10.

A young overweight adult smokes 5-10 sticks of cigarettes/day,

ambitious, looks at life as challenging and perfect and never
considers change in his lifestyle, initially needs:
A. Commitment C. Skills to attempt change
B. Information D. Motivation

Situation - Bernie and John in their late 40’s have been married for
20 years and at the peak of their careers. Suddenly, Bernie
discovered that her husband was falling in love with another
woman. Shaken by this situation, she started to have problems
NURSING PRACTICE V - SET B sleeping and could not function well at work and at the risk of
losing her job. John asked forgiveness and regret very much the
NURSING PRACTICE V — Care of Clients with Physiologic and hurt his wife was going through and suffered guilt feelings:
Psychosocial Alterations (Part C)
11. Bernie and John are going through a:
Situation – Felisa has a ritualistic pattern of constantly washing A. Situational crisis C. Anticipated crisis
her hands with soap and water followed by rubbing alcohol. B. Developmental crisis D. Both developmental and
situational crisis
1. The behavior is categorized as:
A. Delusional 12. All of these are characteristics of crisis EXCEPT:
B. Normal A. A hazardous or threatening event occurs
C. Neurotic b. It has a growth promoting potential
D. Psychotic c. Usual problem solving methods and coping mechanisms
produce a solution
2. A therapeutic intervention in this situation is: d. Anxiety or depression continue to increase
A. Avoid limits on her behavior to release her anxiety
B. Call attention to her ritualistic pattern 13. The nurse employs this approach in crisis intervention:
C. Provide alternative behaviors to deal with increased A. Problem-solving C. Role-playing
anxiety B. Behavior modification D. Nurse-patient relationship
D. Ignore her behavioral totality
14. Assessment data of the nurse include all the following EXCEPT:
3. The anxiety of Felisa is disabling and interferes with her job A. Coping mechanisms C. Perception of the event
performance. Interpersonal relationships and other activities of B. Situational support D. Repressed problems
daily living. To minimize such problems, she is likely to be given:
A. Diazepam (Valium) 15. The duration of crisis usually lasts several days and usually:
B. Haloperidol (Haldol) A. 2 – 4 weeks C. 1 – 2 months
C. Imipramine HCL ( Tofranil) B. 1 – 2 weeks D. 4 – 6 weeks
D. Chlorpromazine (Thorazine)
Situation - The community health nurse encounters special
4. Felisa understands the effects of her medicine when expresses: children in the community.
A. “I should watch out for signs of sore lips or sore
throat” 16. An individual with antisocial personality disorder lacks remorse,
B. “I might have constipation” shame and guilt in going against the norms of society.
C. “I might feel changes in my body temperature” Psychodynamically, this defect in the personality reflects a
D. “ I should not drive or operate machines” disturbance of the:
A. Ego C. Ego ideal
5. The level of anxiety that Felisa is experiencing is: B. Super ego D. Id
A. Panic C. Mild
B. Severe D. Moderate 17. The nurse teaches parents about children’s beginning concepts
of right and wrong by emphasizing child rearing attitude and
Situation - The nurse recognizes the need to learn to cope with practices during the:
stress and change. She becomes interested to practice natural A. School age C. Infancy period
ways to enhance well being. B. Toddler age D. Latency period

