Jun 22, 2010

NP5 Nursing Board Exam December 2006 Answer Key 'Nursing Care of Client with Physiological and Psychosocial Alteration'

100 Nursing Board Exam test questions of December 2006 Nurse Licensure Examination (NLE)
Nursing Practice V – Nursing Care of Client with Physiological and Psychosocial Alteration
Medical and Surgical Nursing / Psychology

PART 1 Board Exam test questions 1 - 50


DIRECTION: Choose the letter of the BEST answer by shading the corresponding letter of your choice on the answer sheet provided. STRICTLY NO ERASURE!

Situation 1: The nurse is envisioning a career  path in mental health psychiatric nursing. As a beginning professional nurse, she is guided with basic beliefs about the practice.

1. Which of the following statement reflects the scope of mental health psychiatric nursing?
     A. it includes nursing actions aimed at returning the patient to his highest potential of productivity.
     B. it is an integral aspect of all nursing and a specialty service to all people affected by mental illness.
     C. it includes nursing actions to reduce the rate of new cases of mental disorder in population
     D. it consist of early recognition and treatment of mental disorders to reduce severity and duration of      mental illness      

2. The beginning professional nurse can do mental health counseling with the following clients, EXCEPT:
     A. actively psychotic patients                            C. parents with child rearing concerns
     B. out of school adolescents                                  D. school children with behavioral problem



3. A professional responsibility of the mental health psychiatric nurse is to provide a safe and therapeutic environment. This is BEST reflected in:
     A. restraining patients who violates policies and do not follow schedule of activities.
     B. maintaining a closed door policy to prevent patients from absconding.
     C. keeping a restrictive environment to prevent patients from becoming assaultive and hostile
     D. ensuring physical safety and maintaining therapeutic attitude towards the patients

4. The foundation of the therapeutic process is the therapeutic relationship. What is the essential component that the nurse must bring to the relationship?
     A. humor                                                                C.  reframing
     B. empathy                                                                       D. confrontation

5. Which of these people, the highest in population groups that would need priority mental health therapy?
     A. adults going through active skills                          C. young professionals entering the workplace
     B. single elderly with no social support             D. women preparing for overseas employment


Situation 2: Some activity therapies are organized and conducted in groups where nurses may participate in.

6. A mental health nurse may not be a member of this self help group because help given to members comes from members themselves:
     A. Remotivation Group                                               C. Activity Therapy Group
     B. Alcoholics Anonymous                                           D. Art Therapy Group

7. Which of the following determines the success of client government groups?
     A. willingness of psychiatric professionals to be open and receptive to client’s ideas and suggestions
     B. a way of permitting clients provide themselves with a more creative and wholesome life
     C. means to acquire a variety of social skills
     D. opportunity to learn democratic living

8. Which of this client situation appropriately illustrate horticulture therapy?
     A. the therapist brings bongos, tambourine, and bells and encourages client participation
     B. Tommy, Karen, Jon and Pia play scrabble every night after supper
     C. every afternoon, Vic goes in the garden where he work with plants, seedlings, tree planting                   
            And watering them
     D. Paul finds sketching relaxing and rewarding
9. Eva is a member of a group who controls endless talking. Her role is that of a/an:
     A. blocker                                                               C. recognition seeker
     B. self-confessor                                                       D. monopolizer

10. Community meetings are held as a part of milieu therapy on an in-patient psychiatric unit.  The purpose of these meetings would be:
     A.  to focus on issue arising from group living
     B.  to encourage expression on topics of interest
     C.  to provide direction from the treatment plan
     D.  to encourage expression of intrapsychic conflicts

Situation 3:  The patient who is depressed will undergo electroconvulsive therapy.

11.  Studies on biological depression support electroconvulsive therapy as a mode of treatment.  The rationale is:
     A.  ECT produces massive brain damage which destroys the specific area containing memories related to
     the events surrounding the development of psychotic condition
     B.  The treatment serves as a symbolic punishment for the client who feels guilty and worthless
     C.  ECT relieves depression psychologically by increasing the norepinephrine level
     D.  ECT is seen as a life-threatening experience and depressed patients mobilize all their bodily defenses
to deal with this attack.
 
12.  The preparation of a patient for ECT ideally is MOST similar to preparation for a patient for:
     A.  electroencephalogram                                          C. general anesthesia
     B.  X-ray                                                                  D. electrocardiogram

13. Which of the following is a possible side effect which you will discuss with the patient?
     A. hemorrhage within the brain                                              C. encephalitis
     B. robot-like body stiffness                                          D. confusion, disorientation and short term     
                                                                                        memory loss

14. Informed consent is necessary for the treatment for involuntary clients. When this cannot be obtained, permission may be taken from the:
     A. social worker                                                        C. next of kin or guardian
     B. doctor                                                                  D. chief nurse

15. After ECT, the nurse should do this action before giving the client fluids, food or medication:
     A. assess the gag reflex                                        C. next of kin or guardian
     B. assess the sensorium                                            D. check O2 Sat with a pulse oximeter


Situation 4: The community health nurse encounters special children in the community.

