Question 1

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During the period of enlightenment, a social reformer who believed that the society was obligated to
those who were mentally ill and promoted adequate shelter, nutritious food, and warm clothing, paved
the way to a more moral treatment of the mentally ill, by the name of:

a.

Eugene Bleuler

b.

Dorothea Lynde Dix

c.

Leonardo da Vinci

d.

Aristotle

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The correct answer is: Dorothea Lynde Dix

Question 2

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While doing her interaction with the client, the nurse practices active listening and focuses on the clients
energies. The nurse also clarifies preconceptions and expectations of the nurse to the client. On what
phase of the nurse-client relationship are they in?
a.

Exploitation

b.

Termination

c.

Identification

d.

Orientation

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The correct answer is: Orientation

Question 3

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The client begins to pace and clench his fist. What should the nurse do in this instance?

a.

call security service

b.

explore the meaning of the behavior

c.

leave the room

offer an injection of Haloperidol (Haldol)

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The correct answer is: leave the room

Question 4

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SITUATION: Mr. Bean, a 3rd year student of University of Cebu was assigned in the male ward of the
Center for Behavioral Sciences in VSMMC. He encountered patients with different diagnoses. Some were
hesitant to interact to the people around and some were also aggressive and energetic. Mr. Bean then
reviewed what he had learned in his Psychiatric Nursing class. Mr. Bean recalls that this is defined as not
merely the absence of mental disorder, rather it originates in a persons biology and then is
demonstrated in the type, quantity, quality of the individuals perception, thoughts, emotions and
behaviors.

a.

Mental Health

b.

Mental Illness

c.

Psychiatric Nursing

d.

Mental Challenge

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The correct answer is: Mental Health

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SITUATION: Ms. Howard is a 19-year old nursing student of Concord University who is about to have her
clinical experience in the Psychiatric ward of a local hospital. She is part of a group of students who were
given the opportunity to care for the mentally-ill patients. Before the said exposure, she must take into
consideration the different principles related to therapeutic communication and the therapeutic nurse-
client relationship. The theorist who defined nursing as a significant , therapeutic, interpersonal process
is:

a.

Sr. Callista Roy

b.

Dorothea Orem

c.

Betty Neuman

d.

Hildegard Peplau

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The correct answer is: Hildegard Peplau

Question 6

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Sad to say, a stigma has been associated to Mental illness. As nurses, one of our role as client advocates
is to reduce that stigma. Which statement most clearly shows stigma with respect to mental illness?

a.

The main reason for mental illness is that mothers are working instead of staying home with their
children

b.

People with mental illness are too weak to overcome their emotions

c.

Biological, personal, environmental and sociocultural factors influence the development of Mental
Illness

d.

If people with mental illness would use some self-discipline, they would not have so many problems

e.

Many mental illnesses are not genetically transmitted. People can never change their genes

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The correct answer is: Biological, personal, environmental and sociocultural factors influence the
development of Mental Illness

Question 7

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Self- awareness is the first step a psychiatric health nurse must undergo before moving into the
psychiatric setting. This is very important so as beliefs, values and perceptions will be clearly examined
and therefore will not affect the nurses interaction with the client. Which of the following statements
reflects Self-Awareness:
a.

I do not like the client in room 10 who is a very disturbing alcoholic

b.

I do not want to be assigned to Mr. A.J tonight

c.

A.J., you can stay up later than the other clients tonight

d.

I am very angry at A.J because he is so irritable

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The correct answer is: I do not like the client in room 10 who is a very disturbing alcoholic

Question 8

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Throughout the assessment, Mr. Casey displays disorganized thinking, jumping from one idea to another
with no clear relationship between the thoughts. The nurse would document the client as having which
of the following?

a.

Loose associations

b.

Concrete thoughts
c.

Word salad

d.

Ideas of reference

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The correct answer is: Loose associations

Question 9

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Which of the following questions is best to ask when assessing the clients judgment and decision
making?

a.

Can you describe your usual daily activities for me

b.

What problem would you like to work on while you're hospitalized

c.

If you found yourself downtown without money or a car, how would you get home

d.

