Test Prep for Nursing Exam about Pediatric Nursing (91-95)

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91. A nurse is performing an assessment on a 10-year old child suspected having Hodgkin's disease. The nurse understands that which of the following assessment findings is characteristic of this disease?

a) fever and malaise
b) anorexia and weight loss
c) painful, enlarged inguinal lymph nodes
d) painless, firm, and movable adenopathy in the cervical area

92. When assessing a 2 year-old child brought by his mother to the clinic for a routine check-up, which of the following would the nurse expect the child to be able to do?

a) ride a tricycle
b) tie his shoelaces
c) kick a ball forward
d) use blunt scissors

93. After having blood sample drawn, a 5 year-old child insists that the site be covered with an adhesive bandage strip. When the mother tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse interprets this behavior as indicating a fear of which of the following?

a) injury
b) compromised body integrity
c) pain
d) loss of control

94. After teaching a group of mothers about temper tantrums, the nurse knows the teaching has been effective when one of the mothers states which of the following?

a) I will ignore the temper tantrums
b) I should pick up the child during the tantrums
c) I'll talk to my daughter during the tantrums
d) I would put my child in time out

95. After teaching the parents of a preschooler who has undergone T and A (Tonsillectomy and Adenoidectomy) about appropriate foods to give the child after discharge, which of the following, if stated by the parents as appropriate foods, indicates successful teaching?

a) meatloaf and uncooked carrots
b) pork and noodle casserole
c) cream of chicken soup and orange sherbet
d) hot dog and potato chips


91) D
- Clinical manifestations specifically associated with Hodgkin’s disease include painless, firm, and movable adenopathy in the cervical and supraclavicular areas. Hepatosplenomegaly also is noted. Although fever, malaise, anorexia, and weight loss are associated with Hodgkin’s disease, these manifestations are seen in many disorders.

92) C
a 2 year old usually can kick a ball forward. Riding a tricycle is characteristic of a 3 year old. Tying a shoelaces is a behavior to be expected of a 5 year old. Using blunt scissors is characteristic of a 3 year old.

93) B
the preschool child does not have an accurate concept of skin integrity and can view medical surgical treatments as hostile invasions that can destroy or damage the body. The child does not understand that exsanguination will not occur from an injection site. Fear of pain would be manifested if the child thought that bodily harm would occur. If the child thought that he would urinate in his pants, then he would be demonstrating fear of loss of control.

94) A
children who have temper tantrums should be ignored as long as they are safe. They should not receive either positive or negative reinforcement to avoid perpetuating the behavior. Temper tantrums are a toddler's way of achieving independence.

95) C
for the first few days after a T and A, liquids and soft foods are best tolerated by the child while the throat is sore. Avoid hard and scratchy foods until throat is healed.

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Nursing Board Exam Topnotchers and Passers for November 2008 (Top 10 Passers)

Congratulations to the Top 10 Passers (Topnotchers) of the recently concluded Nursing Board Exam Results (Nursing Licensure Examination Results) for November 2008.

Top 1:
Jovie Ann Alawas Decoyna, Baguio Central University, 89.00%

Top 2:
John Patrick Morales Dimarucot , Central Luzon Doctorss Hospital Educational Institute, 88.40%

Top 3:
Gian Karlo Timog Cusi, Baguio Central University 88%;
Erycar Del Mundo Manaois-Pamantasan ng Lungsod ng Maynila, 88%

Top 4:
Florina Conde Corpuz, saint Dominic savio College 87.60%;
Angelica Aubrey Pantig Morla, Far Eastern University Manila 87.60%;
Jamie Anne Tolentino Tinio, Angeles University Foundation 87.60%

Top 5:
Roberto Madrona Asuncion, Arellano University, Pasay City, 87.40;
Irisa Kriya Turaja Biag, san Pedro College, Davao City, 87.40;
Miguela Macuto Gabisan, Cebu Normal University, 87.40%;
Edita Te Lim-Arriesgado College Foundation, Inc, 87.40%;
Rosario Lei Mosqueda Pasimio, Xavier University, 87.40%;
Elaine Grace Esperancilla Praile saint Paul University, Iloilo 87.40%;
Catherine Duran Reyes, Our Lady of Fatima College QC, 87.40%

Top 6:
Geronimo Carillo Burce Jr., Mabini College, 87.20%;
Joanna Mae Francisco Evangelista, San Beda College, 87.20%;
Christopher Alvarez Irorita, San Pedro College, Davao City, 87.20%,
Paul Delfin Reyes Jamero, Father saturnino Urios University (Urios College), 87.20%;
Hazel Joy Amarillo Jimenez, University of Batangas, 87.20%;
Ma. Concepcion Ashley Delizo Mapagu, saint Louis University, 87.20%;
Maria Cecilia Castillo Navata, Canossa College, 87.20%;
Francis Ian sabanal Pascual, Universidad de Zamboanga (ZAEC), 87.20%;
George Garcia Vega Jr., University of saint Louis, Tuguegarao, 87.20%

Top 7:
Katrina Andrea Pagdanganan Arceo, Nueva Ecija College, 87.00%;
Rose Jean Dumaboc Capidlac, Silliman University, 87.00;
Carla Mae Tenorio Cuisia, Silliman University, 87.00;
Mary Ann Alvarez Garing, Lyceum of Batangas, 87.00;
Ma. Joya Jimenea Genzola, Colegio de san Agustin, Bacolod City, 87.00%;
Rose Anne Miranda Mungcal, Angeles University Foundation, 87.00%;
Pretzel Estremos Vicencio, Butuan Doctors College (Butuan Dr. HsP. sch. of Nursing), 87.00%;
Faye stephanie Yao Yu, Remedios T. Romualdez Medical Foundation, 87.00%

Top 8:
Lylani Mutya Balote, University of Makati, 86.80;
Jamaicca Rabulan Banting, Davao Doctors College, Inc., 86.80%;
Garey Jay Avelino Delfin, Iloilo Doctors? College, 86.80%;
Josephine Celoso Elvas, 86.80%;
Vanito Diocson Ilanga Jr., Sultan Kudarat Educational Institution, 86.80%;
Maria Edna Charise Godoy Java, Misamis University, Ozamiz City, 86.80%;
Hannah Lee Alde Padilla, University of san Agustin, 86.80%;
Bryan Morella Peralta, Univesity of Makati, 86.80%;
Robinson Uy Kaw sing, Iloilo Doctors College, 86.80%

