4. Answer: D. The censoring portion of the mind.

Answers and Rationale

The critical censoring portion of ones personality; the conscience.

1. Answer: B. A state of well-being where a person can realize his Option A: This refers to the ego function that protects itself

own abilities can cope with normal stresses of life and work from anything that threatens it.

productively. Option B: The Id is composed of the untamed, primitive

drives and impulses.

Mental health is a state of emotional and psychosocial well being. A Option C: This refers to the ego that acts as the moderator of
mentally healthy individual is self-aware and self-directive has the the struggle between the id and the superego.
ability to solve problems, can cope with the crisis without assistance

beyond the support of family and friends fulfill the capacity to love and 5. Answer: C. Teaching the client stress management techniques

work and sets goals and realistic limits.

Primary level of prevention refers to the promotion of mental health and

Option A: This describes the ego function reality testing. prevention of mental illness. This can be achieved by rendering health

Option C: This is the definition of Mental Health and teachings such as modifying ones responses to stress.

Psychiatric Nursing.
Option A: This is tertiary level of prevention that deals with
Option D: Mental health is not just the absence of mental
rehabilitation.
illness.
Options B and D. Secondary level of prevention which

2. Answer: A. Administers medications to a schizophrenic patient. involves reduction of actual illness through early detection and

treatment of illness.
Administration of medications and treatments, assessment,

documentation are the activities of the nurse as a technician. 6. Answer: A. Are you being threatened or hurt by your partner?

Option B: Activities as a parent surrogate. The nurse validates her observation by asking simple, direct question.

Option C: Refers to the ward manager role. This also shows empathy.

Option D: Role as a teacher.

Options B, C, and D are indirect questions which may not

3. Answer: A. Subconscious lead to the discussion of abuse.

Subconscious refers to the materials that are partly remembered partly 7. Answer: A. Sexual desire disorder

forgotten but these can be recalled spontaneously and voluntarily.

Has little or no sexual desire or has a distaste for sex.

Option B: This functions when one is awake. One is aware of

Option B: Failure to maintain the physiologic requirements
his thoughts, feelings actions and what is going on in the environment.
for sexual intercourse.
Option C: The largest portion of the mind that contains the
Option C: Persistent and recurrent inability to achieve an
memories of ones past particularly the unpleasant. It is difficult to
orgasm.
recall the unconscious content.
Option D: Also called dyspareunia. Individuals with this
Option D: The conscious self that deals and tests reality.
disorder suffer genital pain before, during and after sexual intercourse.
 8. Answer: A. Heres the number of a crisis center that you can 12. Answer: B. Conflict between id and superego

call for help .

Freud explains anxiety as due to opposing action drives between the id

Protection is a priority concern in abuse. Help the victim to develop a and the superego.

plan to ensure safety.

Option A: Sullivan identified 2 types of needs, satisfaction

Option B: Do not give advice to leave the abuser. Making and security. Failure to gratify these needs may result in anxiety.

decisions for the victim further erodes her esteem. However, discuss Option C: Biomedical perspective of anxiety.

options available. Option D: Explanation of anxiety using the behavioral model.

Option C: The victim tends to isolate from friends and family.

13. Answer: D. Impaired social interaction
Option D: This is judgmental. Avoid in any way implying that

she is at fault.
The client may not have difficulty in social exchange. The cues do not

9. Answer: B. When I tell my child to do something once, I dont support this diagnosis.

expect to have to tell.

Option A: The client maladaptively uses body symptoms to

manage anxiety.
Abusive parents tend to have unrealistic expectations on the child.
Option B: The client will have discomfort due to pain.

Options A, B, and C are realistic expectations on a 3-year- Option C: The client may fail to meet environmental

old. expectations due to pain.

10. Answer: C. Ensure the safety of the victim 14. Answer: C. Expression of conflicts through bodily symptoms

The priority consideration is the safety of the victim. Attend to the Bodily symptoms are used to handle conflicts.

physical injuries to ensure the physiologic safety and integrity of the

Option A: Manifestations do not have an organic basis.
child. Reporting suspected case of abuse may deter recurrence of
Option B: This occurs unconsciously.
abuse.
Option D: Medical treatment is not used because the

Options A, B, and D may be addressed later. disorder does not have a structural or organic basis.