6. Lifestyle modification begins with: 18. It is BEST for parents to teach healthy interpersonal
A. Minimizing eating in fast food restaurants relationships to their children by:
B. Having an exercise regimen to follow regularly A. Modeling to their children
C. Recognizing the impact of unhealthy habits B. Encouraging their children to attend secondary school
D. Avoiding pollutants in the environment C. Encouraging their children at home to behave properly
D. Teaching their children good manners and right conduct
7. All of these are the behavior intervention to stress management.
EXCEPT: 19. An important principle for the nurse to follow in interacting with
A. Guided imagery C. Meditation retarded children is:
B. Pharmacotherapy D. Progressive muscle A. Seen that if the child appears contented, his needs are being
relaxation met
8. Basic to progressive muscle relaxation is: B. Provide an environment appropriate to their development
A. Focusing on an image to relax task as scheduled
B. Relaxing muscles from tension C. Treat the child according to his chronological age
C. Use of industrial equipment D. Treat the child according to his developmental level
D. Stopping disturbing thoughts
20. Mental retardation is:
9. Dietary practices are very important to the health of the Filipino A. A delay in normal growth and development caused by an
family. The nurse needs to assess this lifestyle because: inadequate environment
A. The nurse wants to change the eating patterns of the Filipino B. A lack of development of sensory abilities
family C. A condition of subaverage intellectual functioning that
B. The nurse knows that being overweight is a major health originates during the developmental period and is associated
hazard with impairment in adaptive behavior
C. The nurse wants to stop all the mainstream weight-loss diets D. A severe lag in neuromuscular development and motor
D. The nurse has to find out what people are eating abilities
Situation - As a professional, it is imperative that the nurse is accomplished children and recalls challenging career as a lawyer.
accountable to oneself hence the importance of personal and She is demonstrating a sense of:
professional development. A. Ego integrity
B. Industry
21. Nurse: “I feel personally involved with my client’s problems” C. Generativity
demonstrates: D. Autonomy
A. Counter transference C. Transference
B. Empathy D. Sympathy Situation – The supervising nurse received report that a staff nurse
is displaying frequent irritation, anger and even indifference toward
22. The nurse has achieved self-awareness in which of the clients and co-workers.
following verbalizations?
A. Every time people around me yell, I feel upset and 31. The initial action of the supervisor would be to:
withdrawn A. Post guidelines on proper decorum of nurses in the bulleting
B. When the patient yelled at me I became speechless board
C. With the patients tone of voice and stare, I got reminded of B. Write a memo of warning to the house
how my father would be so angry and this made me anxious C. Request anecdotal report form nurse’s co-workers
D. I thought it was rude for the patient to yell hence I kept D. Call the nurse for a one on one conference
quiet
32. The nurse expressed increasing feelings of dissatisfaction. The
23. An accepting attitude requires being: supervising nurse intervenes therapeutically by taking the role of:
A. Aware of ones biases A. Administrator by relieving her of responsibilities
B. Tolerant of the faults of others B. Therapist by delving into the nurse’s internal conflict
C. Non judgmental C. Counselor by actively listening
D. In control of tendency to blame D. Educator by reorienting her of her role as a nurse

24. Self-awareness, knowledge and understanding of human 33. Coupled with poor work performance, mental and physical
behavior and communication skills define what is essential in caring fatigue and actual withdrawal from client contact and nursing
for every nurse to be able to demonstrate: duties, the nurse can be said to be suffering from:
A. Positive self-projection A. Psychotic anxiety
B. Assertiveness B. Staff burnout
C. Therapeutic use of self C. Personality maladjustment
D. Self-mastery D. Neurotic depression

25. Considering that man is by nature social, it is BEST for the 34. A priority in the nurse’s personal development would be to:
nurse to gain self-awareness by: A. Address her physical well-being
A. Participating in intensive group experiences B. Boost her self-confidence
B. Individual psychotherapy C. Provide social support
C. Hypnotherapy D. Help her find value and meaning in her work
D. Writing an autobiography for self introspection
35. The most relevant professional program for her would be:
Situation – Ninety year old Purita is confined at the medical unit for A. Assertiveness training
respiratory ailment for which a breathing apparatus is prescribed B. Stress management
for her to use while she sleeps. She refuses to wear it continuously C. Group dynamics and team building
though she full understands the medical indication for it: D. Behavior modification

