.
the nurse administer first to this client? c. activate the canister at the
a. Oral steroids beginning of a slow deep
b. Bronchodilators breath.
c. Inhaled steroids d. place the canister 6 inches in
d. Mucolytics front of an open mouth.

23. The nurse is admitting a client with 27. A client who has asthma asks the nurse
asthma who is to be started on why the preferred route of administration
theophylline. Which of the following for corticosteroids is inhalation. The
questions would be appropriate to ask appropriate response by the nurse is
this client? which of the following?
a. “Are you a diabetic and taking a. “Inhaled medications are easier
insulin?” to take.”
b. “Do you take cimetidine b. “The systemic adverse
(Tagamet)?” reactions are reduced.”
c. “Do you use aspirin on a daily c. “No weaning is required when
basis?” stopping the drug.”
d. “Do you exercise routinely?” d. “Oral care is not required.”

24. After instructing a client to use a 28. A client with asthma awakens in the
beclomethasone (Vanceril) inhaler, middle of the night with an asthma
which of the following statements by the attack. Which of the following inhaler
client indicates to the nurse that the medications should the nurse administer
teaching has been successful? first?
a. “I will limit myself to two cups of a. Albuterol (Proventil)
coffee per day.” b. Triamcinolone acetonide
b. “I will take it before bed each (Azmacort)
night.” c. Fluticasone propionate (Flovent)
c. “I will take it with meals to mask d. Cromolyn (Intal)
the taste.”
d. “I will rinse my mouth after 29. After a client diagnosed with pneumonia
each use.” has an episode of respiratory distress,
the client is intubated and placed on a
25. Which of the following statements made ventilator. The breath sounds are
by the client indicates to the nurse that diminished and the chest x-ray shows
the client does not understand how to left lower lobe consolidation. The
 physician orders respiratory treatments extubated, which of the following orders
with acetylcysteine (Mucomyst). The should the nurse question?
nurse should monitor the client for which a. Continuation of the current
of the following results from this antibiotics
treatment? b. O2 per nasal cannula at 6
a. Bronchodilation L/min
b. Increased sputum, removed c. Out of bed with assistance
with suctioning d. Continuation of current nebulizer
c. Decreased level of treatments
consciousness
d. Hypotension 35. The nurse is preparing to teach a class
on the appropriate use of nebulizers and
30. The nurse is caring for a client with lung metered dose inhalers. Which of the
cancer who has an intractable cough following should the nurse include in the
and is exhausted from the effort of class?
coughing. Which of the following drugs a. Metered dose inhalers require a
should the nurse administer to this gas flow rate of 6 to 10 L/min
client? b. Nebulizers deliver medication
a. Rifampin (Rifadin) through a face mask or
b. Acetylcysteine (Mucomyst) mouthpiece
c. Fluticasone (Flovent) c. Nebulizers deliver doses in puffs
d. Codeine d. Metered dose inhalers require
refrigeration
31. Which of the following treatments is the
priority for the nurse to administer to a 36. Which of the following is the priority for
client who has a positive tuberculosis the nurse to assess before
(TB) skin test but has no other evidence administering digoxin (Lanoxin)?
of active disease? a. Auscultate the apical pulse for
a. No treatment and repeat skin test 1 full minute
in 6 months b. Palpate the radial pulse for 60
b. Isoniazid (INH) for 12 months seconds
c. Multidrug therapy for at least 12 c. Monitor the renal function tests
months d. Assess the serum sodium
d. Streptomycin for 12 months
37. Upon finding a client in cardiac arrest,
32. The nurse is developing a medication the nurse should administer which of the
schedule for a client who is receiving following drugs first?
isoniazid (INH). To promote the best a. Atropine
absorption, this medication would be b. Epinephrine
administered c. Lidocaine
a. on an empty stomach. d. Atenolol (Tenormin)
b. with antacids to relieve stomach
upset. 38. After medication teaching on atenolol
c. with food. (Tenormin), which of the following
d. 30 minutes after meals. statements by a client with diabetes
mellitus demonstrates an understanding
33. Which of the following is the priority for of the atenolol?
the nurse to monitor a client who has a. “It may cause hyperglycemia.”
been on a ventilator and on 70% FIO2 b. “It may mask an early
for the past 72 hours? indication of hypoglycemia.”
a. Atelectasis c. “It may increase the action of
b. Pulmonary fibrosis insulin.”
c. Expense to client d. “It may diminish the action of
d. Oxygen dependence insulin.”