11. Answer: D. Somatoform Pain Disorder 15. Answer: A. I know the feeling is real tests revealed negative

results.
This is characterized by severe and prolonged pain that causes

significant distress. Shows empathy and offers information.

Option A: This is a chronic syndrome of somatic symptoms Option B: This is a demeaning statement.

that cannot be explained medically and is associated with psychosocial Option C: This belittles the clients feelings.

distress. Option D: Giving undue attention to the physical symptom

Option B: This is an unrealistic preoccupation with a fear of reinforces the complaint.

having a serious illness.

16. Answer: A. provide as much structure as possible for the child
Option C: Characterized by alteration or loss in sensory or

motor function resulting from a psychological conflict.

 Decrease stimuli for behavior control thru an environment that is free of
distractions, a calm nonconfrontational approach and setting limit to
time allotted for activities.
Option B: The child will not benefit from a lenient approach.
Option C: Dissipate energy through safe activities.
Option D: This indicates that the classroom environment
lacks structure.
17. Answer: D. Serious violations of age-related norms.
This is a disruptive disorder among children characterized by more
serious violations of social standards such as aggression, vandalism,
stealing, lying and truancy.
Option A: This is characteristic of attention deficit disorder.
Options B and C: These are noted among children with
autistic disorder.
18. Answer: A. increased attention span and concentration
The medication has a paradoxical effect that decreases hyperactivity
and impulsivity among children with ADHD.
Options B, C, D. Side effects of Ritalin include anorexia,
insomnia, diarrhea, and irritability.
19. Answer: A. Returning the child to the school immediately with
family support.
Exposure to the feared situation can help in overcoming anxiety.
Option B: This will not help in relieving the anxiety due
separation from a significant other.
Options C: Anxiety in school phobia is not due to being in
school but due to separation from parents/caregivers so these
interventions are not applicable.
Option D: This will not help the child overcome the fear
20. Answer: C. Moderate
The child with moderate mental retardation has an I.Q. of 35-50
Option A: Profound Mental retardation has an I.Q. of below
20.
Option B: Mild mental retardation 50-70.
Option D: Severe mental retardation has an I.Q. of 20-35.
21. Answer: A. Overprotection of the child
The child with mental retardation should not be overprotected but need
protection from injury and the teasing of other children.
Options B, C, and D Children with mental retardation have a
learning difficulty. They should be taught with patience and repetition,
start from simple to complex, use visuals and compliment them for
motivation. Realistic expectations should be set and optimize their
capability.
22. Answer: B. altered parenting role
Altered parenting role refers to the inability to create an environment
that promotes optimum growth and development of the child. This is
reflected in the parents inability to care for the child.
Option A: This refers to the lack of choices or inability to
mobilize ones resources.
Option C: Refers to change in family relationship and
function.
Option D: Ineffective coping is the inability to form valid
appraisal of the stressor or inability to use available resources
23. Answer: B. intolerance to change, disturbed relatedness,
stereotypes
These are manifestations of autistic disorder.
Option A: These manifestations are noted in Oppositional
Defiant Disorder, a disruptive disorder among children.
Option C: These are manifestations of Attention Deficit
Disorder.
Option D: These are the manifestations of Conduct Disorder
24. Answer: D. Rearrange the environment to activate the child
 The child with autistic disorder does not want change. Maintaining a
consistent environment is therapeutic.
Option A: Angry outburst can be re-channelled through safe
activities.
Option B: Acceptance enhances a trusting relationship.
Option C: Ensure safety from self-destructive behaviors like
head banging and hair pulling.
25. Answer: C. Pre-operational
Preoperational stage (2-7 years) is the stage when the use of
language, the use of symbols and the concept of time occur.
Option A: Sensorimotor stage (0-2 years) is the stage when
the child uses the senses in learning about the self and the
environment through exploration.
Option B: Concrete operations (7-12 years) when inductive
reasoning develops.
Option D: Formal operations (2 till adulthood) is when
abstract thinking and deductive reasoning develop.
26. Answer: B. Tolerance
Tolerance refers to the increase in the amount of the substance to
achieve the same effects.
Option A: Withdrawal refers to the physical signs and
symptoms that occur when the addictive substance is reduced or
withheld.
Option B: Intoxication refers to the behavioral changes that
occur upon recent ingestion of substance.
Option D: Psychological dependence refers to the intake of
the substance to prevent the onset of withdrawal symptoms.
27. Answer: A. Delirium tremens
Delirium Tremens is the most extreme central nervous system
irritability due to withdrawal from alcohol.
Option B: This refers to an amnestic syndrome associated
with chronic alcoholism due to a deficiency in Vit. B.
Option C: This is a complication of liver cirrhosis which may
be secondary to alcoholism.
Option D: This is a complication of alcoholism characterized
by irregularities of eye movements and lack of coordination.
28. Answer: A. Monitoring his vital signs every hour
Pulse and blood pressure are usually elevated during withdrawal;
Elevation may indicate impending delirium tremens.
Option B: Client needs quiet, well lighted, consistent and
secure environment. Excessive stimulation can aggravate anxiety and
cause illusions and hallucinations.
Option C: Adequate nutrition with supplements of Vit. B
should be ensured.
Option D: Sedatives are used to relieve anxiety.
29. Answer: B. Cocaine
The manifestations indicate intoxication with cocaine, a CNS stimulant.
Option A: Intoxication with heroine is manifested by euphoria then
impairment in judgment, attention and the presence of papillary
constriction. Option C: Intoxication with hallucinogen like LSD is
manifested by grandiosity, hallucinations, synesthesia and increase in
vital signs. Option D: Intoxication with Marijuana, a cannabinoid is
manifested by
Option A: Intoxication with heroine is manifested by euphoria
then impairment in judgment, attention and the presence of papillary
constriction.
Option C: Intoxication with hallucinogen like LSD is
manifested by grandiosity, hallucinations, synesthesia and increase in
vital signs.
Option D: Intoxication with Marijuana, a cannabinoid is
manifested by the sensation of slowed time, conjunctival redness,
social withdrawal, impaired judgment, and hallucinations.
30. Answer: B. Narcan (Naloxone)
Narcan is a narcotic antagonist used to manage the CNS depression
due to overdose with heroin.
 Option A: This is an opiate receptor blocker used to relieve The client should be reoriented to reality and be focused on the here