26. Which of these ethical principles can guide the nurse in her Situation – A nurse assigned in the neurologic unit is taking of
action? clients with varying degree of degenerative disorders.
A. Beneficence
B. Fidelity 36. Mr. A with myasthenia gravis is having difficulty speaking. What
C. Autonomy communication strategies should the nurse avoid when interacting
D. Nonmaleficence with Mr. A?
A. Repeating what the client says for better understanding
27. Purita has six children who are already adults. They differ in B. Using paper and pencil in communication with the client
their opinion whether or not to allow their mother to decide for her. C. Encouraging the client to speak slowly
The nurse would encourage family conference for: D. Encouraging the client to speak quickly
A. The eldest child’s opinion to be given priority
B. Majority of the children to decide 37. When planning for nursing care for Mr. B who has Parkinson’s
C. Allowing the medical staff to decide in their behalf disease. Which of the following goals would be most appropriate?
D. Consensus building A. To improve muscle tone
B. To start rehabilitation as much as possible
28. Breathing treatments are to be given to Purita. In anticipation C. To treat the disease
that Purita might refuse. Dino, one of the children requests that he D. To maintain optimal body function
be the one to sign the consent in behalf of their mother. The nurse
explains that Purita is rational in her thinking and which of this 38. For the past 10 years. Alma, 42 years old has had multiple
client’s right must be regarding? sclerosis Client with multiple sclerosis experience many different
A. Right to refuse treatment symptoms. As part of the rehabilitation planned for Alma, the nurse
B. Right privacy suggested therapy and hobbies to help her:
C. Right to informed consent A. Strengthen muscle coordination
D. Right of habeas consent B. Establish routine
C. Develop perseverance and motivation
29. Which of these would be the nurse’s priority following the D. Establish good health habits
treatment principle of least restrictive alternative?
A. One of one staffing 39. On his second day of hospitalization, Mr. Santos was unable to
B. use of on site guard/watcher stand and is having difficulty swallowing and talking. Which of the
C. Physical restraint following is the priority of the nurse in assisting Mr. Santos?
D. Seclusion A. To prevent bladder distention
B. To prevent decubitus ulcer
C. To prevent contracture
D. To prevent aspiration pneumonia
30. Purita talks about her joy in having responsible and 40. The wife of a seventy two year old man with a diagnosis of
Alzheimer’s disease begins to cry and tells the nurse, “I could not recording an incident?
understand my husband anymore. He has changed drastically.” A. When asked about his relationship with his father, client
Which of the following responses of the nurse is MOST became anxious
appropriate? B. When asked about his relationship with his father, client
A. The physician an the staff will make sure that your husband clenched his jaw, teeth, made a fist and turned away from
will be comfortable and safe here the nurse.
B. This has been a difficult time for you. Let us walk and find a C. When asked about his relationship with his father, client
quiet place where we can talk was resistant to respond
C. He will soon recover in this condition D. When asked about his relationship with his father, his anger
D. You need not worry, we are doing the best we could was suppressed

Situation – Annie has a morbid fear of heights. She asks the nurse 49. To encourage thoughts, which of the following approaches is
what desensitization therapy is: NOT therapeutic?
A. Why do you feel angry?
41. The accurate information of the nurse the goal of B. When do you usually feel angry?
desensitization is: C. How do you usually express anger?
A. To help he clients relax and progressively work up a list of D. What situations provoke you to be angry?
anxiety provoking situations through imagery
B. To provide corrective emotional experience through a one- 50. A patient grabs and about to throw it. The nurse best responds
to-one intensive relationship saying:
C. To help clients in a group therapy setting to take on specific A. Stop! Put that chair down
roles and reenact in front of an audience, situations in which B. Don’t be silly
interpersonal conflict is involved C. Stop! The security will be here in a minute
D. To help client cope with their problems by learning D. Calm down
behaviors that we are more functional and be better
equipped to face reality and make decision Situation – A vehicle hit some pedestrians while waiting for a bus
ride. Some of the victims suffered injuries in different part of the
42. It is essential in desensitization for the patient to: body. The victims were brought to the nearby hospital. One of the
A. Have rapport with the therapist victims, Josephine was confirmed to have a fractures left arm.
B. use deep breathing or another relaxation technique While waiting or plaster cast to be applied, Josephine appears to be
C. Assess one’s self for the need of an anxiolytic drug anxious.
D. Work through unresolved unconsciousness conflicts
51. To reduce anxiety, the nurse teaches the procedure to the
43. In this level of anxiety, cognitive capacity diminishes. Focus client, which of the following topics should NOT be included in the
becomes limited and client experiences lurned vision. Physical signs teaching plan?
of anxiety become more pronounced. A. Leave the cast uncovered to promote drying
A. Sever anxiety B. Bear weight on the plaster for one hour. A stockinet will be
B. Panic placed over the left arm to be placed in cast
C. Mild anxiety C. Handle hardening cast with palm of hands
D. Moderate anxiety D. Trim and reshape finish cast with knife or cutter