16. An individual with antisocial personality disorder lacks remorse, shame and guilt in going against the norms of society. Psychodynamically, this defect in the personality reflects a disturbance of the:
     A. ego                                                                      C. ego ideal
     B. super ego                                                                       D. id

17. The nurse teaches parents about children’s beginning concepts of right and wrong by emphasizing child rearing attitude and practices during the:
     A. school age                                                            C. infancy period
     B. toddler age                                                        D. latency period

18. It is BEST for parents to teach healthy interpersonal relationships to their children by:
     A. modeling to their children
     B. encouraging their children to attend secondary school
     C. encouraging their children at home to behave properly
     D. teaching their children good manners and right conduct

19. An important principle for the nurse to follow in interacting with retarded children is:
     A. seen that if the child appears contented, his needs are being met
     B. provide an environment appropriate to their development task as scheduled
     C. treat the child according to his chronological age
     D. treat the child according to his developmental level


20. Mental retardation is:
     A. a delay in normal growth and development caused by an inadequate environment
     B. a lack of development of sensory abilities
     C. a condition of subaverage intellectual functioning that originates during the developmental  
             period and is associated with impairment in adaptive behavior
     D. a severe lag in neuromuscular development and motor abilities

Situation 5: The nurse recognizes the need to learn to cope with stress and change. She becomes interested to practice natural ways to enhance well being.

21. Lifestyle modification begins with:
     A. minimizing eating in fast food restaurants
     B. having an exercise regimen to follow regularly
     C. recognizing the impact of unhealthy habits
     D. avoiding pollutants in the environment

22. All of these are the behavior intervention to stress management. EXCEPT:
     A. guided imagery                                                     C. meditation
     B. pharmacotherapy                                              D. progressive muscle relaxation    

23. Basic to progressive muscle relaxation is:
     A. focusing on an image to relax                                 C. use of industrial equipment
     B. relaxing muscles from tension                         D. stopping disturbing thoughts

24. Dietary practices are very important to the health of the Filipino family. The nurse needs to assess this
      lifestyle because:
     A. the nurse wants to change the eating patterns of the Filipino family
     B. the nurse knows that being overweight is a major health hazard
     C. the nurse wants to stop all the mainstream weight-loss diets
     D. the nurse has to find out what people are eating

25. A young overweight adult smokes 5-10 sticks of cigarettes/day, ambitious, looks at life as challenging and perfect and never considers change in his lifestyle, initially needs:
     A. commitment                                                         C. skills to attempt change
     B. information                                                        D. motivation
           
Situation 6: Bernie and John in their late 40’s have been married for 20 years and at the peak of their careers. Suddenly, Bernie discovered that her husband was falling in love with another woman. Shaken by this situation, she started to have problems sleeping and could not function well at work and at the risk of losing her job. John asked forgiveness and regret very much the hurt his wife was going through and suffered guilt feelings:

26. Bernie and John are going through a:
     A. situational crisis                                                C. anticipated crisis
     B. developmental crisis                                              D. both developmental and situational crisis

27. All of these are characteristics of crisis EXCEPT:
     A. a hazardous or threatening event occurs
     B. it has a growth promoting potential
     C. usual problem solving methods and coping mechanisms produce a solution
     D. anxiety or depression continue to increase 

28. The nurse employs this approach in crisis intervention:
     A. problem-solving                                                            C. role-playing
     B. behavior modification                                            D. nurse-patient relationship

29. Assessment data of the nurse include all the following EXCEPT:           
      A. coping mechanisms                                              C. perception of the event
      B. situational support                                                D. repressed problems

30. The duration of crisis usually lasts several days and usually:
      A. 2 – 4 weeks                                                         C. 1 – 2 months
      B. 1 – 2 weeks                                                         D. 4 – 6 weeks

Situation 7: Felisa has a ritualistic pattern of constantly washing her hands with soap and water followed by rubbing alcohol.