34. The nurse is caring for a client who has 39. The nurse is caring for a client with
chronic obstructive lung disease hypertension. Which of the following
(COPD) and pneumonia. After being drugs should the nurse administer?
a. Mexiletine (Mexitil)
 b. Triamterene and d. The effect of nitroglycerin is
hydrochlorothiazide (Dyazide) impaired by concurrent use with
c. Digoxin (Lanoxin) Viagra
d. Warfarin
45. Which of the following adverse reactions
40. Based on an understanding of should the nurse assess in a
nitroglycerin, the nurse administers it for 70-year-old adult who is receiving a
which of the following reasons to a client continuous infusion of lidocaine?
with angina? a. Hypertension
a. Increase afterload b. Osteoarthritis
b. Increase preload c. Confusion
c. Constrict the arteries d. Decreased visual acuity
d. Dilate the veins
46. Based on an understanding of beta
41. The nurse is caring for a client with atrial blockers used for unstable angina, the
fibrillation who is being treated with a nurse administers a beta blocker
variety of drugs. The nurse administers because of which of the following
which of the following drugs in actions?
combination with quinidine that may a. To increase myocardial
result in an increased level of the drug? contractility
a. Furosemide (Lasix) b. To decrease heart rate
b. Digoxin (Lanoxin) c. To promote cardiovascular fluid
c. Propranolol (Inderal) shift
d. Triamterene and d. Coronary artery vasodilation
hydrochlorothiazide (Dyazide)
47. Which of the following interventions
42. The nurse should administer should the nurse include in the plan of
amiodarone (Cordarone) to treat which care for a client taking an ACE inhibitor?
of the following arrhythmias? a. Monitor the blood pressure
a. Sinus bradycardia closely for 2 hours after the
b. Bundle branch block first dose
c. Ventricular tachycardia b. Begin with a high dose and
d. Junctional rhythm gradually decrease the dose
c. Administer potassium
43. Which of the following is the priority supplements to the client
nursing intervention for a client who is d. Begin with daily dosing followed
receiving adenosine (Adenocard) for by dosing every other day
supraventricular tachycardia (SVT)?
a. Document the presence of 48. A client’s family member asks the nurse
peripheral pulses how to know if the client is improving
b. Monitor the pulse oximetry while receiving furosemide (Lasix) for
c. Assure a patent IV in the congestive heart failure. The nurse’s
antecubital vein response should be based on the
d. Prepare for emergency understanding that improvement in the
defibrillation client’s condition is characterized by
a. diminishing oxygen needs.
44. A client has been taking Viagra and is b. increased thirst.
now experiencing angina. The physician c. weight gain.
has prescribed nitroglycerin p.r.n. for the d. intake greater than output.
angina. Which of the following should
the nurse include in the discharge 49. A client with congestive heart disease
instructions? returns to the clinic with muscle aching.
a. Viagra should not be used The physician orders a potassium level,
within 24 hours of taking which shows hypokalemia. The drug
nitroglycerin regimen includes furosemide (Lasix) 80
b. Nitroglycerin and Viagra should mg b.i.d. In addition to treatment with a
be taken at the same time potassium supplement, the nurse
c. Viagra is not effective when used administers which of the following
in combination with nitroglycerin prescribed drugs?
 a. Bumetanide (Bumex)
b. Torsemide (Demadex)
c. Spironolactone (Aldactone)
d. Clonidine (Catapres)

50. The nurse is caring for a client on a

heparin infusion when the client
expresses concern over a progressively
painful headache. Which of the following
is the priority nursing action?
a. Stop the heparin infusion
b. Administer protamine
c. Notify the physician
d. Administer morphine
 PEDIA WORKBOOK flexed vigorously moving. The nurse
assess the Apgar score to be:
1. The most developed sense of the a. 6
newborn is ___. b. 7
a. Touch c. 8
b. Taste d. 9
c. Sight
d. Hearing 7. The following is true of neonatal
screening except:
