COMPETENCY APPRAISAL 01
PSYCHIATRIC NURSING
PRACTICE TEST#1
QUIJANO GEM EUNCE B.
1. A patient in an acute mental health program refuses his morning dose of an oral antipsychotic
medication and believes he is being poisoned. The nurse should respond sby taking which of the
following actions?
a. Administering the medication by injection
b. Omitting the dose and trying the next day
c. Crushing the medication and putting it in his food
d. Consulting with the physician about a plan of care
Medication are not to be skipped not unless instructed by physician.
2. What is the nurse’s most important role in caring for a patient with mental health disorder?
a. To offer advice
b. To know how to solve the client’s problem
c. To establish trust and rapport
d. To set limits with the client
Being able to establish this basic guidilines will enable the nurse to have a good patient relationship,
thus making it easy for nurse and client
3. The nurse is caring for a patient, a Gulf war veteran, who exhibits signs and symptoms of PTSD
which include
a. A hyperalertness and sleep disturbance
b. Memory loss of traumatic event and somatic distress
c. Feeling of hostility and violent behavior
d. Sudden behavior changes and anorexia
Patient who have PTSD tend to always recall the traumatic event that happened in their lives, thus most
of the time they are alert as if they would knew something is about to happen
Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event
— either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe
anxiety, as well as uncontrollable thoughts about the event.
Most people who go through traumatic events may have temporary difficulty adjusting and coping, but
with time and good self-care, they usually get better. If the symptoms get worse, last for months or even
years, and interfere with your day-to-day functioning, you may have PTSD.
Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and
improve function.
4. A patient with borderline personality disorder is admitted to the psychiatric unit. Initial nursing
assessment reveals that the client’s wrists are scratched from a recent suicide attempt. Based
on this finding, the nurse should formulate a nursing diagnosis of
a. Ineffective individual coping related to feelings of guilt
b. Self-esteem disturbance related to feelings of loss of control
c. Risk of violence: Self-directed related to impulsive mutilating acts.
d. Risk for violence: Directed toward others related to verbal threat
Suicidal behavior is influenced in varying degrees by biological, personal, and social factors. Identifying 4
common reasons for suicidal acts (psychosis, major depression, philosophical reasons, and poor impulse
control) can be very helpful in evaluating suicidal patients quickly and making decisions about how
patients should be treated.
5. The patient id diagnosed of chronic schizophrenia has been taking neuroleptics for many years.
Assessment reveals unusual movements of the tongue, neck, and arms. Which condition would
the nurse suspect?
a. Tardive dyskinesia
b. Dystonia
c. Neuroleptic malignant syndrome
d. Akathisia
6. A patient tells the nurse that people from Mars are going invade the earth. Which response by
the nurse would be most therapeutic?
a. “That must frightening to you can you tell me how you feel about it?”
b. “There are no people living on Mars.
c. ”What do you mean when you say they’re going to invade the earth?”
d. “I know you believe the earth is going to be involved, but I don’t believe that”
As nurses we are not supposed to tolerate patients imagination for this might worsen their anxiety and
could lead to panic.
7. After learning that a roommate is HIV-positive, a patient asks the nurse about moving to another
room on the psychiatric unit because the client doesn’t feel “safe” now. What should the nurse
do first?
a. Move the patient to another room
b. Ask the patient to describe any fears
c. Move the patient’s roommate to a private room
d. Explain that such a move wouldn’t be therapeutic for the patient or roommate
8. Opiate withdrawal causes severe physical discomfort and can be life-threatening. To minimize
these effects, opiate users are commonly detoxified with
a. Barbiturates
b. Amphetamines
c. Methadone
d. Bensodiapines
9. The nurse is using drawing, puppetry, and other forms of play therapy while treating a
terminally ill, school-age child. The purpose of these techniques is to help the child.
a. Internalize his feeling about death and dying
b. Accept responsibility for his situation
c. Express feelings that he can’t articulate
d. Have a good time while he’s in the hospital
10. A 26-year old male report losing his sight in both eyes. He’s diagnosed as having a conversion
disorder and is admitted to psychiatric unit. Which nursing intervention would be most
appropriate for the client?
a. Not focusing on his blindness
b. Providing self-care for him
c. Telling him his blindness isn’t real
d. Teaching eye exercises to strengthen his eyes
11. A patient age 87, with major depression undergoes a sixth electroconvulsive therapy (ECT)
treatment. When assessing the client immediately after ECT, the nurse expects to find
a. Transitory short-term memory loss and permanent long-term memory loss
b. Transitory short-and long-term memory loss and confusion
c. Permanente short-term memory loss and hypertension
d. Permanent long-term memory loss and hypomania.
