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
June 2008
NURSING PRACTICE V - NURSING CARE OF CLIENT WITH PHYSIOLOGICAL AND PSYCHOSOCIAL ALTERATIONS (Part C)
1. This behavior is categorized as:
A. delusional
B. normal
C. neurotic
D. psychotic
2. 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
3. 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 )
B. haloperidol ( Haldol )
C. imipramine Hcl ( Tofranil )
D. chlorpromazine ( Thorazine )
4. 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”
5. The level of anxiety that Felisa is experiencing is:
A. Panic
B. Severe
C. Mild
D. Moderate
Situation - The nurse recognizes the need to learn to cope with stress and change. She becomes interested to practice natural ways to enhance well being.
6. 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
7. All of these are the behavior intervention to stress management. EXCEPT:
A. guided imagery
B. pharmacotherapy
C. meditation
D. progressive muscle relaxation
8. Basic to progressive muscle relaxation is:
A. focusing on an image to relax
B relaxing muscles from tension
C. use of industrial equipment
D. stopping disturbing thoughts
9. 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
10. 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
B. information
C. skills to attempt change
D. motivation
Situation - 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:
11. Bernie and John are going through a:
A. situational crisis
B. developmental crisis
C. anticipated crisis
D. both developmental and situational crisis
12. 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
13. The nurse employs this approach in crisis intervention:
A. problem-solving
B. behavior modification
C. role-playing
D. nurse-patient relationship
14. Assessment data of the nurse include all the following EXCEPT:
A. coping mechanisms
B. situational support
C. perception of the event
D. repressed problems
15. The duration of crisis usually lasts several days and usually:
A. 2 – 4 weeks
B. 1 – 2 weeks
C. 1 – 2 months
D. 4 – 6 weeks
Situation - 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
B. super ego
C. ego ideal
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
B. toddler age
C. infancy period
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 - As a professional, it is imperative that the nurse is accountable to oneself hence the importance of personal and professional development.
21. Nurse: “ I feel personally involved with my client’s problems” demonstrates:
A. counter transference
B. empathy
C. transference
D. sympathy
22. 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
23. An accepting attitude requires being:
A. aware of ones biases
B. tolerant of the faults of others
C. non judgmental
D. in control of tendency to blame
24. 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
B. assertiveness
C. therapeutic use of self
D. self-mastery
25. 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 – Ninety year old Purita is confined at the medical unit for respiratory ailment for which a breathing apparatus is prescribed for her to use while she sleeps. She refuses to wear continuously though she full understands the medical indication for it:
26. Which of these ethical principles can guide the nurse in her action?
A. Beneficence
B. Fidelity
C. Autonomy
D. Nonmaleficence
27. Purita has six children who already adults. They differ in their opinion whether or not to allow their mother to decide for her. The nurse would encourage family conference for:
A. The eldest child’s opinion to be given priority.
B. Majority of the children to decide
C. Allowing the medical staff to decide in their behalf
D. Consensus building
28. Breathing treatments are to be given to Purita. In anticipation that Purita might refuse. Dinio, one of the children requests that he be the one to sign the consent in behalf of their mother. The nurse explains that Purita is rational in her thinking and which of this client’s right must be regarding?
A. Right to refuse treatment
B. Right to privacy
C. Right to informed consent
D. Right of habeas consent
29. Which of these would be the nurse’s priority following the treatment principle of least restrictive alternative?
A. One on one staffing
B. Use of on site guard/watcher
C. Physical restraint
D. Seclusion
30. Purita talks about her joy in having responsible and accomplished children and recalls challenging career as a lawyer. She is demonstrating a sense of:
A. Ego integrity
B. Industry
C. Generativity
D. Autonomy
Situation – The supervising nurse received report that a staff nurse is displaying frequent irritation, anger, and even indifference toward clients and co-workers.