Top 9:
Maria Jurem Quilar Alcarde, Central Philippine University, 86.60%;
Ruel Bobadilla Arzadon, Saint Louis University, 86.60%;
Karina Genciane Banayat, Our Lady of Fatima College, Quezon City, 86.60%;
Ryan Daniel Rivera Dablo, University of san Carlos, 86.60%;
Matthew Wayne Real Chang, silliman University, 86.60%;
Fritzie Quiatzon Dela Raga, Fellowhip Baptist College, 86.60%;
Hiromi Balaguer Fernandez, saint Paul University, Iloilo, 86.60%;
Josephine Franz Pagulayan Gammad, Saint Paul University, Tuguegarao, 86.60%;
Paul Fabian Robosa Gumabao, Arellano University, Manila, 86.60%;
Maila Carl Majam Morantte, Colegio De sta. Lourdes of Leyte Foundation Inc., 86.60%;
Michael Dorothy Frances Gaer Montojo, Ateneo de Davao University, 86.60%;
Cindy Mae Alvarez Na?oz, Ateneo de Zamboanga, 86.60%;
Glenda Mae Macapal Oma?a, Riverside College, 86.60%;
Rhea Jhoy Padinay Pantaleon, Saint Louis University, 86.60%;
Rolly Mendoza Policarpio, Angeles University Foundation, 86.60%;
Arlette Castillo Quinan, University of St. Louis, Tuguegarao, 86.60%;
Crystal Mae Abejuela sabela, Xavier University, 86.60%;
Katrina Isabel Hugo santos, Philippine Women?s University, Quezon City, 86.60%;
shiella Marie Gamboa simplina, Saint Louis University, 86.60%

Top 10:
James Altura Baguio, saint Mary?s University, 86.40%;
Miljoyce Daligdig Cabat, Lyceum Northwestern, 86.40%;
sarah Mae Clemente Capulong, Angeles University Foundation, 86.40%;
Johcy Angeleme Fausto De La Fuente, Central Philippine University, 86.40;
Renante Lazarte Dig-Aoan, Baguio Central University, 86.40%;
Jake Desor Diputado, silliman University, 86.40%;
Marjory Boquia Emperio, Misamis University , Ozamiz City, 86.40%,
Marissa Raposas Ferrer, Lyceum Northwestern, 86.40%;
Erika Bautista Galang, Central Luzon Doctor?s Hospital Educational Institute, 86.40%;
Francis Gerwin Uy Jalipa, san Pedro College, Davao City, 86.40%;
Angela Gilda Baltazar Mencias, Unciano Colleges & General Hospital, Manila, 86.40%;
Carina Yabut Pacete, Our Lady of Fatima University, Valenzuela, 86.40%;
Joy Jenelynn Chua Tan, University of sto. Tomas, 86.40%;
Francis Dollente Villanueva, Saint Paul University, Tuguegarao, 86.40%

To view the complete file of the November 2008 Nursing Licensure Passers, visit this site --> November 2008 Exam Results.

Nurse's Role in Psychiatric Settings Practice Exam/Test (1-10)

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Situation: A., age 15, is admitted to the unit for chronic psychiatric patients. This unit uses a token economy system as its treatment modality.

1. A token economy system is based on the principles of:

a) psychoanalytic theory
b) psychosocial theory
c) behavior modification theory
d) interpersonal theory

2. The success of a token economy system depends on:

a) consistency of all staff members in rewarding targeted behaviors
b) redemption of tokens for concrete rewards, such as candy, soda, or other snacks
c) setting behavioral goals high enough to motivate the patient
d) flexibility of staff members in allowing for slippage when the patient is having a difficult day

3. A."s treatment plan states that he will receive one token for making his bed each morning. After 2 weeks, the nurse reports that A. has not earned any tokens for making his bed. The nurse suggests that:

a) the goal remain the same; he will earn a token when he makes his bed
b) an attempt to motivate A. should be made by offering him two tokens for making his bed
c) the goal should be changed to a one-token penalty when his bed is not made
d) the goal should be modified to reflect more attainable goals at this time

4. A staff member reports that A. may be receiving tokens from other patients who feel sorry for him. Which strategy will control such donations?

a) keep an accurate account of all tokens earned and spent
b) use special, personalized tokens for A
c) penalize the other patients for giving tokens to A
d) penalize A. for accepting tokens from others

Situation: D., an 8 year old girl, is admitted to the pediatrics unit after an emergency appendectomy. Parental visits are permitted around the clock, but the nurses are concerned about Mrs. M.'s overprotective behavior. Mrs. M. is almost constantly at her daughter's side, feeding her, bathing her, and talking baby talk to her. She refuses to let D. walk and keeps her in bed to rest and regain her strength.

5. D. has a slightly elevated temperature, and the nurse notes some lung congestion. The best approach to enlist Mrs. M.'s cooperation in D.'s ambulation is to say:

a) you are not helping D. get better by keeping her in bed. She needs to move around to clear her lungs
b) the physician has told you that D. needs to walk around and get some exercise. Don't you want her to get better?
c) I want D. to get out of bed at least three times a day. Will you help me?
d) D. needs to move around more because her lungs are getting congested. Let's walk her down the hall and back

6. Mrs. M. does not allow D. to do anything for herself. When Mr. M. visits, staff members overhear the parents arguing about Mrs. M.'s babying behavior. Mr. M. asks the nurse if this behavior is normal. How should the nurse respond?

a) of course it's normal. Your daughter had emergency surgery, and your wife is anxious
b) I wouldn't be too concerned at this point. Your wife is in a crisis right now
c) I'd like to learn more about how your wife cares for D. at home
d) do you think it's normal to be so overprotective?

7. Mr. M. asks the nurse to speak with his wife about her over-protectiveness. He says that he has tried everything and that his wife refuses to change. The most appropriate intervention is to:

a) talk to Mrs. M. about her parenting behaviors
b) provide Mr. M. with a referral for family therapy
c) suggest that Mr. M. discuss the problem with D.'s physician
d) ask D. about her relationship with her parents

Situation: After D. is discharged from the hospital, Mr. and Mrs. M. decide to consult a clinical nurse specialist in family therapy.

8. During their initial visit, Mr. and Mrs. M. are asked to complete a chart of their family relationships and history through several generations. That chart is called:

a) a family tree
b) a genogram
c) a sociogram
d) mapping

9. The nurse therapist will use the chart to identify:

a) multigenerational transmission of presenting signs and symptoms
b) signs and symptoms related to the position of siblings within the family
c) family roles and responsibilities
d) family support systems

10. When the nurse therapist suggests that Mr. and Mrs. M. bring their daughter with them to the next therapy session. Mrs. M. states, "D. is too young to understand all this. Why should she be involved?" How should the nurse reply?

a) D. may not understand everything we say, but she's part of the problem and should be included
b) it sounds to me like you are trying to protect D. once again
c) perhaps we should ask D. whether or not she wants to be included in our sessions
d) you've brought up an important issue. Let's discuss why the whole family should attend.