the craving for heroin. and now.

Option C: Disulfiram is used as a deterrent in the use of

Option B: This is not a helpful approach because of the short
alcohol.

Option D: Methadone is used as a substitute in the term memory of the client.

Option C: This indicates a pompous response.

withdrawal from heroin
Option D: The cognitive limitation of the client makes the

31. Answer: C. Agnosia client incapable of giving an explanation.

This is the inability to recognize objects. 35. Answer: B. Insidious onset

Option A: Apraxia is the inability to execute motor activities Dementia has a gradual onset and progressive deterioration. It causes

despite intact comprehension. pronounced memory and cognitive disturbances.

Option B: Aphasia is the loss of ability to use or understand

Options A, C, and D are all characteristics of delirium.
words.

Option D: Amnesia is loss of memory.

36. Answer: B. Fluid volume deficit

32. Answer: C. This must be difficult for you and your mother.
Fluid volume deficit is the priority over altered nutrition since the

situation indicates that the client is dehydrated.

This reflecting the feeling of the daughter that shows empathy.

Options A and D are psychosocial needs of a client with

Options A and D. Giving advice does not encourage
anorexia nervosa but they are not the priority.
verbalization.

Option B: This response does not encourage verbalization of

37. Answer: C. Approach the nurse and talk out her feelings
feelings.

The client with anorexia nervosa uses starvation as a way of managing

33. Answer: C. Remains in a safe and secure environment
anxiety. Talking out feelings with the nurse is an adaptive coping.

Safety is a priority consideration as the clients cognitive ability

Option A: Starvation should not be encouraged. Physical
deteriorates.
safety is a priority. Without adequate nutrition, a life threatening

Option A is appropriate interventions because the clients situation exists.

Option B: The client with anorexia nervosa is preoccupied

cognitive impairment can affect the clients ability to attend to his
with losing weight due to disturbed body image. Limits should be set on
nutritional needs, but it is not the priority

Option B: Patient is allowed to reminisce but it is not the attempts to lose more weight.

