Nursing Practice V – Nursing Care of Client with Physiological and Psychosocial Alteration
Medical and Surgical Nursing / Psychology
PART 2 Board Exam test questions 51 - 100
Situation 11 – The nurse is often met with the following situations when clients become angry and hostile.
51. To maintain a therapeutic eye contact and body posture while interacting with angry and aggressive individual, the nurse should:
A. keep an eye contact while staring at the client
B. keep his/her hands behind his/her back or in one’s pockets
C. fold his/her arms across his/her chest
D. keep an “open” posture, e.g. Hands by sides but palms turned outwards
52. During the pre-interaction phase of the N-P relationship, the nurse recognizes this normal INITIAL reaction to an assaultive or potentially assaultive person.
A. To remain and cope with the incident
B. Display empathy towards the patient
C. To call for help from other members of the team
D. To stay and fight or run away
53. Which of the following is an accurate way of reporting and recording an incident?
A. “When asked about his relationship with his father, client became anxious.”
B. “When asked about his relationship with his father, client clenched his jaw/teeth, made a fist and turned away from the nurse.”
C. “When asked about his relationship with his father, client was resistant to respond”
D. “When asked about his relationship with his father, his anger was suppressed”
54. To encourage thought, which of the following approaches is NOT therapeutic?
A. “Why do you feel angry?”
B. “When do you usually feel angry?”
C. “How do you usually express anger?”
D. What situations provoke you to be angry?”
55. A patient grabs and about to throw it. The nurse best responds saying.
A. “Stop! Put that chair down.”
B. “Don’t be silly.”
C. “Stop! The security will be here in a minute.”
D. “Calm down.”
Situation 12 – Nursing care for the elderly
56. In planning care for a patient with Parkinson’s disease, which of these nursing diagnoses should have priority?
A. potential for injury
B. altered nutritional state
C. ineffective coping
D. altered mood state
57. A healthy adaptation to aging is primarily related to an individual’s…
A. Number of accomplishments
B. Ability to avoid interpersonal conflict
C. Physical health throughout life
D. Personality development in his life span
58. The frequent use of the older client’s name by the nurse is MOST effective in alleviating which of the following responses to old age?
A. Loneliness
B. Suspicion
C. Grief
D. Confusion
59. An elderly confused client gets out of bed at night to go to the bathroom and tries to go to another bed when she returns. The MOST appropriate action the nurse would take is to:
A. Assign client to a single room
B. Leave a light on all night
C. Remind client to call the nurse when she wants to get up
D. Put side rails on the bed
60. An elderly who has lots of regrets, unhappy and miserable is experiencing:
A. Crisis
B. Despair
C. Loss
D. Ambivalence
Situation 13 – Graciela 1½ year old is admitted to the hospital from the emergency room with a fracture of the left femur due to a fall down a flight of stairs. Graciela is placed on Bryant’s traction.
61. While on Bryant’s traction, which of these observations of Graciela and her traction apparatus would indicate a decrease in the effectiveness of her traction?
A. Graciela’s buttocks are resting on the bed.
B. The traction weights are hanging 10 inches above the floor.
C. Graciela’s legs are suspended at a 90 degree angle to her trunk.
D. The traction ropes move freely through the pulley.
62. The nurse notes that the fall might also cause a possible head injury. She will be observed for signs of increased intracranial pressure which include:
A. Narrowing of the pulse pressure
B. Vomiting
C. Periorbital edema
D. A positive Kernig’s sign
63. Graciela is assessed to have no head injury. The Bryant’s traction is removed. A plaster of Paris hip spica is applied. Which of these finding is a concern of immediate attention that must be reported to the physician immediately?
A. Graciela is scratching the cast over her abdomen.
B. The toes of Graciela’s left foot blanch when the nurse applies pressure on them.
C. Graciela’s cast is still damp.
D. The nurse is unable to insert a finger under the edge of Graciela’s cast on her left foot.
64. Part of discharge plan is for the nurse to give instructions about the care of Graciela’s cast to the mother. Which of these statements indicate that the mother understood an important aspect of cast care?
A. I will use white shoe polish to keep the cast neat.
B. I will place plastic sheeting around the perineal area of the cast.
C. I will use cool water to wash the cast.
D. I will reinforce cracked areas on the cast with adhesive tape.
65. The nurse counsels Graciela’s mother ways to safeguard safety while providing opportunities for Graciela to develop a sense of:
A. Trust
B. Initiative
C. Industry
D. Autonomy
Situation 14 – Jolina is an 18 year old beginning college student. Her mother observed that she is having problems relating with her friends. She is undecided about her future. She has lost insight, lost interest in anything and complained of constant tiredness.