2. The terms growth and development are a. done 24 hours after birth or
often used interchangeably. To which of before one week old
the following does development refer? b. cord blood is sent to the
a. A boy grows taller all through laboratory
early childhood c. mandated to be done on all
b. He learns to throw a ball neonates
overhand d. provides information on some
c. He triples his weight during the inborn error in metabolism that
first year could be dangerous to the
d. His brain increases in size until neonate
school age
8. Several days after a baby girl’s birth she
3. Which of the following factors would begins to vomit and lose weight.
contribute least to the ultimate height Galactosemia is diagnosed. The nurse
that a child reaches? explains to the parents that
a. His mother included nutritious galactosemia is an inherited autosomal
food at meals recessive disorder which is the result of:
b. The genetic material the child a. An intolerance of wheat and rye
inherited b. An inborn error of
c. Whether he enjoys active sport or carbohydrate metabolism
not c. The inability to metabolize an
d. The occupations of his father essential amino acid
and mother d. The absence of parasympathetic
ganglion cells in the colon
4. The primary critical observation for
Apgar scoring is the: 9. The nurse is aware that another
a. Heart rate diagnostic test is needed to further
b. Respiratory rate confirm phenylketonuria. The nurse is
c. Color correct in choosing which of the
d. Reflex irritability following tests that utilizes urine
specimens?
5. Establishment of warmth after birth is a. Schillings test
made possible through the following b. Phenistix
means EXCEPT: c. Guthrie test
a. Drying the skin immediately with d. Urinalysis
towel
b. Putting the baby on a 10. The parent of a child with congenital
pre-warmed crib with floor lamp hypothyroidism is concerned about the
c. Giving warm sterile water to condition of her child. The nurse knows
warm up his stomach that the most important consideration in
d. Letting the mother embrace the caring for this child is all but which of the
baby following?
a. Safety
6. At one minute after birth, a newborn’s b. Give levothyroxine
body is pink with blue extremities, the c. Isolation
heart rate is 99, there is withdrawal d. Allow to play
when the soles are flicked, the
respiration are easy with no evidence of 11. During physical assessment of a
distress, and the arms and legs are newborn, which of the following
 comparative measurements would d. close with thumb outside the
necessitate additional investigation? fingers
a. Head circumference 34 cm;
chest circumference 31 cm 17. Negativism and ritualistic behaviors are
b. Head circumference 31 cm; chest normal characteristics of:
circumference 33 cm a. preschoolers
c. Head circumference 34.5 cm; b. toddlers
chest circumference 32 cm c. infants
d. Head circumference 32 cm; chest d. adolescents
circumference 30 cm
18. A 5-year-old boy believes that there are
12. A 6 month old infant is admitted with a “bogeymen and monsters” in his
diagnosis of failure to thrive. The birth bedroom at night. What advice can the
weight was 7 pounds. Based on growth nurse give to Eric’s parents to help Eric
and development chart, the nurse cope with his fears?
should expect an infant at 6 months to a. Let Eric sleep with his parent
weigh approximately: b. Tell Eric that bogeymen and
a. 10 pounds monster do not exist
b. 14 pounds c. Keep a night-light on in Eric’s
c. 18 pounds room
d. 21 pounds d. Tell Eric that no one else sees
any monsters, so he must not
13. Which of the following behaviors see them either
indicates normal biological
development? 19. On admission, the child’s weight is taken
a. A 6 week old begins to roll over for the following purpose EXCEPT:
b. A 6 months old sits without a. as basis for child’s nutritional
support status
c. A 7 month old transfer a toy b. to determine child’s approximate
from hand to hand age
d. A 7 month old stands unassisted c. as basis for the dose of drug
doctor will give
14. Appetite lags occur in toddlers for all the d. to determine if a child's growth is
following reasons except: within the normal.
a. A form of rebellion against
parents 20. Zendy was assessing Melber, a 30
b. Physiology anorexia month-old child. She is correct if she
c. Preference from one type of food states that the expected type of play
d. High activity level Melbert should be exhibiting at his age
would be:
15. During the oedipal stage of growth and a. Parallel play
development, the child: b. Solitary play
a. Loves and hates both parents c. Competitive play
b. Loves the parent of the same sex d. Associative play
and the parent of the opposite
sex 21. When assessing the social and
c. Loves the parent of the emotional needs of a school-age child,
opposite sex and hates the you should focus on:
parent of the same sex a. psychosexual development and
d. Loves the parent of the same sex establishment of relationship
and hates the parent of the b. development of self-esteem
opposite sex and feeling of social
responsibility
16. The usual position of the hand in the c. body image and feelings about
newborn is: future adult responsibility
a. open with fingers spread apart d. resolving role model conflict with
b. open with fingers flexed apart parent of the same sex
c. close with thumb inside the
fingers
22. The following are typical characteristics
in the social behavior of a schooler. The 27. The following are normal characteristics
most important is: of NB except:
a. opposite sex friends are preferred a. Jaundice after delivery
for variety b. Pink body, blue extremities
b. not so significant as long as c. With full flexion of extremities
feeling of achievement is met d. Vigorous cry
c. same gender company gives
more satisfaction 28. A maternity nurse employed in a
d. teachers become most preferred newborn nursery receives a telephone
company call from the delivery room and is told
the newborn with spina bifida
23. Nutritional problems during adolescence (meningomyelocele type) will be
are caused by all of the following transported to the nursery. The
except: maternity nurse prepares for the arrival
a. Increased concern about their of the newborn and places which of the
developing body image following priority items at the newborn’s
b. Greater variability in caloric bedside?