Option D: The client may have a domineering mother which

priority.

Option D: The client in the moderate stage of Alzheimers causes the client to feel ambivalent. The client will not discuss her

feelings with her mother.

disease will have difficulty in performing activities independently

38. Answer: B. Weight gain

34. Answer: A. Your husband is dead. Let me serve you your

breakfast.
 Weight gain is the best indication of the clients improvement. The goal Option B: Social phobia is fear of performing in the presence

is for the client to gain 1-2 pounds per week. of others in a way that will be humiliating or embarrassing.

Option D: Xenophobia is fear of strangers.

Option A: The client may purge after eating.

Option C: Attending an activity does not indicate 43. Answer: D. Accept her fears without criticizing.

improvement in the nutritional state.

Option D: Body image is a factor in anorexia nervosa, but it The client cannot control her fears although the client knows its silly

and can joke about it.

is not an indicator of improvement.

39. Answer: A. Have episodic binge eating and purging Option A: Allow expression of the clients fears but he should

focus on other productive activities as well.

Bulimia is characterized by binge eating which is characterized by Options B and C: These are not the initial interventions.

taking in a large amount of food over a short period of time.

44. Answer: A. Revealing personal information to the client

Options B and C are characteristics of a client with anorexia

Countertransference is an emotional reaction of the nurse on the client
nervosa.

Option D: Low esteem is noted in both eating disorders based on her unconscious needs and conflicts.

40. Answer: A. Patient will learn problem-solving skills Options B and C: These are therapeutic approaches.

Option D: This is transference reaction where a client has an

If the client learns problem-solving skills she will gain a sense of control emotional reaction towards the nurse based on her past.

over her life.

45. Answer: D. The client will be able to overcome his disabling

Option B: Anxiety is caused by powerlessness. fear.

Option C: Performing self-care activities will not decrease

The client will overcome his disabling fear by gradual exposure to the
ones powerlessness.

Option D: Setting limits to control imposed by others is a feared object.

necessary skill but problem-solving skill is the priority.

Options A, B, and C are not the desired outcome of

41. Answer: B. Discuss their eating behavior. desensitization.

46. Answer: A. Avoid taking CNS depressant like alcohol.

The client is often ashamed of her eating behavior. Discussion should

focus on feelings.
Valium is a CNS depressant. Taking it with other CNS depressants like

Options A, C, and D promote a therapeutic relationship alcohol; potentiates its effect.

42. Answer: C. Claustrophobia Option B: The client should be taught to avoid activities that

require alertness.

Claustrophobia is fear of closed space. Option C: Valium causes dry mouth so the client must

increase her fluid intake.

Option A: Agoraphobia is fear of open space or being a Option D: Stimulants must not be taken by the client
situation where escape is difficult. because it can decrease the effect of Valium.
 47. Answer: C. The conversion symptom has symbolic meaning to 49. Answer: B. It is a deliberate effort to handle upsetting events

the client
Malingering is a conscious simulation of an illness while somatoform

the client uses body symptoms to relieve anxiety. disorder occurs unconsciously.

Option A: The condition occurs unconsciously. Option A: Both disorders do not have an organic or structural

Option B: The client is not distressed by the lost or altered basis.

body function. Option C: Both have primary gains.

Option D: The client should not be confronted by the Option D: This is a characteristic of the somatoform disorder.

underlying cause of his condition because this can aggravate the

50. Answer: C. stress management techniques
clients anxiety.

48. Answer: D. How do you feel about being pressured into sex Stress management techniques is the best management of

by your boyfriend? somatoform disorder because the disorder is related to stress and it

does not have a medical basis. Option A: This disorder is not

Focusing on the expression of feelings is therapeutic. The central force supported by organic pathology so no medical regimen is required.

of the clients condition is anxiety. Options B and D: Milieu therapy and psychotherapy may be used

Option A: This is not therapeutic because the nurse passes Option A: This disorder is not supported by organic

the responsibility to the counselor. pathology so no medical regimen is required.

Option B: Giving advice is not therapeutic. Options B and D: Milieu therapy and psychotherapy may be

Option C: This is not therapeutic because it confronts the used therapeutic modalities but these are not the best.

underlying cause.