1) C
- a token economy system uses the principle of reward from the behavior modification theory. Tokens are used to reinforce desired behaviors based on the belief that all behavior is learned. The psychoanalytic theory, which focuses on understanding the unconscious psyche, and the psychosocial and interpersonal theories, which focus on underlying personality development, are not based on reward systems

2) A
- the success of a token economy depends on the full cooperation and coordination of the staff members. Behaviorists have found that consistent rewards produce desired outcomes. All staff members must be knowledgeable about the treatment plan and consistently reward the patient's performance of targeted behaviors. Inconsistent rewards and flexibility are countertherapeutic and encourage manipulation, resistance, and noncompliance. Tokens should be redeemable for items desired by a particular patient. Although food can be used, free time, walks, library privileges, and especially praise are better reinforcers than tangible items, particularly for teenage patient. Even though the ultimate goal of behavior modification may be extinction (stoppage) of a behavior, beginning goals should be set at a level low enough so that the patient can successfully meet the goal at least part of the time and receive a reinforcer. If this does not occur, the patient will become frustrated and stop trying to change his behavior.

3) D
- goals should be realistic and attainable by the patient. Initial goals may be set rather low to motivate the patient and allow him to attain some success; lack of success can frustrate and discourage the patient. Goals should be reassessed regularly for their appropriateness. In this case, A. has made no progress after 2 weeks, so his situation should be reevaluated. The reinforcers chosen may not mean enough to A. to motivate him to make his bed; new reinforcers may be necessary. Raising the stakes by offering more tokens for a behavior that has not been attained can lead to manipulation of staff members rather than motivation of the patient. Negative reinforcement usually is reserved to discourage maladaptive behaviors, such as fighting, acting out sexually, or cursing. Rewards are given for desired behaviors, not to penalize patients for nonperformance.

4) B
- a simple, nonpunitive way to end the donations is to reward A. with personalized tokens. He must then redeem his own special tokens, enabling staff members to monitor his behavior. Keeping track of tokens earned and spent by all patients can be an effective way to monitor progress but is a formidable task. Because staff members should encourage positive, helping relationships among patients, penalizing patients for giving or receiving tokens may be misunderstood or misinterpreted

5) D
- the nurse can enlist Mrs. M.'s cooperation by teaching her that inactivity is causing her daughter's lung congestion and by assertively telling her what needs to be done. The nurse's remarks should be made in a positive firm, but nonjudgmental tone. Accusatory responses such as "You're not helping D..." and "Don't you want her to get better?" are likely to be met with defensiveness, not cooperation. These remarks also may shift the focus of the discussion to the mother's behavior rather than of walking D. Asking for Mrs. M.'s help without restating why it is important does not take advantage of the teaching opportunity presented.

6) C
- the nurse is presented with an opportunity to further assess Mrs. M.'s parenting behaviors. To determine whether her behavior is a result of the crisis or evidence of more long-standing family dysfunction the nurse should seek additional data about how Mrs. M. cares for D. at home. Offering false reassurance by telling Mr. M. that his wife's behavior is normal or that he should not worry about it without further exploring his exploring his perception of the event denies his feelings and is nontherapeutic. Asking Mr. M. if he thinks the behavior is normal puts him in an awkward position because he must then take a stand on whether his wife overprotects his child. A more effective approach is to ask Mr. M. how he feels about the behavior, which allows him to express his feelings and provides the nurse with more assessment data.

7) B
- the most appropriate nursing action in this situation is to provide Mr. M. with a referral for family therapy. This decision recognizes that family therapy is a specialized skill requiring careful assessment and analysis and much advanced preparation. Discussing would serve no purpose unless the nurse is prepared to address the problem in ongoing therapy. Suggesting that Mr. M. discuss problem with the physician is nontherapeutic because it avoids answering the question directly.

8) B
- a genogram is a drawing that charts three or more family generations. It identifies family members, dates of birth, occupations, illnesses, significant life event, and relationships. A family tree displays family members and their dates of birth and death but does not usually detail the other areas mentioned. A sociogram is a diagram that helps identify the frequency and direction of messages and communications patterns (how messages are relayed and to whom) between members of a group or family. The therapist uses the sociogram to assess and evaluate these communications patterns. Family mapping is used by a structural family therapist to assess family system characteristics, such as clear, diffuse, or rigid boundaries; subsystems; and conflicts. Boundaries are the rules defining who participates in which subsystem. Family subsystems consist of individuals, pairs, or groups that form as a result of commonalities such as sex, generation, function, or interest. Interventions are directed toward reconstructing the family organization and relationships.

9) A
- the purpose of the genogram is to help the family therapist identify patterns of multigenerational transmission of presenting signs and symptoms. Therapists who follow a systems theory framework believe that signs and symptoms have their roots in earlier generations. A family genogram often can identify patterns that on the surface appear to be isolated in the family seeking treatment. Some family therapists believe that the gender and position of siblings -- for example, oldest daughter or youngest son -- determine personality characteristics that have an impact on relationships with others and adjustments in later life. These therapists focus on the ranking of individuals within the family and are not concerned with a more comprehensive genogram. Neither family roles and responsibilities nor family support systems are designated by the genogram.

10) D
- in responding to Mrs. M., the nurse should attempt to foster trust and cooperation while helping her understand the importance of each member's participation in the family sessions. Showing acceptance of Mrs. M.'s concern by acknowledging "You have brought up an important issue...," allows the matter to be discussed without placing undue focus on D. or Mrs. M. Attacking Mrs. M.'s protectiveness or putting D. in a position against her mother is not helpful.

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Foundations of Psychiatric Nursing Practice Exam/Test (Questions 30-39)

Situation: V., age 40, is admitted to the medical unit for treatment of a peptic ulcer.

30. A nursing assistant remarks. "I don't know what's wrong with V. He never looks at me when I talk to him. He just stares at the floor." How should the nurse respond to the nursing assistant?

a) I wouldn't worry about it. That's just how some people are
b) when I give him his medication, I'll ask him if he is aware that he does this
c) you need to develop more patience with V. It takes time for patients to feel at ease in the hospital
d) what seems to bother you most about V.'s not looking at you?

31. The nurse can help the nursing assistant understand patient responses that are different from her own by explaining the importance of:

a) accepting the patient's way of responding and treat all patients alike
b) suppressing any feelings of discomfort or anxiety that the patient's behaviors create
c) evaluating behaviors in the context of the patient's cultural background
d) confronting the patient about his behaviors in order to understand their meaning.

Situation: The nurse has been caring for G., a 58 year old chronic paranoid schizophrenic patient, for several months. She has held several one-on-one sessions with him. During this particular session, he appears more anxious than usual.