66. Jolina is put on antidepressant drugs. These drugs act on the brain chemistry, therefore they would be useful in which type of depression?
A. exogenous depression
B. neurotic depression
C. endogenous depression
D. psychotic depression
67. This is a tricyclic antidepressant drug:
A. Venlafaxine (Effexor)
B. Flouxetine (Prozac)
C. Sertraline (Zoloft)
D. Imipramine (Tofranil)
68. After one week of antidepressant medication, Jolina still manifests depression. The nurse evaluates this as:
A. Unusual because action of antidepressant drug is immediate.
B. Unexpected because therapeutic effectiveness takes within a few days.
C. Expected because therapeutic effectiveness takes 2-4 weeks.
D. Ineffective result because perhaps the drug’s dosage is inadequate.
69. Jolina continues to verbalize feeling sad and hopeless. She is not mixing well with other clients. One of the nurse’s important considerations for Jolina INITIALLY is:
A. Formulate a structured schedule so she is able to channel her energies
externally
B. Let her alone until she feels like mingling with others.
C. Encourage her to join socialization hour so she will start to relate with others.
D. Encourage her to join group therapy with other patients.
70. During the predischarge conference, the nurse suggests vocational guidance because it should help Jolina to:
A. Find a good job.
B. Make some decisions about her future
C. Realistically assess her assets and limitations
D. Solve her own problems
Situation 15 – Group Approach in Nursing
71. Membership dropout generally occurs in group therapy after a member:
A. Accomplishes his goal in joining the group
B. Discovers that his feelings are shared by the group members
C. Experiences feelings of frustration in the group
D. Discusses personal concerns with group members
72. Which of the following questions illustrates the group role of encourager?
A. What were you saying?
B. Who wants to respond next?
C. Where do you go from here?
D. Why haven’t we heard from you?
73. The goal of remotivation therapy is to facilitate:
A. Insight
B. Productivity
C. Socialization
D. Intimacy
74. The treatment of the family as a unit is based on the belief that the family:
A. is a social system and all the members are interrelated components of that system
B. as a unit of society needs the opportunity to change its own destiny
C. who has therapy together will tend to remain together
D. is “contaminated” by the presence of deviant member and all members need
treatment.
75. The working phase in a therapy group is usually characterized by which of the following?
A. Caution
B. Cohesiveness
C. Confusion
D. Competition
Situation 16 – The mental health – psychiatric nurse functions in a variety of setting with different types of clients.
76. Poverty as reflected in prevalence of communicable diseases, malnutrition and social ills such as street children, homeless and prostitution is a predisposing factor to mental illness. A community approach to cope with this problem is for the nurse to support:
A. aggressive family planning methods
B. provision of social welfare benefits for the poor
C. social action
D. free clinics and more hospitals
77. The MOST cost effective way to meet the mental health needs of the public is through programs with a priority goal of:
A. treatment
B. prevention
C. rehabilitation
D. research
78. Lorelie upon discharge was referred to a volunteer group where she has learned to read patterns, cut out fabric and use a sewing machine to make simple outfits that will help her earn in the future. What type of therapy is this?
A. Recreational therapy
B. Art therapy
C. Vocational therapy
D. Educational therapy
79. In a residential treatment home for adolescent girls, the clients were becoming increasingly tense and upset because of shortening of their recreation time. To deescalate possible anger and aggression among the clients it is BEST to play:
A. religious music
B. relaxation music
C. dance music
D. rock music
80. The parents of special children who are behaviorally disturbed need mental health education. Which of these topics would the school nurse consider as priority for their parent’s class?
A. Drug education
B. Child abuse
C. Effective parenting
D. Sex education
Situation 17 – Nurses in all practice areas are likely to come in contact with clients suffering from acute or chronic drug abuse.
81. The psychodynamic therapy of substance abuse is based upon the premise that drug abuse is:
A. a common problem brought about by socioeconomic deprivation
B. caused by multiplicity of factors
C. predisposed by an inability to develop appropriate psychological resources to manage developmental stresses
D. due to biochemical factors
82. Being in contact with reality and the environment is a function of the:
A. conscience
B. ego
C. id
D. super ego
83. Substance abuse is different from substance dependence in that, substance dependence:
A. includes characteristics of adverse consequences and repeated use
B. requires long term treatment in a hospital based program
C. produces less severe symptoms than that of abuse
D. includes characteristics of tolerance and withdrawal
84. During the detoxification stage, it is a priority for the nurse to:
A. teach skills to recognize and respond to health threatening situations
B. increase the client’s awareness of unsatisfactory protective behaviors
C. implement behavior modification
D. promote homeostasis and minimize the client’s withdrawal symptoms
85. Commonly known as “shabu” is:
A. Cannabis Sativa
B. Lysergic acid diethylamide
C. Methylenedioxy methamphetamine
D. Methamphetamine hydrochloride
Situation 18 – It is common that clients ask the nurse personal questions.