needs about due to variability in a. A bottle of sterile normal saline.
activity patterns and growth b. A specific gravity urinometer.
requirements c. A rectal thermometer.
c. Peer group influence d. A blood pressure cuff.
d. A lower basal metabolism
29. The nurse assesses a 5 year old child
24. Which of the following statements best after a shunt procedure to correct
describes the nutritional profile of the increased ICP. The observation that is
adolescent? most concern would be:
a. slow but steady growth, poor a. Marked irritability
eating habits b. Complaints of pain
b. stunted growth, voracious c. A temperature of 99.4 degree F
appetite d. A pulse of 100 beats per minute
c. rapid growth, likes to eat alone
d. rapid growth, desires 30. A newborn is diagnosed with coarctation
companionship at meals of the aorta. The baby is discharged
with a prescription for digoxin (Lanoxin)
25. An 11-year-old adolescent asks you 0.01 mg po q12h. The bottle of digoxin
what the term puberty means. You tell is labeled 0.01 mg in 1⁄2 teaspoon. The
her: nurse should teach the mother to
a. it is the age at which one administer the medication by using:
becomes capable of sexual a. A nipple
reproduction b. A plastic baby spoon
b. it denotes completion of the c. The calibrated dropper in the
development of secondary sex bottle
characteristics d. The small size baby bottle with 1
c. it is the time span between 12 0z of water
and 18 years
d. it is when boys and girls go out 31. Which nursing diagnosis would best
on dates apply to an infant with Tetralogy of
Fallot?
26. A nurse is performing an admission a. Impaired gas exchange related to
assessment on a 6-month-old infant with a left-to-right shunt
a diagnosis of hydrocephalus. The b. Impaired skin integrity related to
nurse assesses for the major sign constant cyanosis
associated with hydrocephalus when the c. Ineffective airway clearance
nurse related to constricted aorta
a. Palpates anterior fontanel. d. Altered tissue perfusion
b. Takes the blood pressure. related to pulmonary artery
c. Takes the apical pulse. stenosis
d. Test the urine for protein
32. Tetralogy of Fallot is the most frequently b. Has bulky, foul, frothy stools
occurring type of cyanotic heart disease. c. Drinks large amount of fluids
The four anomalies associated with this d. Voids strong, concentrated urine
defect are:
a. Atrial septal defect, pulmonary 37. A 10-month-old infant was admitted to
stenosis, left ventricular the hospital for severe *1/1 abdominal
hypertrophy, overriding of aorta pain. The doctor found out that the distal
b. Ventricular septal defect, aortic ileal segment of the child’s bowel has
stenosis, mitral stenosis, invaginated into the cecum. The nurse
right-sided aorta will suspect what disease condition?
c. Mitral stenosis, right ventricular a. Intussusception
hypertrophy, pulmonary stenosis, b. Pyloric stenosis
atrial-septal defect c. Hirschsprung's disease
d. Ventricular septal defect and d. Vaginismus
right ventricular hypertrophy,
pulmonary stenosis, overriding 38. Why does a toddler typically experience
of aorta temper tantrums?
a. It is the only way the toddler can
33. A child with sickle cell anemia is gain attention from his or her
admitted to the hospital with a vaso mother
occlusive pain episode. The nurse is b. More than likely, toddler is spoiled
aware that this is a result of: and needs a spanking
a. Diminished red blood cell c. The toddler cannot express his
production by the bone marrow or her frustration verbally
b. Pooling of blood in the spleen d. The toddler is expressing his or
with resultant splenomegaly her need for identity
c. Blockage of small blood
vessels with clumped red Situation: A full-term baby boy was delivered
blood cells an hour ago via NSD.
d. Severe depression in circulating
thrombocytes 39. For which of the following findings
should the nurse notify the physician?