32. At the beginning of the session, G. speaks quite rapidly and loudly. This behavior indicates a possible change in which form of nonverbal communication?

a) appearance
b) kinesics
c) paralanguage
d) proxemics

33. Still speaking loudly, G. says, "Speak up! You talk too softly. Who could carry on a conversation with someone who sounds like a squeaky little mouse?" According to Berne's theory of communication, the patient is communicating from which "ego state"?

a) parent
b) adult
c) adolescent
d) child

34. Besides his loud, rapid speech, G. swings his feet and rapidly taps his fingers on the arm of the chair. Yet he says, "I certainly feel calm today, I didn't life could be so tranquil." Which response by the nurse is most appropriate?

a) I'm glad to hear you are feeling calm and settled this morning
b) you tell me that you are calm, but your body seems to be sending a different message
c) I think we should talk about how calm the weather is today
d) I'm glad you are feeling so calm. Things will be better for you now -- you can count on that

35. G.'s anxiety level takes a toll on the nurse, and she feels her body tensing. The nurse momentarily questions the therapeutic quality of her listening skills. Which behavior on the nurse's part indicates her decreased attention to G.'s problems?

a) moving her chair so she directly faces G.
b) leaning forward toward G.
c) maintaining direct eye contact
d) crossing her arms and legs

36. Which statement is most appropriate to end the one-to-one session with G.?

a) your body seems more relaxed now, G.
b) today we talked about how your body can provide clues to your feelings
c) did you think today's session was of value to you?
d) I'm going to lunch now, our time is up

Situation: D., age 21, has just been admitted to the inpatient psychiatric unit. Her facial expression indicates severe panic, and she repeatedly states, "I know the police are going to shoot me. They found out that I'm the daughter of the devil."

37. To initiate a therapeutic nurse-patient relationship with D., the nurse should say:

a) you certainly look stressed, D. Can you tell me about the upsetting events that have occurred in your life recently?
b) hello, my name is A. I'm a nurse, and I will care for you when I am on duty. Would you like me to call you D., or do you prefer something else?
c) you are having very frightening thoughts. I will help you find ways to cope with this scary thinking
d) hello, D. I am going to be caring for you while I am on duty. You look very frightened, but by tomorrow I'm sure you'll feel better

38. After the assessment and intake procedures are completed, the nurse explains that she will try to be available to talk with D. when needed and that she will spend time with her each morning from 10:00 until 10:30 in a specific corner of the dayroom. The main rationale for communicating these planned nursing interventions is to:

a) provide a structured environment for D.
b) instill hope for D.
c) attempt to establish a trusting relationship
d) provide time for completing nursing responsibilities

39. During the first few one-to-one sessions, D. seems eager to talk, discusses her problems readily, and makes great efforts to focus on and describe her experiences. Then she begins to "forget" to come to scheduled sessions. When she does come, she seems suspicious and reluctant to talk. What is he most likely explanation for her behavior?

a) D. is fearful that she has revealed too much and that the nurse will now reject her; she is temporarily retreating to a safe distance
b) D. has found one-to-one sessions to be too personally intrusive and is attempting to protect her privacy
c) D.'s suspiciousness indicates that her symptoms have not responded to treatment and that her medication should be reevaluated
d) D. and the nurse are in a personality conflict, and the nurse should consider transferring the patient to another primary nurse


30) D
- effective communication is based on self-understanding. Exploring the nursing assistant's feelings and responses to the patient's behavior facilitates the development of self-awareness, a prerequisite to planning a therapeutic response. Denying the assistant's feelings of frustration without exploring their cause or intervening with the patient on behalf of the assistant at this point would not be helpful to the assistant. Asking the assistant to have more patience may stop her from exploring her feelings about the situation. By exploring the assistant's feelings, the nurse can help her understand the mental health needs of the patient.

31) C
- to assess the patient's needs, the nursing assistant must take into account the patient's cultural influences, values, beliefs, attitudes, and verbal and nonverbal behavior. In some cultures, looking down is a sign of respect. All patients are different and should be treated as individuals. The nurse should encourage the assistant to discuss her discomfort or anxiety rather than suppress it. She should not recommend confronting the patient because this will cause him to feel alienated.

32) C
- paralanguage is the use of vocal effects, such as tone and tempo, to convey a message. Appearance is to the way people look. Kinetics involves body language or movement. Proxemics is the use of spatial relationships (distance between people) during interaction to communicate learning.

33) A
- the transactional analysis model consists of three ego states -- parent, adult, and child. Each ego state is unique, yet all three combine to form one personality. Berne's parent ego state includes the aspects of critical parent and nurturing parent. G. sounds like a "critical parent" and therefore is communicating from the parent ego state. A patient communicating from child ego state would exhibit feelings formulated during childhood, such as fear of authority figures. A patient communicating from the adult ego state would appear rational and capable of coping with feelings and situations in a logical manner. Berne's theory does not include an adolescent ego state.

34) B
- using confrontation to call attention to the discrepancy between what the patient says (verbal communication) and how he behaves (nonverbal communication) can help the patient become aware of his true feelings. Nonverbal behavior usually is a more precise indicator of feelings. Responses that ignore the incongruent behavior are not therapeutic.

35) D
- crossing the arms and legs can be a sign of defensiveness and decreased involvement with others. Signs of attentiveness and interest include facing another person squarely, leaning forward, and maintaining direct eye contact.

36) B
- summarizing at the end of a one-to-one session helps reinforce the most significant information discussed. Observations about how relaxed the patient appears are more appropriate during the session. Questions that elicit a "Yes" or "No" response are generally nontherapeutic to the patient. The nurse's telling the patient that she is now going to lunch does not focus on the patient and is therefore inappropriate.

37) B
- the first task during the introductory, or orientation phase of the nurse-patient relationship is to formulate contract, which begins with the exchange of names and an explanation of the roles and limits of the relationship. These tasks should precede the exploration of relevant stressors and new coping mechanisms. Offering false reassurance is never therapeutic.

38) C
- availability, reliability, and consistency are critical factors in establishing trust with patients. Being specific about the time and place of meetings helps establish trust, which is the initial main objective. Although important, structuring the environment and instilling hope are not the primary tasks at this time. Arranging a regular meeting with the patient allows the nurse to plan her work load, but it is not a major reason for such scheduling.

39) A
- patients often are fearful that if they reveal themselves initially, the nurse will reject them, as others have done in the past. D. may or may not be aware that she is pulling back from the nurse. Her behavior actually is an indication of her potential to trust and should be considered a normal response at this point in the nurse-patient relationship. No evidence exists to support the other explanations.

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Foundations of Psychiatric Nursing Practice Exam/Test (Questions 21-29)

Situation: F., age 18, returns home from school to discover that her mother has been in a serious automobile accident.

21. F. initially responds to the news by yelling, "No, I don't believe it. It can't be true." F. is using which defense mechanism?

a) introjection
b) suppression
c) denial
d) repression

22. F. excuses herself from the hospital to go home by saying to her father, "I have to go home. I can't stay awake anymore, and I've been here most of the day." Which defense mechanism is F. using?

a) reaction formation
b) rationalization
c) denial
d) regression

23. On arriving home, F. encounters neighbors who ask about her mother's condition. F. tells them all the details unemotionally and without feeling upset. This behavior illustrates her use of:

a) displacement
b) introjection
c) intellectualization
d) conversion

Situation: W., a 27 year old secretary, is brought to the hospital in an agitated state. She is admitted to the psychiatric unit for observation and treatment.