On a scale of 1 to 10, how stressed would you rate yourself

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The correct answer is: If you found yourself downtown without money or a car, how would you get
home
Question 10

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Hildegard Peplau is best known for her writing about which of the following?

a.

Psychopharmacology

b.

Humane treatment

c.

Community-based care

d.

Therapeutic nurse-patient relationship

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The correct answer is: Therapeutic nurse-patient relationship

Question 11

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When Mr. Casey was admitted to the psychiatric unit and states, I am president of the largest
corporation in the world. Everyone comes to me for advice. The client is exhibiting which of the
following?
a.

Grandiosity

b.

Delirium

c.

Loose associations

d.

Confabulation

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The correct answer is: Grandiosity

Question 12

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During the morning mental health meeting, the social worker criticizes Mr. Bean because the client
complained of receiving his medication late. The most effective way for Mr. Bean to deal with this
situation is to:

a.

express anger over the social workers criticism

b.

leave the meeting and look at the medication chart

c.
tell the social worker she is out of line

d.

talk to the social worker after the meeting

Feedback

The correct answer is: leave the meeting and look at the medication chart

Question 13

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A student nurse is assigned to care for a client whose sexual orientation differs from her own. She needs
to seek clinical supervision if she attempted to:

a.

Empathize with the client.

b.

Assist the client to change values.

c.

Identify anxieties regarding the clients values and sexuality.

d.

Discuss her feelings about the client with a supervisor.

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The correct answer is: Assist the client to change values.

Question 14

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During the admission assessment, the nurse asks Mr. Casey, How are you feeling? The client responds, I
feel, I kneel, do you steal? The nurse recognizes this response as which of the following?

a.

Neologisms

b.

Flight of ideas

c.

Echolalia

d.

Clang association

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The correct answer is: Clang association

Question 15

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One evening, Mr. Casey leaves his room and begins marching in the hall. When approached by the
nurse, the client says, God says Im supposed to guard the area. Which of the following responses would
be best?

a.

You are just imagining these things. Do not pay any attention to the voices.
b.

I understand you hear a voice. You and I are the only ones in the hall, and I dont hear a voice.

c.

This guarding responsibility can make you tired. You rest for now, and Ill guard I your behalf for a while.

d.

The voices are part of your illness and they will leave in time.

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The correct answer is: I understand you hear a voice. You and I are the only ones in the hall, and I dont
hear a voice.

Question 16

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Which of the following would best assess Mr. Caseys judgment?

a.

Spelling words backward

b.

Interpreting proverbs

c.

Skip counting by seven

d.
Discussing hypothetical situations for problem solving and decision making

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The correct answer is: Discussing hypothetical situations for problem solving and decision making

Question 17

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A nurse assesses a newly admitted client. Select the example of offering self.

a.

I hope you will feel better after we get your medication doses stabilized

b.

Tell me why you felt you had to be hospitalized for treatment of your depression

c.

I have had stressful experiences in life also. Hospitalization is not the end of the world

d.

I would like to spend some time helping you get comfortable talking to me

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The correct answer is: I would like to spend some time helping you get comfortable talking to me

Question 18

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In initiating the therapeutic nurse-client relationship, Mr. Bean considers that building trust is important
in:

a.

the working phase of the relationship

b.

all phases of the relationship

c.

the termination phase of the relationship

d.

the orientation phase of the relationship

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The correct answer is: the orientation phase of the relationship

Question 19

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SITUATION: Mr. Casey is a 35-year old patient who was admitted due to behavioral changes secondary
to Schizophrenia. He has a history of aggressive behavior precipitated by delusion that somebody is
trying to harm him. The nurse observes Mr. Caseys pacing in the hallway, muttering to himself and
avoiding close contact with anyone. The nurse caring for Mr. Casey must take into consideration the
different principles of Therapeutic Communication, Clients Response to Illness, Legal and Ethical Issues
and the different Considerations in the care of patient with Schizophrenia. If Mr. Casey states, Im here to
get help but has a rigid posture, clenched fists and an agitated facial expression. This communication will
be documented as:

a.

Congruent
b.

Abstract

c.

Incongruent

d.

Covert

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The correct answer is: Congruent

Question 20

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Which of the following statements indicates Active Listening?

a.