34. When giving nursing care to a child with a. Absent Pupillary reflex
leukemia, the nurse notes blood on the b. Expiratory grunt
pillow case and several bloody tissues. c. Respiratory rate of 40
The nurse should check the child’s breath/minutes
laboratory report for the: d. Full breast areola
a. Platelet count
b. Uric acid level 40. Which of the following assessment
c. Prothrombin time findings would alert the nurse that a
d. Red blood cell count newborn needs special attention?
a. birth weight of 3,500 grams
35. The mother of a 13 year old who has b. APGAR score of 3
sickle cell anemia tells the nurse that the c. positive babinski reflex
family is going camping this summer. d. RBC = 6 million/cu mm
She asks what activities would be
appropriate for the child. The nurse 41. The following are true in Apgar Scoring
should suggest: except:
a. Softball games with the family a. done by the birth attendant at 1
b. Collecting logs for the campfire minute then 5 minutes after
c. Motorboat rides around the baby’s birth
lake b. must have a perfect score of 10
d. Walking along the mountain trails at one minute to guarantee
baby’s survival
36. When obtaining history from the mother c. determines prioritization of the
of an infant with celiac disease, the baby’s care after birth
nurse would expect the mother to say d. shows capability of the baby to
that he baby: adapt to extra-uterine life
a. Is irritable at all times
Situation: The nurse is caring for a neonate a. Gentle exercise to stop muscle
delivered by cesarean section at 43 weeks’ breakdown
gestation. The neonate weighed 7 lbs, 8 oz. b. Keep Infant in a warm & dark
and had an Apgar score of 7 at 1 minute and 9 environment
at 5 minutes. c. Administration of oxygen
supplement
42. While assessing the neonate, the nurse d. Early feeding
explains to the mother that post-term
neonates typically have Situation: Nurse Pauline works in a children’s
a. soft, oily skin clinic and helps with care for well and ill
b. a long, thin body children of various ages.
c. very few sole creases
d. abundant lanugo 47. A nurse performs a physical
assessment to a two-month-old infant.
43. Soon after delivery, the neonate Which of the following findings would
receives an injection of Vitamin K. The require further investigation?
nurse explains to the mother that a. Closed anterior fontanelle
Vitamin K is given to the neonate b. Symmetrical magnet reflex
because c. Multiple mongolian spots
a. neonates have no d. Positive moro reflex
gastrointestinal bacteria
b. neonates are susceptible to 48. An infant’s parent says “The soft spot
clotting disorders near the front of my baby’s head is still
c. hemolysis of the fetal red blood big. When will it close?” The nurse’s
cells destroys vitamin K best response would be at
d. the neonate’s liver does not a. 2 to 4 months
produce vitamin K b. 5 to 8 months
c. 9 to 11 months
44. In caring for a newborn the nurse should d. 12 to 18 months
consider the following normal EXCEPT:
a. meconium which colored 49. When providing instructions regarding
greenish black is passed 20 play to a mother of a 4-month old infant,
hours after birth the nurse should include which of the
b. yellow discoloration of skin following?
and sclera 6 hours after birth a. A rattle is an appropriate toy for
c. secretions coming from slightly baby this age
engorged breast b. A teething ring is an appropriate
d. urine is colorless, odorless toy for a baby his age.
c. The baby should be provided
Situation: A nurse is assigned at the NICU. with a playpen where he can
During endorsement rounds the nurse roll over
performs her assessment of the newborn. d. The mother can play peek-a-boo
with the baby to stimulate
45. A newborn’s bilirubin level is 12 mg/dl. cognitive development
The Doctor ordered Phototherapy.