44. Anti-anxiety medication should be used with extreme caution 52. Cast was applied on Josephine’s left arm. In assessing the
because long term use can lead to: neurovascular status of the client, which of the following
A. Parkinsonian like syndrome assessment findings should be reported to the physician?
B. Hypertensive crisis A. Pain on the left arm
C. Hepatic failure B. Swelling of the fingers
D. Risk of addiction C. Skin abrasion on the edges of the plaster cast
D. Nail bed capillary refill time of 10 seconds
45. The nursing management of anxiety related with post traumatic
stress disorder include all of the following, EXCEPT: 53. One of the victims a sixty year old woman sustained hip
A. Encourage participation in recreation or sports activities fracture. Prior to surgery, a Buck’s extension traction is to be
B. Reassurance client’s safety while touching client applied. The rationale of traction is primarily based on the
C. speak in a calm soothing voice understanding that Buck’s extension traction:
D. Remain with the client while fear level is high A. Reduces muscle spasms and helps to immobilize the
fracture
Situation – The nurse is often met with the following situations B. Allows reduction of the fracture site for bone healing
when clients become angry and aggressive individual, the nurse C. Secures the fractures site to prevent damage to the muscle
should: tissues
D. Secures the fracture site for rigid immobilization
46. To maintain a therapeutic eye contact and body posture while
inter-acting with angry and aggressive individual, the nurse should: 54. Philip was placed in skeletal leg traction with an overbed frame.
A. Keep on eye contact while staring at the client He is not allowed to move from side to side. Which of the following
B. Keep his/her hands behind his/her back or in one’s pockets nursing interventions is useful in maintaining:
C. Fold his/her arms across his/her chest A. Assist the client by holding the trapeze and raising the hips
D. Keep an “open” posture, e.g. hands by sides but palms off the bed
turned outwards B. Check the apparatus that weights hand free and knots in
the rope are tied securely
47. During the pre-interaction phase of the N-P relationship, the C. Suspend a trapeze within easy reach of the client
nurse recognizes this normal INITIAL reaction to an assultive or D. Support the affected extremity while the weights are
potentially assaultive person. removed
A. To remain and cope with the incident
B. Display empathy towards the patient 55. To prevent complication when a child is in Buck’s traction, the
C. To call for help from other members of the team nurse should:
D. To stay and fight or run away A. Clean the extremity and keep the skin dry
B. Assess any skin and circulatory disturbances
C. Clean the pin sites as necessary
D. Provide high fiber small meals

48. Which of the following is an accurate way of reporting and 56. The following concept are true EXCEPT:
 A. Hostility is destructive
B. Frustration develops in response to unmet needs, wants and 66. The nurse is aware that identifying the aspects of general
desire patient management and identifying interventions for
C. Anger is incompatible with love meeting these basic needs are distinctions of:
D. Aggression can be expressed in a constructive as well as a A. Psychotherapy
destructive manner B. Therapeutic milieu
C. Pharmacotherapy
57. Carlo is acting out hostile and aggressive feeling by kicking the D. Behavior therapy
chairs in the room, the MOST effective way to deal with Carlo’s
behavior is initially to: 67. In order to get active participation of the clients, to carry out
A. Set limits on the behavior by verbal command the objective of the program is BEST for the nurse to
B. Administer PRN tranquilizer conduct a/an:
C. Remove the chairs from the room A. Community meeting
D. Retrain the patient and place him in the “Isolation Room” B. Survey
C. Observation
58. Mrs. Dizon was visiting her son at the Psychiatry Ward. Which D. Selective interviews of patients
of the following items will the nurse NOT allow to be brought inside
the ward? 68. Through the nurse’s role modeling of effective communication,
A. String rosary bracelet the clients learned new ways of dealing with authority
B. Box of cake figures. This gives the clients a venue to:
C. Bottle of Coke A. Communicate
D. Rubber shoes B. Socialize
C. Identify their problems
59. Which of the following will probably be most therapeutic for a D. Test new patterns of behavior
patient on a behavioral modification ward?
A. If the client is agitated, discuss the feelings especially anger 69. This element of communication facilities evaluation of the
B. Insist to stop obscene language by verbal reprimand program:
C. Give client support and positive feedback for controlling use A. Receiver
of obscene language B. Message
D. Provide a punching bag as an alternative to express upset C. Sender
emotions D. Feedback