Mr. Jones, there is no reason to feel upset because your family loves you

b.

Mr. Jones, it sounds like you are depressed because of your recent job loss

c.

Mr. Jones, you must be feeling pretty low because you are so quiet

d.

Mr. Jones, I find it difficult to believe that losing your job makes you depressed
Feedback

The correct answer is: Mr. Jones, you must be feeling pretty low because you are so quiet

Question 21

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A childs parents enter the nurses station yelling, What is wrong with you people? My daughter cut
herself and you allowed it to happen. I thought my child would be safe here. Select the assertive
response for the nurse.

a.

I cant hear you if youre screaming. Lets sit down and talk about it

b.

Why are you always yelling when you come to visit

c.

I cant respond to that. Your child is assigned to another nurse today

d.

I am sorry this happened. We are short staffed today

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The correct answer is: I cant hear you if youre screaming. Lets sit down and talk about it

Question 22

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A significant change in the treatment of persons with mental illness occurred in the 1950s when:

a.

Psychotropic drugs became available for use

b.

Legislation dramatically changed civil commitment procedures

c.

Community support services were established

d.

The Patients Bill of Rights was enacted

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The correct answer is: Psychotropic drugs became available for use

Question 23

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From among these client outcomes, which outcome should Mr. Bean first direct his interventions to a
client who has depression? The client will:

a.

identify his or her assets and strengths within 1 week

b.

consume at least 50 percent of every meal within 3 days.

contract with the team to report the incidence of suicidal thoughts within 24 hours.

d.

describe characteristics of healthy relationship with others within 1 week.

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The correct answer is: contract with the team to report the incidence of suicidal thoughts within 24
hours.

Question 24

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To distinguish the different roles of the interdisciplinary team, this situation was given to Mr. Bean by his
clinical instructor: The parent of a 10-year-old who has been taking Ritalin had consumed stocks of the
medication and asks the nurse to give her a prescription. Select the nurses best action.

a.

Call the doctor before deciding to give the parent a new prescription.

b.

Explain that the psychologist will have to assess the child before giving a prescription.

c.

Conduct a comprehensive assessment and evaluation and then inform the parent the child no longer
needs to take the medication.

d.

Direct the parent to see the psychiatrist.

Feedback
The correct answer is: Explain that the psychologist will have to assess the child before giving a
prescription.

Question 25

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The patient states to the nurse I cannot stand myself and the way I look. Which of the following
responses is NOT therapeutic?

a.

You sound discouraged of your appearance.

b.

It must be difficult for you to feel that way.

c.

Tell me more about your feelings.

d.

All the patients here feel the same as you do.

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The correct answer is: All the patients here feel the same as you do.

Question 26

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Client: I had an accident. Nurse: Tell me about your accident. This exemplifies which of the following
therapeutic communication techniques?
a.

Making observation

b.

general lead

c.

assessing relationships

d.

offering self

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The correct answer is: general lead

Question 27

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During the working phase of a therapeutic relationship, which of the following actions by the nurse
would best help the client to explore problems?

a.

Identifying possible solutions for the clients problems

b.

Comparing past and present coping strategies

c.
Referring the client to a self-help group

d.

Encouraging the client to clarify feelings and behavior

Feedback

The correct answer is: Encouraging the client to clarify feelings and behavior

Question 28

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A common concern of nurses taking care of psychiatric patients is the fear of:

a.

Physical harm and abuse

b.

Catching illness

c.

Burnout and fatigue

d.

Short temperedness

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The correct answer is: Physical harm and abuse

Question 29

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In the space of 5 minutes, the Mr. Casey has been laughing and euphoric, then angry, then crying for no
reason that is apparent to the nurse. This behavior would be best described as:

a.

Labile mood

b.

Flight of ideas

c.

Lack of insight

d.

Tangential thinking

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The correct answer is: Labile mood

Question 30

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SITUATION: Mr. Bean, a 3rd year student of University of Cebu was assigned in the male ward of the
Center for Behavioral Sciences in VSMMC. He encountered patients with different diagnoses. Some were
hesitant to interact to the people around and some were also aggressive and energetic. Mr. Bean then
reviewed what he had learned in his Psychiatric Nursing class. Mr. Bean designs an hour-by-hour plan
for working with clients for the day. Select the best analysis of Mr. Beans action:

a.
His plan is likely to result in feelings of frustration

b.