Which of the following interventions is 50. When developing a plan of care for a
NOT appropriate? child, the nurse identifies which
a. Covering eyes and scrotum with Eriksonian stage corresponds to Freud’s
an opaque mask oral stage of psychosexual
b. Exposing the infant’s skin to light, development?
turning q2h a. Initiative vs. Guilt
c. Assess capillary Blood b. Autonomy vs. Shame & Doubt
glucose q6h c. Industry vs. Inferiority
d. Measure Intake and output d. Trust vs. Mistrust

46. Which of the following interventions is 51. A mother of a 5-month-old baby asks
done in order to hasten the excretion of the nurse which tooth typically erupts
Direct Bilirubin in a Newborn? first?
a. lower central incisor
 b. upper central incisor behavior is considered normal
c. lower lateral incisor for his age
d. upper lateral incisor c. This is the usual way that the
toddler expresses his needs
52. When teaching the mother on accident during the initiative stage of
prevention on a 6-month-old infant, the development
nurse should emphasize that at this age d. It is best to leave the child alone
the infant can usually in his crib after calmly telling him
a. sit up why his behavior is unacceptable
b. roll over
c. crawl lengthy distances 57. Ear drops, instilled twice a day, are
d. stand while holding on a furniture prescribed for a 2 year old child. When
observing the parent instilling the drops,
53. An infant’s developmental task in the nurse decides the teaching
psychosocial theory is “trust vs concerning how to position the ear lobe
mistrust”. Which of the following when instilling drops is effective when
interventions will help the infant develop the parent pulls the toddler’s ear lobe
trust? a. up and forward
a. Attend to the infant’s needs b. up and backward
b. Motivate to explore and produce c. down and forward
c. Allow child to make simple d. down and backwards
choices
d. Encourage creativity and 58. Mrs. Wallace expresses concern
imagination because Robby has begun thumb
sucking which he had previously
54. When obtaining vital signs on a sleeping outgrown. The nurse would note this
3-month old infant, which of the behavior as:
following assessments would the nurse a. Conservation
obtains first b. Regression
a. Respiratory rate c. Castration
b. Apical pulse d. Bruxism
c. Axillary temperature
d. Blood pressure 59. Which of the following type of play
would a preschooler typically be
55. A 2 1⁄2-year-old child is brought with her involved in?
2-month-old sibling to the clinic by his a. Solitary
father, who explains that the older child b. Parallel
says “no” whenever asked to do c. Associative
something. The nurse would explain that d. Competitive
the negativism demonstrated by
toddlers is frequently an expression of 60. The Oedipus or Electra Complex is
a. a need to expend excess energy likely to occur In which period of
b. a pursuit of autonomy development according to Freud?
c. separation anxiety a. Oral
d. sibling rivalry b. Anal
c. Phallic
56. A father brings his 18 month old son to d. Genital
the clinic. He asks the nurse why his
son is so difficult to please, has temper 61. While playing Joshua accidentally
tantrums, and annoys him by throwing obtained an inch of scraped skin on the
food from the table. The nurse should left knee. He cries intensely after seeing
explain that the injury, you described it as a
a. Toddlers need to be disciplined at manifestation to fear of:
this stage to prevent the a. Dark
development of antisocial b. Mutilation
behaviors c. Separation
b. The child is learning to assert d. Abandonment
independence, and his
62. A mother shares to the nurse about her 68. A post-mature baby will be anticipated
preschooler child who is bedwetting. for the following problems EXCEPT:
Which of the following would be a. infection due to meconium
appropriate to advise? aspiration
a. “Give less fluid at night.” b. metabolic acidosis due to cold
b. “Allow Robby to wear diapers stress
every night.” c. hyperbilirubinemia due to
c. “Bribe your child as a way of polycythemia
reinforcement.” d. hyperglycemia due to
d. “Threaten him as a way of overstaying inside the uterus
disciplining.”