24. The nurse enters W.'s room for the first time and says, "W., I'm E., the nurse. I'll help you get settled." W. responds, "I want another nurse. I don't like you. You're mean." The nurse recognizes that W.'s response in an example of:

a) identification
b) regression
c) countertransference
d) transference

25. Before responding to W.'s initial outburst, the nurse should:

a) make sure she is a safe distance from the patient
b) move closer to the patient to show that she is not afraid
c) assess her own feelings and responses to the patient's behavior
d) recognize that it takes time for relationships to develop and not feel hurt

26. What would be the most therapeutic initial response by the nurse?

a) say nothing, accept what the patient has said, and remain nearby
b) say, "W., we've just met. Why do you think I'm mean?"
c) say, "I'm only trying to be helpful. Let me help you put your things away."
d) say, "I'll be back in half an hour," then leave the patient's room

27. as W. puts her things away, she talks rapidly and folds and unfolds her clothes several times. She cannot seem to settle down. Which nursing diagnostic category is most applicable initially?

a) self-care deficit
b) anxiety
c) impaired verbal communication
d) powerlessness

28. The nurse needs to complete W.'s admission interview. In light of the patient's initial behavior, which nursing approach is best?

a) allow W. as much time as she needs to arrange her clothes and belongings
b) recognize that W. is upset, but stress that the admission interview must be completed
c) tell W. that her repetitious behavior is interfering with the interview and that she must stop and cooperate
d) suggest that W. finish arranging her belongings later, and mention that she needs to complete her admission interview

29. The best way to continue W.'s mental status interview is to ask:

a) why are you here W.?
b) what events led to your coming to the hospital?
c) what do you want us to do for you while you are here
d) tell me about your family. W . . .


21) C
- denial is the avoidance of reality by ignoring or refusing to acknowledge unpleasant incidents. This defense mechanism is used to allay anxiety immediately following a stressful event. Introjection is an intense form of identification in which a person incorporates the values or qualities of another person or group into his own ego structure. Suppression is the conscious analog of repression. A person uses suppression intentionally and consciously excludes material from awareness. Repression is the unconscious exclusion of painful episodes from awareness

22) B
- Rationalization is the offering of a socially acceptable or logical reason for doing, feeling, or behaving in a way that might not be otherwise acceptable. Reaction formation is the development of attitudes or behaviors that are opposite of what one actually feels or wants to do. Denial is avoiding reality by ignoring unpleasant events. Regression is a return to behaviors that reflect an earlier developmental level

23) C
- intellectualization is the splitting off the emotional part of an idea, impulse, or act. The emotional aspect then is repressed, either temporarily or over the long term. Displacement is discharging feelings in an indirect way perceived as safe. Introjection is an intense identification in which an individual incorporates another person's or group's values or qualities into his own ego structure. Conversion is the transfer of a mental conflict into a physical symptom.

24) D
- when a patient's response to the nurse is extremely negative or extremely positive with no apparent basis, transference of feelings from another relationship is probably occurring. If the nurse has similar unwarranted responses to the patient, countertransference is taking place. Identification is a defense mechanism in which the patient adopts the characteristics of the nurse. Regression is a retreat to behaviors manifested during an earlier developmental level

25) C
- the nurse must first identify her feelings toward the patient and use them as a guide to determine an appropriate response. An accurate assessment of the distance needed between the nurse patient is possibly only if the nurse assesses her own response first. The nurse's recognition hat trust takes time to develop may be useful in planning an appropriate response; however, the nurse should identify her feelings about the patient before formulating a response.

26) A
- displaying an accepting attitude of the patient's negative response helps foster trust. It also demonstrates the nurse's interest in and concern for the patient without challenging the patient, denying the patient's feelings, or leaving the patient alone. The patient probably cannot verbalize why she feels the way she does; challenging her will only increase her anxiety and make her feel more vulnerable. By emphasizing that she is only being helpful, the nurse implies that the patient's feelings are erroneous. Leaving the room serves no purpose and may exacerbate the patient's anxiety by increasing her feelings of aloneness and introducing a feeling of desertion.

27) B
- anxiety is an appropriate nursing diagnostic category initially because the patient's behavior mimics some of the objective signs of anxiety, which include restlessness, irritability, rapid speech, inability to complete to complete tasks, and verbal expressions of tension. The other diagnostic categories -- self-care deficit, impaired verbal communication, and powerlessness --- are premature because the nurse has not had an opportunity to complete a thorough nursing assessment.

28) D
- establishing priorities and communicating them to the patient in a clear, nonjudgmental way is important. Suggesting that the patient can continue her activities. Later demonstrates acceptance of the patient's behavior yet helps the nurse complete the admission interview in a timely manner. Emphasizing the nurse's need to complete the interview shifts the focus from the patient to the nurse.

29) B
- obtaining the patient's perspective of the events lading to her admission is an excellent source of assessment data. "Why" questions should be avoided because they require analysis of the problem and often produce anxiety. Finding out about the patient's family and her goals for treatment are important but should be discussed later.

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NCLEX Endocrine Questions (1-7)

Situation: Maria, 48 years old, is a known diabetic type 1. She has often consulted her internist for medication. She asks you if she can get well.1. If Maria asks you what to take for medication, you would answer that she;

a) must try other alternative
b) could consult other doctors
c) can't take a herbal medicine
d) has to follow doctor's prescription

2. One party time, you saw Maria eating a big piece of cake. As a concerned nurse you would tell her

a) it's okay Maria, it's party time anyway
b) why are you hard-headed Maria
c) Maria stop eating the cake
d) Maria, remember that you are taking medicine for diabetes

3. The next morning Maria said she did not feel well, you would say

a) see your doctor once
b) come let me assess your health status
c) I told you so
d) have your blood sugar checked

4. Upon checking, Maria was having hyperglycemia, you tell Maria to;

a) drink plenty of water
b) have a good rest
c) take her prescribed insulin
d) see her doctor right away

5. The following are nursing interventions when administering insulin except:

a) administer insulin at room temperature
b) rotate site of injection
c) aspirate cloudy insulin before clear insulin to combine in one syringe
d) shake insulin vial gently to redistribute insulin particles

6. To prevent lipodystrophy due to insulin injection, the nurse should do the following except:

a) inject insulin at room temperature
b) rotate the site of injection
c) inject insulin between layer of fats and muscles
d) introduce insulin rapidly

7. Among the topics you will include as priority in health teaching to Mario is:

a) nutrition and diet therapy
b) daily foot care
c) good exercise daily
d) prevention of complication

NCLEX Endocrine Questions:

1) D
- The nurse must tell the patient to follow doctor's prescription. Type 1 or insulin dependent DM (IDDM), is characterized by lack of insulin production so that the patient would require insulin injection throughout life. At present, this is the only available treatment of IDDM.

2) D

3) D
- the most common problem of diabetics is related to their sugar control which could be hypoglycemia or hyperglycemia. The initial response of the nurse to complaint of not feeling well by the patient would be to check the patient's blood sugar level.