He has demonstrated goal-directed behavior.

c.

He is likely to feel rewarded at the end of the day.

d.

His plan will support development of the nurses organizational skills

Feedback

The correct answer is: He has demonstrated goal-directed behavior.

Question 31

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The patient told the student nurse Im here on a secret mission for the government. Dont blow my cover.
Which response by the student nurse would be most therapeutic?

a.

It sounds like you have some concerns about your privacy. You are safe here

b.

You have lost touch with reality, which is a symptom of your illness

c.

Lets talk about something other than your mission for the government
d.

Your admission papers do not list you as a government employee

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The correct answer is: Your admission papers do not list you as a government employee

Question 32

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A delusion represents a problem in which of the following areas?

a.

Orientation

b.

Motivation

c.

Thinking

d.

Memory

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The correct answer is: Thinking

Question 33

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The client says to the nurse, I feel really close to you. You are the only true friend I have. The most
therapeutic response the nurse can make is:

a.

Since ours is a professional relationship, lets explore other opportunities in your life for friendship

b.

I am sure there are other people in your life who are your friends; besides, we just met

c.

We are not friends. This is strictly professional

d.

It makes me feel good that you trust me so much; it is important for the work we are doing together

Feedback

The correct answer is: Since ours is a professional relationship, lets explore other opportunities in your
life for friendship

Question 34

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A young adult was informed of a positive laboratory test for HIV. The client tells the nurse, Well, I know
what I need to do now. What is the nurses next action?

a.

assess the clients suicidability

b.

Arrange a consultation with the social worker

give information on local support groups

d.

discuss the result of the newest medical research

Feedback

The correct answer is: assess the clients suicidability

Question 35

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When Mr. Bean was trying to determine which patient he should attend to first, he applies the principles
of prioritization. Mr. Bean would most likely prioritize::

a.

a client with schizophrenia who is having auditory hallucinations of a choir singing.

b.

A newly admitted client diagnosed with major depression whose assessment is incomplete.

c.

A client who recently became unemployed and has a 10 year history of daily alcohol use.

d.

a client with disorganized schizophrenia who has difficulty completing ADL.

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The correct answer is: A newly admitted client diagnosed with major depression whose assessment is
incomplete.

Question 36

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Which is the most appropriate reason for using humor?

a.

promote trust by reducing tension and frustration

b.

make light of an otherwise serious situation.

c.

reduce tension in the too serious client.

d.

reduce anxiety in the nurse

Feedback

The correct answer is: promote trust by reducing tension and frustration

Question 37

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At shift change report, a group of nurses discuss a client who covers his head with underwear. Select the
appropriate use of Humor in this situation.
a.

Let us all show acceptance of this client by wearing underwear on our heads too

b.

Well, this is a psychiatric hospital, and that is craziness for you. That is what we are all about

c.

Another challenge for us! Does anybody have ideas of how to manage this behavior

d.

Humor is not appropriate for this situation.

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The correct answer is: Humor is not appropriate for this situation.

Question 38

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In caring for psychiatric patients in the ward, Mr. Bean takes note that which of the statement below is
BEST attributed to psychiatric nursing care?

a.

Safety and comfort are primodial

b.

More psychologically active but physically passive

c.
Therapeutic regimen is the same for patients with similar diagnoses

d.

It is a unique science

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The correct answer is: Safety and comfort are primodial

Question 39

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Good afternoon. Mr. Hollick. My name is John Toth and a I am a student nurse of University of Cebu
College of Nursing Banilad campus. I will be your nurse today from 3 to 10:30 p.m. This statement is
made for the purpose of:

a.

All of the above

b.

Setting the limit of the relationship

c.

Giving recognition to the patient

d.

Offering both first and last name so the client can choose a comfortable way to address the nurse.

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The correct answer is: All of the above

Question 40
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SITUATION: A group of nursing students were tasked to review on the history on mental health nursing
as part of their preparation prior to being assigned in the different affiliated psychiatric facilities. The
creation of asylums during the 1800s was meant to:

a.