12. Victims of domestic violence should be assessed for what important information?
a. Reasons why they stay in the abusive relationship (for example, lack of financial autonomy
and isolation)
b. Readiness to leave perpetrator and knowledge of resources
c. Use of drugs and alcohol
d. History of previous victimization
13. During a group therapy session in the psychiatric unit, a client constantly interrupts with
impulsive behavior and exaggerated stories that cast her as a hero or princess, she also
manipulates the group with attention-seeking behaviors, such as sexual comments and angry
outburst. The nurse realizes that these behaviors are typical of:
a. Paranoid personality disorder
b. Avoidant personality disorder
c. Histrionic personality disorder
d. Borderline personality disorder
14. When teaching a patient receiving lithium, the nurse should instruct the patient to:
a. Drink at least 6 to 8 glasses of water per day and to avoid caffeine
b. Limit the use in his diet
c. Discontinue medicine when feeling better
d. Increase the amout of sodium in his diet
15. A schizophrenic patient with delusion tells the nurse, “there is a man wearing a red coat who’s
out to get me”. The patient exhibits increasing anxiety when focusing on the delusions. Which
of the following would be the best response?
a. “This subject seems to be troubling you. Let’s walk to the activity room”
b. “Describe the man who’s out to get you. What does he looks like?”
c. “There is no reason to be afraid of that man. This hospital is very secure.”
d. “There is no need to be concerned with a man who isn’t even real”
16. The nurse is developing a plan of care for a patient with anorexia nervosa. Which action should
the nurse include in the plan?
a. Restrict visits with the family until the client begins to eat
b. Provide privacy during meals
c. Set up a strict eating plan, providing initially a one-on-one supervision during meals and for
1 hour afterward
d. Encourage the client to exercise, will reduce her anxiety
17. A patient with paranoid schizophrenia runs to the nurse and says, “Why are you poisoning me?
I know you work for central thought of control! You can keep my thought, Give me back my
soul.” How should the nurse repond during the early stage of the therapeutic process?
a. “I’m a nurse. I’m not poisoning you. It’s against the nursing code of ethics.”
b. “I’m a nurse, and you’re a client in the hospital. I’m not going to harm you.”
c. “I’m not poisoning you. And how could I possible steal your soul”
d. “I sense anger. Are you feeling angry today?”
18. A patient with obsessive-compulsive disorder and ritualistic behavior must brush the hair from
his forehead 15 times before carrying out any activity. The nurse notices that the patient’s hair
is thinning and the skin on the forehead is irritated, a possible effect of this ritual. When
planning the patient’s care, the nurse should assign highest priority to:
a. Help the patient identify how ritualistic behavior interferes with daily activities.
b. Explore the purpose of the ritualistic behavior
c. Set consistent limits on the ritualistic behavior if it harms the patient, or other
d. Use problem solving to help the client manage anxiety effectively
19. The nurse is caring for a patient who believed has been abusing opiates. Assessment findings in
a client abusing opiates as morphine sulfate include:
a. Dilated pupils and slurred speech
b. Rapid speech and agitation
c. Dilated pupils and agitation
d. Euphoria and constricted pupils
20. An agitated, acting-out, delusional patient is receiving large doses of Haloperidol (Haldol) and
the nurse is concerned because this drug can produce untoward effects. The nurse should be
aware that the drug will immediately be stopped if the patient exhibits:
a. Jaundice
b. Dizziness
c. Sleeplessness
d. Extrapyramidal symptoms