86. Anticipation of personal questions is given adequate attention during which phase of the nurse patient relationship?
A. Orientation phase
B. Working phase
C. Pre-interaction phase
D. Termination phase
87. If the client asks for the nurse’s telephone number, which of these responses is NOT appropriate?
A. “It is confidential I just don’t give it to anyone.”
B. “What would you do with my number if I give it to you?”
C. “If I say No to your request, what are your thoughts about it?”
D. “Are you asking for an official number of the hospital/clinic for your reference?”
88. When the client asks about the family of the nurse, the MOST appropriate response is:
A. Avoid the situation and redirect the client’s attention
B. Give a brief and simple response and focus on the client.
C. “Why don’t we talk about your family instead?”
D. Introduce another topic like the client’s interests
89. When the nurse is asked a personal question, which of these reactions indicates a need for her to introspect?
A. The client is simply curious.
B. His/Her right to privacy is being intruded.
C. The client knows no other way to begin a conversation.
D. Some patients are like children in seeking recognition from the nurse.
90. It is 10 o’clock on your watch. The client asks, “What time is it?” The nurse’s appropriate is:
A. “Are you getting bored?”
B. “It is 10 o’clock.”
C. “Why do you ask?”
D. “Guess, what time is it?”
Situation 19 – Ricky is a 12 year old boy with Down’s syndrome. He stands 5’ ½” and weighs 100 lbs. he is slim and walks sluggishly with a limp. He wears a neck brace as a support for his neck. X-ray of cervical spine showed “subluxation of C1 in relation to C2 with cord compression”. He attends a school for a special education.
91. The classroom teacher consults the school nurse for guidance on how to take care of Ricky while inside of the classroom. The nurse considers as priority, Ricky’s:
A. Physiological needs
B. Need for self esteem
C. Needs for safety and security
D. Needs for belonging
92. Ricky’s mother visited the school nurse. She asked, “What should I do when Ricky fondles his genitalia?” An appropriate response of the nurse is for the mother to:
A. Divert Ricky’s attention and engage him in satisfying activities
B. Tell Ricky that it is wrong to keep fondling his genitalia
C. Ignore Ricky’s behavior because he will outgrow it later
D. Engage him in computer TV games that engage his hands
93. The nurse had one on one health education sessions with Ricky’s mother. The mother understood that for her son to learn to cope and be independent, she should constantly provide activities for Ricky to be able to:
A. socialize with people
B. eventually go to school alone
C. select and prepare his own food
D. do activities of daily living
94. All of the following activities are appropriate for Ricky EXCEPT:
A. Working with clay
B. Competitive sport
C. Preparing and cooking simple menu
D. Card and table games
95. Ricky’s IQ falls within the range of 50-55. he can be expected to:
A. Profit from vocational training with moderate supervision
B. Live successfully in the community
C. Perform simple tasks in closely supervised settings
D. Acquire academic skills of 6th grade level
Situation 20 – The abuse of dangerous drugs is a serious public health concern that nurses need to address.
96. The nurse should recognize that the unit primarily responsible for education and awareness of the members of the family on the ill effects of dangerous drugs is the:
A. law enforcement agencies
B. school
C. church
D. family
97. A drug dependent utilizes this defense mechanism and enables him to forget shame and pain.
A. repression
B. rationalization
C. projection
D. sublimation
98. This drug produces mirthfulness, fantasies, flight of ideas, loss of train of thought,
distortion of size, distance and time, and “bloodshot eyes” due to dilated pupils.
A. Opiates
B. LSD
C. Marijuana
D. Heroin
99. The nurse evaluates that her health teaching to a group of high school boys is effective if these students recognize which of the following dangers of inhalant abuse.
A. Sudden death from cardiac or respiratory depression
B. Danger of acquiring hepatitis or AIDS
C. Experience of “blackout”
D. Psychological dependence after prolonged use
100. The mother of a drug dependent would never consider referring her son to a drug rehabilitation agency because she fears her son might just become worse while relating with other drug users. The mother’s behavior can be described as:
A. Unhelpful
B. Codependent
C. Caretaking
D. SupportiveCLICK HERE PART 1 (1 - 50)'NP5 Nursing Board Exam June 2007 Answer Key Nursing Care of Client with Physiological and Psychosocial Alteration'
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