4) C
- the most important management for hyperglycemia is to take insulin. Hyperglycemia occurs when insulin is not enough to transport glucose from the blood to the cells causing blood glucose to rise to abnormal levels. Common causes of hyperglycemia are:
  • inadequate insulin injection
  • skipping insulin injection
  • increased insulin need: pregnancy, trauma, surgery, infection, stress, puberty
  • insulin resistance due to the presence of insulin antibodies
In the absence of glucose, fat stores are mobilized as an alternate source of energy. The end product fats metabolism, however, are ketone bodies. As more and more fats are burned, more ketone bodies are produced. Ketones, then, accumulate because the body cannot excrete them in the same speed as they are being produced resulting to ketoacidosis. Ketoacidosis is the most common complication of hyperglycemia.

5) C
- insulin is administered at room temperature to prevent lipodystrophy and minimize discomfort.
It is important to rotate sites of insulin injection in order to avoid tissue damage. The instructions to the patient regarding site for insulin injection are:
  • do not use the same site more than once in one month
  • avoid areas above muscles that will be used for exercise during the day or where heat will be applied as it will cause more rapid absorption
  • the abdomen is the site because of it's more rapid and even rate of absorption
  • change injection area until the whole site has been used. Sites for injection should be spaced about one inch apart. This is in order to avoid sudden changes in absorption rate
  • the areas of absorption are the abdomen (fastest absorption), deltoid, upper thigh and the hip
  • pressure may be applied over the site but do not massage after injection as this will alter absorption rate.
Insulin Storage Instructions:
  • unopened vials should be refrigerated
  • opened vials can be stored at room temperature
  • prefilled syringes can be stored for up to 3 weeks in the refrigerator with the needles pointing upward to prevent suspended particles from clogging the needle
  • insulin should not be left in the car or checked in airline baggage because of potential changes in temperature
Mixing Insulin:
  • two types of insulin is usually recommended to diabetic patient's in order to achieve a more effective diabetic control. Insulin may be mixed so that the patient will only one have injection. Patient instructions regarding insulin mixing are:
  • do not mix human and animal insulin
  • NPH and PZI insulin can be mixed only with regular insulin
  • Lente insulin may be mixed with each other but it is not recommended to mix it with regular, NPH or PZI insulin.
  • withdraw clear or regular insulin first before cloudy insulin to prevent contaminating the clear insulin with the cloudy insulin
  • gently rotate cloudy insulin before withdrawing the drug from the vial. Experts now believe that it is alright to shake insulin vials in order to mix insulin thoroughly.
6) C
- lipodystrophy occurs when tissue changes occur due to repeated insulin injection. It can be in form of hypertrophy or atrophy. The tissue affected feels hard under the skin and it is often caused by using the same site for injection repeatedly and with porcine and beef insulin.

Measures to prevent lipodystrophy include:
  • rotate site of injection
  • inject insulin at room temperature
  • if it develops, do not use the site o at least 6 months to allow it to heal
To minimize discomfort:
  • avoid injecting air bubbles
  • do not change direction of the needle once it is inside the skin
  • do not inject insulin straight out of the refrigerator
  • don't use dull needle
  • wait until alcohol has dried completely before injecting
  • penetrate the skin quickly with the needle. Aspiration is not a routine
Insulin should be injected at the subcutaneous tissue. Injecting it in the muscle will increase absorption rate and can lead to fluctuations in the blood glucose level. It is injected at 90 degree angle. If the patient is very thin. It is injected at 45 degree angle to avoid the needle reaching the muscle layer.

7) A
- the most important aspect of health teaching to diabetics is regarding their nutrition and diet therapy.

Nutrition and Diet Therapy for Diabetics:
  • avoid fasting as it causes hypoglycemia
  • avoid feasting as it causes hyperglycemia
  • eat before exercising to prevent hypoglycemia
  • have a bedtime snack especially if taking insulin snacks to prevent hypoglycemia while asleep
  • distribute food intake to 6 small meals a day to maintain blood sugar level and prevent sudden surges in blood sugar
  • alcohol affects blood sugar
  • stress, anxiety and illness affect blood sugar level and insulin requirements may need to be adjusted
Teach patient that compared to fats and protein, carbohydrates have the greatest impact on blood sugar.
  • carbohydrates should provide between 50% and 60% of the daily caloric intake
  • complex carbohydrates found in whole grains and vegetables are preferred over those found in starch-heavy foods, such as pastas because they are longer to digest causing glucose from these type of carbs to be released slowly in the blood preventing a sudden rise in serum glucose level.
  • simple sugars, either as sucrose or fructose, increases blood glucose levels quickly, and provides no other nutrients
  • avoid food with high glycemic index. Glycemic index refers to how quickly a food can raise blood glucose. Foods that raise blood glucose quickly have high glycemic index such as simple sugars and starches. Foods with low glycemic index include high fiber foods such as insoluble fiber found in wheat bran, whole grains, seeds, nuts, legumes, and fruit and vegetable peels and soluble fiber found in dried beans, oat bran, barley, apples, citrus fruits, and potatoes.
Protein should provide 12% to 20% of calories
  • fish is probably the best source of protein for heart protection as it can help lower blood pressure, triglyceride levels, and tendency for blood clots, and the risk for stroke
  • soy is rich in both soluble and insoluble fiber, omega-3 fatty acids, and provides all essential proteins. Soybeans also contain natural compounds that may reduce LDL (harmful cholesterol) and triglycerides and increase HDL (beneficial cholesterol). The best sources are soy products (tofu, soymilk) or whole soy protein
Avoid harmful fats such as saturated fats and trans fatty acids to maintain normal cholesterol levels.
Saturated fats are mostly found on animal products, including meat and dairy products.
Trans fatty acids are manufactured fats which are used at stabilizing polyunsaturated oils to prevent them from becoming rancid and to keep them solid at room temperature.
Good fats include polyunsaturated fats that are found in safflower, sunflower, corn, and cottonseed oils and fish; and monosaturated fats found in olive, canola, and peanut oils and in most nuts. Some studies have reported that replacing carbohydrates with monosaturated fats improves glucose control after meals and reduces triglycerides in people with type 2 diabetes.