Improve treatment of mental disorders

b.

Provide food and shelter for the mentally ill

c.

Punish mentally ill persons believed to be possessed

d.

Remove dangerous mentally ill persons from the community

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The correct answer is: Improve treatment of mental disorders

Question 41

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Mr. Casey is reluctant to take his prescribed oral medication. The most therapeutic response by the
nurse to this refusal is:

a.
What is it about the medicine you dont like

b.

If you refuse these pills, youll have to get an injection.

c.

I can see that you're uncomfortable now, so we can wait until tomorrow.

d.

You know you have to take this medicine for your own good.

Feedback

The correct answer is: What is it about the medicine you dont like

Question 42

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The nurse asks Mr. Casey, What is similar about a cow and a horse? and What do a bus and an airplane
have in common? These questions would best assess which of the following areas?

a.

Memory

b.

Insight

c.

Intellectual function
d.

Judgment

Feedback

The correct answer is: Intellectual function

Question 43

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As Sunshine performs her function as a psychiatric nurse, she recognizes that this nursing activity
touches the patients heart more profoundly:

a.

Praying for his recovery

b.

Listening to patients aches

c.

Providing physical care

d.

Providing music

Feedback

The correct answer is: Listening to patients aches

Question 44

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As a client with mental illness is discharged from a facility, Mr. Bean invites the client to a birthday party
for a staff psychologist. Select the correct analysis of this scenario:

a.

The nurse has demonstrated acceptance of persons with mental illness.

b.

The nurses action helps the client to transition into community living.

c.

The invitation will support development of the clients healthy self-esteem.

d.

The nurses action violates the boundaries of a therapeutic relationship.

Feedback

The correct answer is: The nurses action helps the client to transition into community living.

Question 45

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Each day presents a unique set of challenges when working with clients who have mental disorders. The
following are principles that will facilitate the nurse-client relationship, the clients well-being, and the
nurses action.

a.

mutual formulation of the plan of care

b.
inform clients of the rationale for not keeping promises

c.

Avoid giving advice

d.

foster independence

e.

make observations

Feedback

The correct answer is: foster independence

Question 46

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During the psychotherapy, the nurse was seated with crossed legs and arms folded across the chest. For
Mr. Casey, this gesture may mean:

a.

unconditional positive regard

b.

Openness

c.

Unacceptance
d.

Non-threatening

Feedback

The correct answer is: Unacceptance

Question 47

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When assuming the role of a student nurse in the psychiatric-mental health setting, which behavior
would be LEAST effective in helping to achieve personal and professional growth?

a.

Completing a task for a client instead of repeatedly prompting him to finish it

b.

Taking time to adjust to a slower pace

c.

Use listening and observing skills

d.

Avoiding frustration when a client refuses to interact

Feedback

The correct answer is: Completing a task for a client instead of repeatedly prompting him to finish it

Question 48

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A client with a bipolar mood disorder in the manic phase had been hyperactive and sarcastic to the
nurse and other clients. This behavior has been decreasing and the client tells the nurse, My husband
and I have problems getting along sometimes. We see things differently. The response by the nurse that
would be LEAST therapeutic is:

a.

Not getting along with ones spouse can be upsetting

b.

Explain what you mean by seeing things differently

c.

You are calmer today. What has made the difference

d.

Tell me about a specific time when you and your husband had problems

Feedback

The correct answer is: You are calmer today. What has made the difference

Question 49

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Cognizant of the role of a psychiatric health nurse, Mr. Bean should embody what general attitude of
nurses toward patients in a psychiatric facility?

a.

Respect and trust

Friendliness and concern

c.

Sympathy and understanding

d.

Objectivity and formality

Feedback

The correct answer is: Respect and trust

Question 50

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In the ward, Mr. Bean is looking forward to his duty because one of his patients is a single, attractive 21-
year-old woman who came in as an outpatient. The psychodynamic term for Mr. Beans response to his
patient is best termed:

a.

Projection

b.

Empathy

c.

Transference

d.
Countertransference

Feedback

The correct answer is: Countertransference

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