31. The initial action of the supervisor would be to:
A. Post guidelines on proper decorum of nurse in the bulletin board.
B. Write a memo of warning to the house
C. Request anecdotal report from the nurse’s co-workers
D. Call the nurse for a one on one conference
32. The nurse expressed increasing feelings of dissatisfaction. The supervising nurse intervenes therapeutically by taking the role of:
A. Administrator by relieving her of responsibilities
B. Therapist by delving into the nurse’s internal conflict
C. Counselor by actively listening
D. Educator by reorienting her of role as a nurse.
33. Coupled with poor work performance, mental and physical fatigue and actual withdrawal from client contact and nursing duties. The nurse can be said to be suffering from:
A. Psychotic anxiety
B. Staff burn-out
C. Personality maladjustment
D. Neurotic depression
34. A priority in the nurse’s personal development would be to:
A. Address her physical well-being
B. Boost her self-confidence
C. Provide social support
D. Help her find value and meaning in her work
35. The most relevant professional program for her would be:
A. Assertiveness training
B. Stress management
C. Group dynamics and team building
D. Behavior modification
Situation – A nurse assigned in the neurologic unit is taking of clients with varying degrees of generative disorders.
36. Mr. A with Myasthenia Gravis is having difficulty speaking. What communication strategies should the nurse avoid when interacting with Mr. A?
A. Repeating what the client says for better understanding
B. Using paper and pencil in communicating with the client
C. Encouraging the client to speak slowly
D. Encouraging the client to speak quickly
37. When planning for nursing care for Mr. B who has Parkinson’s disease. Which of the following goals would be most appropriate?
A. To improve muscle tone
B. To start rehabilitation as much as possible
C. TO treat the disease
D. TO maintain optimal body function
38. For the past 10 years, Alma
A. Strengthen muscle coordination
B. Establish routine
C. Develop perseverance and motivation
D. Establish good health habits
39. On his second day of hospitalization, Mr. Santos was unable to stand and is having difficulty swallowing and talking. Which of the following is the priority of the nurse in assisting Mr. Santos?
A. To prevent bladder distention
B. To prevent decubitus ulcer
C. To prevent contracture
D. To prevent aspiration pneumonia
40. The wife of a seventy two year old man with a diagnosis of Alzheimer’s disease begins to cry and tells the nurse, “I could not understand my husband anymore. He has changed drastically.” “Which of the following responses of the nurse is MOST appropriate?
A. The physician and the staff will make sure that your husband will be comfortable and safe here.
B. This has been a difficult time for you. Let us walk and find a quiet place where we can talk.
C. He will soon recover in his condition.
D. You need not worry, we are doing the best we could.
Situation – Annie has a morbid fear of heights. She asks the nurse what desensitization therapy is:
41. The accurate information of the nurse the goal of desensitization is:
A. To help the clients relax and progressively work up a list of anxiety provoking situations through imagery
B. To provide corrective emotional experiences through a one-to-one intensive relationship
C. To help clients in a group therapy setting to take on specific roles and reenact in front of an audience, situations in which interpersonal conflict is involved.
D. To help clients cope with their problems by learning behaviors that we are more functional and be better equipped to face reality and make decisions.
42. It is essential in desensitization for the patient to:
A. Have a rapport with therapist
B. Use deep breathing or another relaxation technique
C. Assess one’s self for the need of anxiolytic drug
D. Work through unresolved unconsciousness conflicts
43. In this level of anxiety, cognitive capacity diminishes. Focus becomes limited and client experiences turned vision. Physical signs of anxiety become more pronounced.
A. Severe anxiety
B. Panic
C. Mild anxiety
D. Moderate anxiety
44. Anti-anxiety medication should be used with extreme caution because long term use can lead to.
A. Parkinsonian like syndrome
B. Hypertensive crisis
C. Hepatic failure
D. Risk of addiction
45. The nursing management of anxiety related with post traumatic stress disorder includes all of the following EXCEPT:
A. Encourage participation in recreation or sport activities
B. Reassurance client’s safety while touching client
C. Speak in calm soothing voice
D. Remain with the client while fear level is high
Situation – The nurse is often met with the following situations when clients become angry and aggressive individual, the nurse should:
46. 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
47. During the pre-interaction phase of the N-P relationship, the nurse recognizes thisnormal 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
48. 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”
49. 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?”
50. 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.”
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