After you reviewed your answers through its rationale, you can now proceed to the next set of questions: 

NCLEX Endocrine Questions (8-14)

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    Psychiatric Nursing Degree Questions - Foundations of Psychiatric Nursing (11-20)

    Psychiatric Nursing Degree Questions

    11. Which of the following is a generally accepted criterion of mental health?

    a) self-acceptance
    b) absence of anxiety
    c) ability to control others
    d) happiness

    12. The basis for a therapeutic nurse-patient relationship begins with the nurse's:

    a) sincere desire to help others
    b) acceptance of others
    c) self-awareness and understanding
    d) sound knowledge of psychiatric nursing

    13. Which of the following should occur during the working phase of the nurse-patient relationship?

    a) the nurse assesses the patient's needs and develops a plan of care for the patient
    b) the nurse and the patient together evaluate and modify the goals of the relationship
    c) the nurse and the patient discuss their feelings regarding the termination of the relationship
    d) the nurse and the patient explore each others expectations of the relationship

    14. The nurse should introduce information about the end of the nurse-patient relationship:

    a) during the orientation phase
    b) as the goals of the relationship are reached
    c) at least one or two sessions before the last meeting
    d) when the patient is able to tolerate it

    15. One example of the psychiatric nurse's role in primary prevention is:

    a) handling crisis intervention in an outpatient setting
    b) visiting the patient's home to discuss medication management
    c) conducting a post-discharge support group
    d) providing sex education classes for adolescents

    16. the most effective way for the nurse to set limits for newly admitted patient who puts out his cigarettes on the dayroom floor is to:

    a) restrict the patient's smoking to times when he can be closely supervised by a staff member
    b) encourage other patients to speak with the patient about dirtying the dayroom floor
    c) ask the patient if he puts out his cigarettes on the floor at home
    d) hand the patient and astray and tell him he must use it or he will not be allowed to smoke

    17. A busy woman attorney with a successful law practice is admitted to the acute care hospital with epigastric pain. Since admission, she has called the nurse every 15 minutes with one request or another. The patient exhibiting:

    a) repression
    b) somatization
    c) regression
    d) converson

    18. G. Lost an important advertising account and had a flat tire on the way home. That evening, he began to find fault with everyone. Which defense mechanism is he using?

    a) displacement
    b) projection
    c) regression
    d) sublimation

    19. Which primary unconscious defense mechanism keeps highly anxiety-producing situations out of conscious awareness?

    a) introjection
    b) regression
    c) repression
    d) denial

    20. J. age 17; rarely expresses his feelings and usually remains passive; however, when he is angry, his face typically becomes flushed and his blood pressure rises to 170/100 mm Hg. His parents are described as passive and easygoing. J may be using which defense mechanism to handle anger?

    a) displacement
    b) introjection
    c) projection
    d) sublimation

    Psychiatric Nursing Degree Questions:

    11) A
    - Rationale: self-acceptance is a generally accepted criterion of mental health and serves as the basis for healthy relationships with others. Some degree of anxiety is necessary to stimulate growth and adaptation. Self-control and self-direction rather than the ability to control others are indicative of mental health. Happiness, though desirable, is not an effective indicator of mental health because even mentally healthy people are unhappy when faced events and illness, loss, and death.

    12) C
    - Rationale: Although all the choices are certainly desirable, knowledge of self serves as the basis for building a strong therapeutic nurse-patient relationship. Then nurse must be aware and understand her feelings and behavior before she can understand and help others.

    13) B
    - Rationale: the therapeutic nurse-patient relationship consists of four phases; Preinteraction, introduction or orientation, working, and termination. In the working phase, the nurse and the patient together evaluate and refine the goals established in the orientation phase. In addition, major therapeutic work takes place, and insight is integrated into a plan of action. The orientation phase involves assessing the client, formulating a contract, exploring feelings, and establishing expectations about the relationship. In the termination phase, the nurse prepares the patient for separation and explores feelings about the end of the relationship.

    14) A
    - Rationale: preparation for ending the nurse-patient relationship begins during the orientation phase, when the limits of the relationship are established. Termination also should be discussed as goals are achieved and the relationship nears an end. Although the nurse should remind the patient that only one or two sessions are left, she must not wait until then to prepare the patient for the relationship's termination. Waiting until the patient can tolerate ending the relationship also is too late. Because many patients have had negative experience when ending relationships, the nurse can use termination of the nurse-patient relationship to prepare the patient for -- and work him through -- positive termination experiences with others.

    15) D
    - Rationale: the psychiatric nurse participates in primary, secondary, and tertiary prevention activities. Primary prevention includes providing sex education classes for adolescents and education programs that promote mental health and prevent future psychiatric episodes. Secondary prevention involves treatment to reduce psychiatric problems. Crisis intervention in an outpatient setting is one example of secondary prevention. Administering and supervising medication regimens and participating in the therapeutic milieu are other means of secondary prevention. Tertiary prevention involves helping patients who are recovering from psychiatric illness; activities that are directed toward providing aftercare and rehabilitation are part of this role. Conducting a post discharge support group is a tertiary prevention activity.

    16) D
    - Rationale: setting limits is necessary to help patients behave in socially acceptable ways. By handling the patient an ashtray and clearly stating that he must use it or he will not be allowed to smoke, the nurse is setting limits on his behavior. Because he is a newly admitted patient, the nurse need to restate these limits in a manner that shows disapproval of the behavior but does not reject him as a person. A manner-of-fact, nonpunitive tone of voice is important. If the patient does not comply, he must face the consequences, in this case, not to be allowed to smoke. If the patient's mental status is such that he cannot understand or follow these limits, his smoking may need to supervised. Encouraging other patients to deal with new patient is not advisable. asking the patient if he puts out cigarettes on the floor at home has no bearing on whether this behavior is acceptable in the hospital.

    17. C
    - Rationale: the patient is exhibiting the defense mechanism of regression - - a return to behaviors characteristic of an earlier developmental level. Her dependent, attention-getting behavior is an attempt to relieve anxiety. Repression would be evidenced by ignoring the symptoms. Somatization is the channeling of anxiety into a preoccupation with physical complaints. Conversion involves the transfer of a mental conflict into a physical symptom to relieve anxiety.

    18) A
    - Rationale: G is using displacement, a mechanism in which the patient discharges his feelings of anger and rejection in an indirect way that he perceives as safe - - in this situation, by displacing his anger from work and car problems onto family members. Projection is attributing one's emotion to -- or blaming them on -- others. Regression is a retreat to earlier levels of developmental behavior to relieve anxiety. Sublimation is a socially acceptable discharge of psychic energy or anger, such as through exercise or some other productive activity.

    19) C
    - Rationale: Repression, the unconscious exclusion of painful or conflicting thoughts, impulses, or memories from awareness, is the primary ego defense. Other defense mechanisms tend to reinforce the anxiety. Introjection is an intense identification in which an individual incorporates another person's or group's values or qualities into his own ego structure. Regression is a retreat into an earlier developmental level in a time of stress. Denial is avoidance of unpleasant realities by ignoring them.

    20) B
    - Rationale: J may be introjecting his parent's belief that anger should not be outwardly expressed. He also may be holding in his angry feelings, as evidenced by his increased high blood pressure. (Increased blood pressure is a common physiologic reaction to the fight-or-flight response brought on by strong emotions. Habitual failure to express anger may contribute to hypertension.) Displacement is the discharge of negative feelings onto another person or an object. Projection is the attribution of one's own thoughts or impulses to another person. Sublimation is the channeling of unbearable or socially unacceptable behaviors to more socially acceptable outlets.

    Go to the next page: Psychiatric Nursing Degree Questions - Foundation of Psychiatric Nursing (21-29)  

    Or go back to Psychiatric Nursing Degree Questions - Foundation of Psychiatric Nursing (1-10) to start the test from the beginning.