69. Immediate nursing care for a neonate
63. According to Erikson's theory of born with a cleft lip is directed primarily
development, chronic illness can toward:
interfere with which stage of a. Modifying feeding methods
development in an 11-year-old? b. Keeping the baby from crying
a. Intimacy versus isolation c. Minimizing handling by parents
b. Trust versus mistrust d. Preventing the occurrence of
c. Industry versus inferiority infection
d. Identity versus role confusion
70. A priority nursing measure for an infant
64. A mother of a 7-year-old boy reported during the immediate postoperative
that her son resisted attending his period following a surgical repair of a
classes. As a school nurse, which of the cleft lip is to:
following is the appropriate action? a. Minimize the infant’s crying
a. Determine the cause of b. Restraint the infant at all times
resistance to school c. Oxygenate the infant frequently
b. Allow the client to take a vacation d. Handle the infant as little as
c. Discipline and punish the child possible
d. Isolate the child
71. The characteristic cough of
65. On average, the adolescent growth laryngotracheobronchitis will be:
spurt begins: a. dry and hacking
a. Earlier for boys than for girls b. barking and “seal-like”
b. Earlier for girls than for boys c. moist and productive
c. At approximately the same time d. spasmodic with wheezing
for both sexes
d. Between the seventh and eighth 72. An infant with tetralogy of Fallot became
years cyanotic and dyspneic after a crying
episode. To relieve the cyanosis and
66. According to developmental authorities, dyspnea, the nurse should place the
the tasks of adolescents include the infant in the:
following except: a. Knee-chest position
a. Development of strong family b. Orthopneic position
ties c. Side lying position
b. Acquiring a set of values and d. Semi Fowler’s position
ethics
c. Acceptance of a new body image 73. The mother of a 5-month-old infant with
d. Achieving a masculine or heart failure questions the necessity of
feminine social role weighing the infant every morning. The
nurse’s response should be based on
67. A 14-year-old child must have the the fact that this daily information is
capacity for self-awareness to: important in determining:
a. Develop role identity a. Renal failure
b. Eliminate fear of the dark b. Fluid retention
c. Maintain self-control c. Nutritional status
d. Focus on more than one d. Medication dosage
dimension of an object
74. The clubbing seen on the fingers of increasing frequency and force after
patients with tetralogy of fallot indicates: feeding. Pyloric stenosis is diagnosed.
a. clot formation on the distal The nurse is aware that the
extremities manifestations of pyloric stenosis are:
b. the body responding to a. Avid hunger and effortless
peripheral hypoxia vomitus
c. the child is dehydrated b. Non-bile stained vomitus and
d. the child is calcium deficient visible peristaltic waves
c. Vomiting several hours after a
75. A 1-year-old with postductal coarctation feeding and tarry stools
of the aorta is admitted to the acute care d. Bile-stained vomitus and
unit for treatment. When performing an generalized abdominal distention
assessment, you find that the lower
extremities are cool. Which finding 80. An 8-month-old infant was admitted to
should you anticipate as the the ER from the OPD. The
assessment continues? manifestations presented points to a
a. Bounding femoral pulse possible Hirschsprung's disease. These
b. Low blood pressure in the arms would include the following EXCEPT:
c. Low blood pressure in the legs a. olive-shaped mass
d. Bilateral pedal edema b. stool with blood and mucus
c. severe abdominal distention
76. When a child with hemophilia complains d. history of constipation
of joint pains, what should be the
immediate management upon noting 81. The nurse assessing newborn babies
that the part is swelling? and infants during their hospital stay
a. apply warm compress to relieve after birth will notice which of the
the pain following symptoms is a primary
b. give aspirin then apply ice to the manifestation of Hirschsprung's
area disease?
c. immobilize the part then bring a. A fine rash over the trunk
to the hospital b. Failure to pass meconium
d. consider this as normal for during the first 24 to 40 hours
hemophilic patient after birth
c. The skin turns yellow and then
77. Teaching for parents whose baby is brown over the first 48 hours of
undergoing frequent casting to correct a life
foot deformity should include information d. High-grade fever
on cast care, such as:
a. Covering damp cast with 82. For a child with hypospadias, which
adhesive petals description of this condition is most
b. Applying lotion to the skin at cast accurate?
edges to keep it soft a. Ventral curvature of the penis.
c. Checking the skin at the edges b. Meatal opening located on the
of the cast daily for redness dorsal surface of the penis.
d. Immersing the cast briefly during c. Narrowing or stenosis of the
the tab bath and wiping it lightly prepuce opening of the foreskin.
d. Urethral opening located
78. When assessing a newborn for behind the glans penis or
developmental dysplasia of the hip, the along the ventral surface of the
nurse would expect to assess which of penile shaft.
the following?
a. Symmetrical gluteal folds 83. If a shunting procedure is done, it is for
b. Trendelenburg sign what purpose?