60. Which of the following must be considered while planning 70. The nurse’s style of leadership in milieu therapy is:
activities for the depressed patient? A. Autocratic
A. Activities which require exertion of energy B. Laissez-faire
B. Challenging activities to get him out of his depression C. Democratic
C. Structured activities that the client can participate D. Benevolent
D. Variety of unstructured activities
Situation – Loretta is a 28 years old, unemployed patient, admitted
Situation – The nurse works with Mina to help her work through to the psychiatric unit with diagnosis of chronic undifferentiated
termination of the nurse- patient relationship. schizophrenia. She described herself as the “Virgin Mary” and her
mission is to propagate peace. She was observed laughing and
61. Preparation for termination of the nurse-patient relationship talking to herself. Her thought processes were profoundly
begins during the: disorganized. She was also fearful and suspicious of others.
A. Termination phase
B. Working phase 71. Loretta’s claim of being the “Virgin Mary” is a/an:
C. Pre-orientation phase A. Imagination
D. Orientation phase B. Delusion
C. Hallucination
62. Mina’s past reaction to ending relationships is withdrawal. The D. Obsession
nurse assists her to practice better ways of coping termination by
providing opportunities to: 72. Her mission to propagate peace is:
A. Test new patterns of behavior A. A serious call for a need of transformation
B. Plan for alternatives B. An attempt to overcome low self-esteem
C. Conceptualize her problem C. Realistic and laudable
D. Value and find meaning in experience D. An advocacy that she can participate in

63. During the early part of the interaction, the nurse asked after a 73. Which of this intervention would NOT be therapeutic in
period of silence. “Perhaps we would talk about leaving”. decreasing Loretta’s anxiety?
The nurse utilized which communication technique: A. Joke about her thought to help her feel at
A. Encouraging ease
B. Suggesting B. Listen to her thoughts and feelings
C. Focusing on client C. Simply accept
D. Understanding D. Do not convince her that her perception

64. The longest and the most productive phase of the NPR is: 74. The nurse evaluates that Loretta’s ready for rehabilitation
A. Termination phase program when she:
B. Working phase A. Approaches the nurse at frequent intervals
C. Pre-orientation phase B. Ceases to talk about “Virgin Mary”
D. Orientation phase C. Goes to the coffee shop alone more often
D. Carries a book “The Purpose Driven Life”
65. The objection of the nurse-patient relationship is to provide an
opportunity of the patient to:
A. Clarify problems
B. Develop insights
C. Have a corrective emotional experience
D. Develop interpersonal relationship 75. The nurse is leading a group meeting of patients to prepare
them to be discharged. An appropriate goal for the group
Situation – As a program manager: the mental health psychiatric members is to develop:
nurse is tasked to provide general patient management. A. Attitudes of society towards the mentally ill
 B. Skills for maintaining daily living C. Explain that he is depreciating himself too
C. Awareness of interpersonal patterns of much
interactions D. Acknowledge how he feels and focus on
D. Insight into personal problems reality oriented topics

