NURSING PRACTICE V: PSYCHIATRIC NURSING

December 2007 Board Exam Qe!"#o$!

S#"a"#o$ %: Anita had been invited to a fraternity
party. She had too much of a drink and she was
raped by her date. The day after, she was brought to
the hospital. She has feelings of anger, humiliation,
helplessness, nausea, vomiting, nightmare and
muscle tension. She is experiencing rape-trauma
syndrome and is presently in the acute phase.
1. hen the nurse approached Anita, initially
she was !ust crying, felt she was in a
nightmare and was at a loss. The
appropriate nursing diagnosis for her at the
time is"
a. Situational low self-esteem
b. Sexual violence
c. #neffective coping
d. Sexual dysfunction
$. Anita said to the nurse, %# have douched,
showered for half an hour and still did not
feel clean.& Anita is most probably
experiencing"
a. 'uilt
b. Anger
c. (enial
d. )rustration
*. hich of these responses would
communicate unconditional acceptance of
Anita and her situation+
a. %Trust me. ,ou are safe here and #
am ready to listen.&
b. %ill you tell me why you dated a
guy you hardly knew+&
c. %This must be hard for you to talk
about. -ust tell me when you are
ready and #.ll come back to you.&
d. %# would be best if you stop crying.&
/. Anita is experiencing what type of crisis+
a. 0aturational crisis
b. (evelopmental crisis
c. Anticipated crisis
d. Situational crisis
1. hich of these expressions of Anita signifies
that she is ready to proceed to the working
phase of the nurse-patient relationship+
a. She states she trusted the nurse
b. She wants to talk to a lawyer
c. She in2uires about personal
information about the nurse
d. She wants to be told what her rights
are
S#"a"#o$ 2: 3icanor was discharged from the
hospital and recovered from a manic episode of
4ipolar (isorder. A week later, 3icanor was
readmitted with an entirely different behavior. 5e was
very depressed.
6. The defense mechanism utili7ed by manic
patients to cover up depression is"
a. 8eaction formation
b. 9ompensation
c. (isplacement
d. (enial
:. The psychodynamic cause of depression is"
a. ;ax super ego
b. eak super ego
c. #nternali7ed hostility feelings
d. 3arcissistic personality
<. hich of these drugs is likely indicated for
3icanor.s present condition+
a. Serenace =5aloperidol>
b. ?alium =(ia7epam>
c. Tofranil =#mipramine 59l>
d. Trilafon =@herphena7ine>
A. Therapeutic use of self is essential in relating
with psychiatric patients. Therapeutic use of
self is 4BST demonstrated by"
a. Sympathi7ing with 3icanor
b. Bngaging 3icanor in productive
activity
c. Bngaging 3icanor in introspective
thinking
d. Suppressing her own feeelings
toward 3icanor
1C. After three days of antidepressant regimen,
3icanor still manifests symptoms of
depression. ,ou as the nurse evaluates this
as"
a. Dnusual because the action of
antidepressant drug is immediate
b. Bxpected because it takes about
two weeks for the medication to be
effective
c. Dnexpected because it takes only
one week for the medication to be
effective
d. #neffective because perhaps the
drug.s dosage is inade2uate
S#"a"#o$ & : 0arina, $6 years old, is aloof in relating
with other patients and the members of the staff. She
claims that the medications being given to her by the
nurses are meant to poison her. She is also
suspicious about the food being served to her.
11. 4asically, when a person is suspicious like
0arina, there is an inability to develop a
sense of "
a. #ntimacy
b. 'enerativity
c. Trust
3ursing @ractice 1" @sychiatric 3ursingE4hei E 1
d. #nitiative
1$. Suspicious patients like 0arina utili7e
pro!ection as a defense emchanism. This
means"
a. Dnconsciously refusing to accept a
feeling, thought or impulse and
attributing it to someone else
b. -ustifying the behavior, attitudes
and feelings with excuses
c. #nvoluntarily refusing to
acknowledge reality
d. #nvoluntarily excluding wishes,
inpulses, memories and feelings
from awareness
1*. Fnowing the condition of 0arina, which of
these nursing approaches would be 0GST
appropriate for the nurse to begin with+
a. Bngage 0arina for at least one hour
in one-on-one interaction daily
b. #nvite her to sociali7e with other
patients
c. 0ake self available while
maintaining distance until she
shows readiness to interact with
you and others
d. 8efer her for activity therapy
1/. hen she refuses to take her medications, it
is best to "
a. ;et her read the drug literature to
convince her that it is safe and
therapeutic
b. )orce her to take the drug to
maintain therapeutic effectiveness
c. 5ave the same nurse, who she
interacts with regularly, administer
the drug
d. 8e2uest the doctor to give her the
medication
11. Another reason why she refuses to take
Thora7ine is because she complains of
robot-like movement and slurred speech.
The nurse.s 4BST action is to"
a. (ecrease the dosage of thora7ine
b. Bxplain the extrapyramidal side
effects and administer 4enadryl
c. Avoid giving foods that are rich in
tyramine
d. ithhold medication until referral is
made to the doctor
S#"a"#o$ ': Sexual (isorders
16. A hospitali7ed male adolescent is obviously
flirting and is sexually provocative toward a
young female nurse. The nurse can respond
0GST therapeutically by doing which of the
following+
a. Telling him that she is married
b. #ntroducing him to female clients
who are within his age group
c. Bncouraging him to watch T? in his
room
d. Simply ignoring the flirtatious and
provocative behaviors
1:. The premorbid personality of a person with a
non psychotic maladaptive response to
anxiety may most accurately be described
as"
a. Dnpredictable, impulsive and
aggressive
b. 8igid, insecure and conforming
c. (ependent, pessimistic and moody
d. Anxious, insensitive and self-
absorbed
1<. The first stage of life may be termed as the
sensory-oral stage. An oral-dependent
personality is characteri7ed by which of the
following+
a. 5elplessness
b. 5opelessness
c. Aggressiveness
d. Suspiciousness
1A. @edophilia is another form of sexual
disorder. The pedophile.s choice of a sex
ob!ect is primarily based on"
a. (ifficulty relating with adults
b. )eelings of kindness toward
children
c. )ears of incestuous impulses
d. @reference for a more passive
sexual role
$C. -ay, a young adult male unable to stay put in
his current !ob and has no commitment in his
relationships with women. 4ased on this
description, he is probably having difficulty
achieving a sense of"
a. Autonomy
b. Trust
c. #ndustry
d. #ntimacy
3ursing @ractice 1" @sychiatric 3ursingE4hei E $