c. Ortolani sign a. provide outlet for excess CSF
d. Characteristic limp b. restore cerebral function
c. remove and correct the
79. A 6-week-old infant is brought to the obstruction
clinic by her parents. They state that d. control meningeal irritation
their baby has been vomiting with
84. The mother asks what cerebral palsy is. 89. A mother tells you her 6 year old has
The nurse base her response on the been biting his fingernails since he
understanding that CP is began first grade. After analyzing the
a. An infectious disease of the cause of this as increased stress, the
central nervous system advice you would give his mother
b. The inflammation of the brain due regarding this problem would be to:
to bacterial infection a. Encourage the child to drink more
c. A congenital condition that results milk for stronger nails
from folic acid deficiency b. Distract the child by teaching him
d. A chronic disability a new skill, such as wrestling
characterized by impaired c. Allow some time everyday for
muscle movement and posture the for the child to talk about
new experiences
85. A 7-year-old has been scheduled for a d. Allow the child to choose a
tonsillectomy. Which of the following reward for not biting his nails
would be most important to assess prior
to surgery? 90. Upon admission to the nursery, this
a. Specific gravity of urine. infant would necessitate the following
b. Pulse and respiratory rate. EXCEPT:
c. Bleeding and clotting time. a. immediate suctioning and O2
d. Blood pressure both lying down administration as ordered
and sitting up b. warmth by putting them inside the
isolette
86. Which statement about cystic fibrosis is c. assessment for early jaundice
true? d. immediate feeding to increase
a. It is a disorder involving weight
excess mucus production in
the lungs and digestive tract 91. Vomiting is common for these babies. To
b. It causes obstruction of the prevent this, the nurse should:
airways from bronchospasm a. feed the infant first before doing
c. It is caused by allergic reaction to all procedures so that they are
food, dust, or other substances satisfied
such as smoke or pollens b. do all nursing procedures
d. It is characterized by polyps in before feeding the baby
the respiratory tract that impede c. position infant on the left side
breathing after feeding
d. turn the infant side to side to
87. Mark, diagnosed of cystic fibrosis is promote gastric emptying
underdeveloped and small for his age
primarily because he: 92. In measuring the neonate, the nurse
a. Ingested little food for several would refer if:
months because of poor appetite a. she notices the head bigger than
b. Was unable to absorbed the chest
nutrients because of lack of b. she notices the chest and
pancreatic enzymes abdomen to be of same size
c. Secreted less than normal c. she notices the length to be 47
amounts of pituitary growth cm on a 6 lbs baby
hormones d. she notices the chest bigger
d. Developed muscular and bony than the abdomen
atrophy from lack of motor activity
93. Daily umbilical cord care to prevent the
88. An infant was diagnosed with potential for infection should include
phenylketonuria (PKU) at age 6 weeks. which of the following?
At follow-up home visits, you assess for: a. Bathe daily with warm water and
a. hemolytic disease pat dry
b. delayed development b. Apply oil to the cord
c. erythroblastosis fetalis c. Apply lotion to the area just next
d. hyaline membrane disease to the cord
 d. Keep the cord and area directly 99. Which of the following is the most
surrounding clean and dry accurate description of cognitive
development in Wendy, aged 5?
94. At 72 hours after birth, the umbilical a. Thinks abstractly
stump finding is considered normal? b. Has magical thinking
a. Slight swelling at the base of the c. Comprehends conservation of
stump matter
b. Slight amount of drainage from d. Sees more than one dimension of
the stump an object
c. Redness at the base of the stump
d. Beginning to dry and atrophy 100. Which of the following statements
best describes a child’s cognitive ability
95. Popcorn and nuts should not be given to during Piaget’s concrete operations
a toddler primarily because they stage?
a. Will spoil the child’s appetite a. Behavior changes from reflexive
b. Are easily aspirates to purposeful
c. Have very little food value b. The child is unable to put himself
d. Can cause tooth decay or herself in the place of another
c. Thought processes become
96. Mrs. Lucas, mother of 10 month-old more systematic and logical
Malou, feeds her baby only formula and d. Abstract thinking and logical
baby cereals. In preparing to teach her conclusions are made more
methods for introducing solid foods, the frequently
nurse would include which of the
following statements:
a. “Baby cereals should be
discontinued at 1 year of age
when the infant is eating other
sources of food.”
b. “Eggs are the best source of
protein to introduce initially.”
c. “Introduce one food at a time,
try this food at least 1 week
before adding new food.”
d. “Once cereals are added to your
child’s diet, her vitamins can be
stopped.

97. Which of the following behaviors

indicates normal biological
development?
a. A 6 week old begins to roll over
b. A 6 months old sits without
support
c. A 7 month old transfer a toy
from hand to hand
d. A 7 month old stands unassisted

98. When ordering a regular diet for a young

toddler the nurse should choose foods
such as:
a. Spaghetti and bread
b. Corn dog and French fries
c. Hamburger with bun and grapes
d. Hot dog with bun and potato
chips