Situation – A group of adult chronic schizophrenic patient were 85. Which of the following drugs will most likely decrease Andy’s
recommended to undergo social skill training. hallucination?
A. Chlorpromazine (Thorazine)
76. The following are the objectives of a social skills training B. Chlomipramine (Anafranil)
program EXCEPT: C. Fluoxetine (Prozac)
A. Explore deep seated intrapsychic conflicts D. Carbamazepine (Tegretol)
B. Practice skills in relating with people
C. Help build self esteem and self confidence 86. Which of this client situation appropriately illustrate
D. Develop and practice general coping skills horticulture therapy?
A. The therapist brings bongos, tambourine,
77. Social skills training is NOT primarily indicated for psychiatric and belis and encourages client participation
patients who are: B. Tommy, Karen, Jon and Pia play scrabble
A. In acute stage of illness every night after supper
B. Having difficulties starting and maintaining C. Every afternoon, Vic goes in the garden
interpersonal relationships where he work with plants, seedlings, tree
C. Having chronic episodes of stress and planting and watering them
anxiety while interacting with others D. Paul finds sketching relaxing and rewarding
D. Experiencing recurrence of symptoms in
front of particular people or among people in 87. The beginning professional nurse can do mental health
general counseling with the following clients, EXCEPT:
A. Actively psychotic patients
78. The focus of the group interaction is “here and now”. An B. Out of school adolescents
appropriate topic would be: C. Parents with child rearing concerns
A. Ways to celebrate Valentine’s Day in D. School children with behavioral problem
February
B. How to spend the summer vacation 88. A professional responsibility of the mental health psychiatric
C. An unforgettable experience as a child nurse is to provide a safe and therapeutic environment. This
D. How to tell a joke is BEST reflected in:
A. Restraining patients who violates policies
79. An appropriate technique for the participants to practice how and do not follow schedule of activities
to communicate effectively is through/a: B. Maintaining a closed door policy to prevent
A. Lecture from absconding
B. Seminar C. Keeping a restrictive environment to prevent
C. Role play patients from becoming assaultive and
D. Psychodrama hostile
D. Ensuring physical safety and maintaining
80. Considering that it is BEST to learn example, it is MOST therapeutic attitude towards the patients
practical to
A. Model good social skills throughout the 89. The foundation of the therapeutic process is the therapeutic
session relationship. What is the essential component that the nurse
B. Relate successful past experiences must bring to the relationship?
C. Invite a resource person A. Humor
D. Watch a movie B. Empathy
C. Reframing
Situation – Andy, 30 years old, was admitted to the Psychiatric D. Confrontation
Ward because of religious pre-occupation, deterioration in self-care
and disturbed thoughts. He believes that he has committed a lot of 90. Which of these people, the highest in population groups that
sins. He is threatened by people reaching out to him. His fasting for would need priority mental health therapy?
several days was not sufficient for him to feel forgiven. A. Adults going through active skills
B. Simple elderly with no social support
81. Andy is demonstrating. C. Young professionals entering the workplace
A. Religious delusion D. Women preparing for overseas employment
B. Delusion of grandeur
C. Somatic delusion Situation – The nurse observed that Marie, age 28 years old had
D. Delusion of being controlled not participating in activity therapies.

82. A delusion is: 91. Which of the following remarks from the nursing attendants
A. Psychomotor disturbance indicates a need to further teaching and observation?
B. Mood disturbance A. Marie made no response to an invitation to
C. Disturbance of thought play
D. Disturbance of perception B. Marie is aloof and indifferent to co-patients
C. Marie read a book while other patients
83. The nursing goal for Andy is to: played a ballgame
A. Have him see a priest for confession
B. Encourage him to pray to atone for his sins
C. Help him develop a positive self image
D. Socialize him with a group to keep him in
touch with reality

92. Marie said “I don’t like to be a part of it, Look, they are being
84. As Andy talks about his sins, that he believes make people look laughed at because they are singing and acting like
down upon him. It is BEST to: children”. The nurse notes that in order for the activity
A. Agree with him and sympathize how sinful therapy to be therapeutic:
he ha really been A. The staff should decide solely what activities
B. Explore the nature of the sins to be done and what rules apply
 B. Patients should be allowed solely to decide
what they want to do on their own
C. Ballgames should be limited to male patients
only
D. Age and needs of patients should be
considered in the choice of game

93. To encourage active participation among patients, it is BEST to

plan activities they can engage in through a:
A. One to one interaction
B. Community meeting
C. Checklist
D. Feedback evaluation forum

94. In planning activities for the patients, it is essential to consider

FOREMOST:
A. Safety and security
B. Variety and fun
C. Novelty and creativity
D. Excitement and challenge

95. Adults, “singing and acting like children” is a form of:

A. Displacement
B. Regression
C. Sublimation
D. Compensation

Situation – Nursing care for elderly.

96. In planning care for a patient with Parkinson’s disease, which

of these nursing diagnoses should have priority?
A. Potential for injury
B. Altered nutritional state
C. Ineffective coping
D. Altered mood state

97. The frequent use of the older client’s name by the nurse is
MOST effective in alleviating which of the following
responses to old age?
A. Loneliness
B. Suspicion
C. Grief
D. Confusion

98. An elderly who has lot of regrets, unhappy and miserable is

experiencing?
A. Crisis
B. Despair
C. Loss
D. Ambivalence

99. The pre-morbid personality of an schizophrenic elderly client

is:
A. Schizoid
B. Extrovert
C. Ambivert
D. Cycloid

100.Schizophrenia is a/an:
A. Anxiety disorder
B. Neurosis
C. Psychosis
D. Personality disorder