31. This behavior is categorized as:
     A. delusional                                                             C. neurotic
     B. normal                                                                 D. psychotic

32. A therapeutic intervention in this situation is:
     A. avoid limits on her behavior to release her anxiety
     B. call attention to her ritualistic pattern
     C. provide alternative behaviors to deal with increased anxiety
     D. ignore her behavior totally

33. The anxiety of Felisa is disabling and interferes with her job performance, interpersonal relationships and other activities of daily living. To minimize such problems, she is likely to be given:
     A. diazepam ( Valium )                                          C. imipramine Hcl ( Tofranil )
     B. haloperidol ( Haldol )                                             D. chlorpromazine ( Thorazine )

34. Felisa understands the effects of her medicine when expresses:
     A. “I should watch out for signs of sore lips or sore throat”
     B. “I might have constipation”
     C. “I might feel changes in my body temperature”
     D. “ I should not drive or operate machines”

35. The level of anxiety that Felisa is experiencing is:
     A. Panic                                                                    C. Mild
     B. Severe                                                                D. Moderate

Situation 8:As a professional, it is imperative that the nurse is accountable to oneself hence the importance of personal and professional development.

36. Nurse: “ I feel personally involved with my client’s problems” demonstrates:
     A. counter transference                                        C. transference
     B. empathy                                                               D. sympathy

37. The nurse has achieved self-awareness in which of the following verbalizations?
     A. every time people around me yell, I feel upset and withdrawn
     B. when the patient yelled at me I became speechless
  C. with the patients tone of voice and stare, I got reminded of how my father would be so angry  and this made me    anxious
     D. I thought it was rude for the patient to yell hence I kept quiet

38. An accepting attitude requires being:
     A. aware of ones biases                                        C. non judgmental
     B. tolerant of the faults of others                                D. in control of tendency to blame

39. Self-awareness, knowledge and understanding of human behavior and communication skills define what is essential in caring for every nurse to be able to demonstrate:
     A. positive self-projection                                           C. therapeutic use of self
     B. assertiveness                                                        D. self-mastery

40. Considering that man is by nature social, it is BEST for the nurse to gain self-awareness by:
     A. participating in intensive group experiences
     B. individual psychotherapy
     C. hypnotherapy
     D. writing an autobiography for self introspection

Situation 9: Recording and the nurse.

41. To facilitate identification of persons and relationships, the family nurse utilizes this diagrammatic representation of members of a family and their relationships:
      A. flowchart                                                             C. algorithm
      B. genogram                                                         D. kardex

42. A problem oriented recording system that utilizes the problem solving process as the basis of patient care management:
     A. NANDA Diagnosis                                                  C. Gordon’s Functional Health Patterns
     B. Nursing Care Plan                                                 D. Problem Oriented Medical Recording

43. This is a SOAP recording of the patient’s problem of “Nervousness”. Which is the subjective data?
     A. Mr. Z was nervous during the interview, he moved frequently in the bed and his palms were sweaty.
     B. Mr. Z does not seem to tolerate stress too well which will aggravate his cardiac condition. He understands
         Little about his health which may be increasing his state of anxiety.
     C. “I am nervous at times”. Exerts himself physically and is hesitant to discuss problems.
     D. Mr. Z should:
          1. demonstrate an ability to cope with nervousness
          2. demonstrate an understanding of the relationship between his nervousness and cardiac condition

44. The nurse researcher mutually agreed with the research subjects that all personal data of the subjects shall be kept confidential. To safeguard anonymity of data after the report is written, the nurse researcher should:
     A. throw the papers in a wastebasket
     B. keep the papers for 5 years and dispose of these after
     C. burnt or shred the papers
     D. have the papers recycle but not as writing scratch paper

45. A step by step procedure for the management of common problems is a :
      A. Gavin chart                                                          C. decision tree protocol
      B. pedigree chart                                                     D. problem listing

Situation 10:The nurse works with Mina to help her work through termination of the nurse-patient relationship.

46. Preparation for termination of the nurse-patient relationship begins during the:
      A. termination phase                                                C. pre-orientation phase
      B. working phase                                                     D. orientation phase

47. Mina’s past reactions to ending relationships is withdrawal. The nurse assists her to practice better ways of coping termination by providing opportunities to:
      A. test new patterns of behavior                                C. conceptualize her problem
      B. plan for alternatives                                             D. value and find meaning in experience

48. During the early part of the interaction, the nurse asked after a period of silence. “Perhaps we would talk about my leaving”. The nurse utilized which communication technique:
      A. encouraging                                                         C. focusing on client
      B. suggesting                                                        D. understanding

49. Mina: (angrily) “ I am angry, I should never have gotten involved with you” (silence)
     Nurse: “You have reason to be disappointed and to feel angry. Just when we were getting somewhere.
        I leave you.”
       A. reflecting words                                                  C. orienting
        B. understanding                                                            D. reflecting feelings

50. The objection of the nurse-patient relationship is to provide an opportunity of the patient to:
      A. clarify problems                                                   C. have a corrective emotional experience
      B. develop insights                                                   D. develop interpersonal relationship

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