    Psychiatric Nursing Degree Questions - Foundations of Psychiatric Nursing (1-10)

    Welcome to the Psychiatric Nursing Degree Questions - Foundations of Psychiatric Nursing. Before you begin answering this questions, I recommend that you read this special offer that will surely help you to pass your NCLEX Licensure Examination:

    Enjoy answering and I hope that this site: NCLEX Review and Secrets can somehow help you in your future nursing licensure examination. Good Luck.

    1. The nurse can use self-disclosure with a patient if:

    a) she has experienced the same situation as the patient
    b) the patient asks her directly about his experience
    c) it helps the patient to talk more easily
    d) it achieve a specific therapeutic goal

    2. The nurse who uses self-disclosure should:

    a) refocuses on the patient's experience as quickly as possible
    b) allow the patient to ask questions about her experience
    c) discuss her experience in detail
    d) have the patient explain his perception of what the nurse has revealed

    3. During the mental status examination a patient may be asked to explain several proverbs, such as "Don't cry over spilled milk." The purpose is to evaluate the patient's ability to think:

    a) rationally
    b) concretely
    c) abstractly
    d) tangentially

    4. The terms judgment and insight sometimes are used incorrectly. Insight is the ability to:

    a) make appropriate choices
    b) control inappropriate impulses
    c) explain one's psychiatric diagnosis
    d) understand the nature of one's problem or situation

    5. The nurse documents, "The patient described her husband's abuse in an emotionless tone and with a flat facial expression. "This statement describes the patient's:

    a) feelings
    b) blocking
    c) mood
    d) affect

    6. Although a patient changes topics quickly while relating his past psychiatric history, the nurse is able to follow his thoughts. The patient's pattern of thinking is called:

    a) looseness of association
    b) flight of ideas
    c) tangential thinking
    d) circumstantial thinking

    7. The nurse who suspects that a patient's behavior has a cultural basis should:

    a) read several articles about the patient's culture
    b) ask staff members of a similar culture about the patient's behavior
    c) observe the patient and his family and friends interacting with each other and other staff members
    d) accept the patient's behavior because it is probably culturally based

    8. Which contribution of the psychoanalytic model is particularly useful to psychiatric nurses?

    a) all behavior has meaning
    b) behavior that is reinforced will be perpetuated
    c) the first 6 years of a person's life determine his personality
    d) behavioral deviations result from an incongruence between verbal and non-verbal communication

    9. According to Freud's psychosexual theory, the ego has several functions, one of which is to:

    a) serve as the source of instinctual drives
    b) stimulate psychic energy
    c) operate as a conscience that controls unacceptable drives
    d) test reality and direct behavior

    10. Erikson described the psychosocial tasks of the developing person in his theoretical model. The primary developmental task of the young adult (age 18 to 25) is:

    a) intimacy versus isolation
    b) industry versus inferiority
    c) generativity versus stagnation
    d) trust versus mistrust

    Try to read the latest type of cancer, it might be included in the exam --> Mesothelioma Cancer

    Psychiatric Nursing Degree Questions:

    1) D
    - Rationale: self-disclosure, making personal statements about oneself, can be a useful tool for the nurse. However, the nurse should use self-disclosure judiciously and with a specific therapeutic purpose in mind. The nurse should listen to the patient closely and remember that experiences are sometimes similar but never the same for different people. Too many self-disclosures can shift the focus from the patient to the nurse. Self-disclosure that distracts the patient from treatment issues does not benefit the patient and may alienate him from the nurse.

    2) A
    - Rationale: the nurse's self-disclosure should be brief and to the point so that the interaction can be refocused on the patient's experience. Because the patient is the focus of the nurse-patient relationship, the nurse should not dwell upon her experience.

    3) C
    - Rationale: Abstract thinking is the ability to conceptualize and interpret meaning. It is a higher level of intellectual functioning than a concrete thinking, in which the patient would explain the proverb by its literal meaning. Rational thinking involves the ability to think logically, make judgments, and be goal directed. Tangential thinking is scattered, non-goal-directed, and difficult to swallow. Patients with such conditions as organic brain disease and schizophrenia typically are unable to conceptualize and comprehend abstract meaning. They interpret such statements as "Don't cry over spilled milk" in a literal sense, such as "Even if you spill your milk, you shouldn't cry about it."

    4) D
    - Rationale: Insight is the degree to which the patient understands a situation or problem and its effect on his life. Judgment is the ability to make decisions and behave in an appropriate manner. Although a patient may be able to explain his psychiatric diagnosis, he may not have enough insight to understand the underlying problem and how it is affecting his life.

    5) D
    - Rationale: Affect refers to one's emotional expression, in this case the manner in which the patient talks about her experiences. feelings are emotional states or perceptions. Blocking describes the interruption of thoughts. Moods are prolonged emotional states expressed by the affect.

    6) B
    - Rationale: Flight of ideas describes a thought pattern in which a patient moves rapidly from one topic to the next with some connection. Looseness of association describes a pattern in which no logical connection between ideas is apparent. Tangential thoughts seem to be related but miss the point. A circumstantial thought pattern is exhibited when a patient talks around the subject and includes much unnecessary information

    7) C
    - Rationale: Assessing the patient's interactions with others helps to determine whether the behavior is part of his usual pattern. It also may help the nurse to understand the meaning of the behavior for this particular patient. Reading about a different culture, consulting other staff members, and talking with the patient also are helpful once the nurse has observed the patient's interaction with others. Although the nurse must be able to accept the patient as an individual, she need not accept behaviors that are unhealthy or inappropriate. The nurse should work with the patient to better understand the cultural differences and to help him change any unhealthy or unacceptable behaviors, such as unwarranted sexual advances.

    8) A
    - Rationale: The principle that all behavior has meaning is of particular importance to the psychiatric nurse. It is the basis for the nurse's assessment and analysis of the patient's behavior, which reflects his needs. Psychoanalytic theory also proposes that the first 6 years of a person's life determine his later personality. These early influences are difficult if not impossible to counteract. However, this assumption is less useful to the nurse in planning interventions that meet the patient's current needs. Reinforcement as a means of perpetuating behavior is associated with behavioral theory, not the psychoanalytic model. Similarly, incongruence between verbal and nonverbal communications is apart of communications theory.

    9) D
    - Rationale: The ego tests reality and directs behavior by mediating between the pleasure-seeking instinctual drives of the id and the restrictiveness of the super ego. The super ego also is called the conscience. The id is the source of psychic energy.

    10) A
    - Rationale: the primary developmental task of the young adult is to develop intimacy with another person while making choices about relationships and career. Industry, a task associated with 6 to 12 year old, involves active socialization as the child moves from family into society; much of the child's energy is focused on acquiring competency. Generativity is associated with middle age and is characterized by parental responsibility and concern for future generations. The task of trust is typical of infancy. It is accomplished when the infant receives adequate mothering and his oral needs are met.

    After you reviewed your answers through its rationale, you can now proceed to the next set of questions: 

    Psychiatric Nursing Degree Questions (11-20)

    You can also check our main page for the different Compilation of NCLEX Practice Questions