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 2 Board Exam test questions 51 - 100

Situation 11: As a program manager, the mental health psychiatric nurse is tasked to provide general patient management.

51. The nurse is aware that identifying the aspects of general patient management and identifying interventions for meeting these basic needs are distinctions of:
     A. psychotherapy                                                      C. pharmacotherapy
     B. therapeutic milieu                                                         D. behavior therapy

52. In order to get active participation of the clients to carry out the objective of the program, it is BEST for the nurse to conduct a/an:
     A. community meeting                                           C. observation
     B. survey                                                                 D. selective interview of patients

53. Through the nurse’s role modeling of effective communication, the clients learned new ways of dealing with authority figures. This gives the clients a venue to:
     A. communicate                                                        C. identify their problems
     B. socialize                                                               D. test new patterns of behavior

54. This element of communication facilitates evaluation of the program:
     A. receiver                                                               C. sender
     B. message                                                              D. feedback    
              
   55. The nurse’s style of leadership in milieu therapy is:
     A. autocratic                                                             C. democratic
     B. laissez-faire                                                          D. benevolent


Situation 12: Loretta is a 28 years old, unemployed patient, admitted to the psychiatric unit with a diagnosis of chronic undifferentiated schizophrenia. She described herself as the “Virgin Mary” and her mission is to propagate peace. She was observed laughing and talking to herself. Her thought processes were profoundly disorganized. She was also fearful and suspicious of others.

56. Loretta’s claim of being the “Virgin Mary” is a/an:
     A. imagination                                                           C. hallucination
     B. delusion                                                             D. obsession

57. Her mission to propagate peace is:
     A. a serious call for a need of transformation               C. realistic and laudable
     B. an attempt to overcome low self-esteem        D. an advocacy that she can participate in

58. Which of this intervention would NOT be therapeutic in decreasing Loretta’s anxiety?
     A. joke about her thought to help her feel at ease
     B. listen to her thoughts and feelings
     C. simply accept
     D. do not convince her that her perception is unreal

59. The nurse evaluates that Loretta’s ready for a rehabilitation program when she:
     A. approaches the nurse at frequent intervals  C. goes to the coffee shop alone more often
     B. ceases to talk about “Virgin Mary”                               D. carries a book “The Purpose Driven Life”

60. The nurse is leading a group meeting of patients to prepare them to be discharged. An appropriate goal for the group members is to develop:
     A. attitudes of society towards the mentally ill
     B. skills for maintaining daily living
     C. awareness of interpersonal patterns of interactions
     D. insight into personal problems

Situation 13: A group of adult chronic schizophrenic patients were recommended to undergo social skills training.

61. The following are the objectives of a social skills training program EXCEPT:
     A. explore deep seated intrapsychic conflicts         C. help build self esteem and self confidence
     B. practice skills in relating with people                            D. develop and practice general coping skills

62. Social skills training is NOT primarily indicated for psychiatric patients who are:
     A. in acute stage of illness
     B. having difficulties starting and maintaining interpersonal relationships
     C. having chronic episodes of stress and anxiety while interacting with others
     D. experiencing recurrence of symptoms in front of particular people or among people in general

63. The focus of the group interaction is “here and now”. An appropriate topic would be:
     A. ways to celebrate Valentine’s Day in February
     B. how to spend the summer vacation
     C. an unforgettable experience as a child
     D. how to tell a joke

64. An appropriate technique for the participants to practice how to communicate effectively is through/a:
     A. lecture                                                                 C. role play
     B. seminar                                                                D. psychodrama

65. Considering that it is BEST to learn by example, it is MOST practical to:
     A. model good social skills throughout the session
     B. relate successful past experiences
     C. invite a resource person
     D. watch a movie

Situation 14: Community health nurses integrate their knowledge of mental health with their clients in their practice when they do mental health counseling.

66. Who among these clients need immediate referral for psychotherapy?
     A. those who are plotting to commit suicide
     B. those who are not responding to usual motivators
     C. those who are not solving their problems which they have the resources to solve
     D. those who are engaging in self-defeating behaviors

67. All of these describe what counseling, EXCEPT:
     A. helping people manage their own problems
     B. assisting people to use their own resources
     C. a set of technique, skills and attitudes
     D. giving advices

68. This quality of the nurse allows “connecting with others feelings”:
     A. warmth                                                                C. sensitivity
     B. courage                                                                D. prudence

69. “ To refuse gossip” is a reflection of the mental health nurses quality of:
     A. firmness                                                             C. judgment
     B. coolness                                                               D. trustworthiness

70. Which of the following concepts BEST describe the nurse’s interaction when she/he can recognize and identify feelings and emotions of another person without even having personally experienced those feelings and emotions?
     A. over involvement                                                  C. transference
     B. sympathy                                                             D. empathy
           
Situation 15: Communicating effectively with dementia patients is a challenge to psychiatric nurses.

71. Therapeutic ways to engage the elderly to be stimulated include all of the following EXCEPT:
     A. singing to or with the patients                                 C. providing a picture album
     B. listening to old familiar music                                 D. playing complex computer games

72. The LEAST area of satisfying communication with the elderly is on:
     A. recall of their courtship and love life                        C. fashion shown in personal pictures
     B. psychological trauma                                        D. memories of their teenage parties

73. To maximize communication with the elderly, which of the following ways of verbal communication should the nurse use minimally?
      A. asking simple questions                                        C. restating
      B. guiding the patient one step at a time                     D. asking for an open ended response

74. Unconditional positive regard for the elderly is BEST achieved when the nurse-patient relationship is based upon:
       A. vocational choices                                               C. addressing economic problems
       B. keeping                                                              D. providing warmth and caring

75. An optimal supportive  environment for a person with dementia includes all, EXCEPT:
       A. engaging the elderly in logical and abstract thinking
       B. developing a realistic uniformed and consistent daily schedule
       C. handling memory loss by distracting or diverting patient’s attention to something more positive
       D. simple nurse care for the patient day after day

Situation 16: Harry, age 36 is admitted to the psychiatry unit in an acute manic episode of bipolar disorder.

76. Harry’s condition is a disturbance of:
      A. sensorium                                                           C. the CNS
      B. cognition                                                             D. affect   

77. In the ward, Harry manifests excess energy and is difficult for him to sit still. The MOST useful activity for him would be:
      A. delivering supply of linen to other rooms                     C. conducting a drama workshop
      B. engaging in activity therapy and group exercises       D. painting a mural with other patients

78. Harry’s disruptive behavior on the unit has been increasingly annoying other clients. Which of the following would the nurse do?
      A. set limits on his behavior and be consistent in approach
      B. make a rigid structured plan that he will have to follow
      C. ignore his behavior
      D. tell him that he is annoying other clients and isolate him in his room

79. Harry approaches you and says “I have awarded Top Salesman of the Year. My boss will come and celebarate with me”. You know for a fact that this is NOT true. Harry is demonstrating a delusion of:
      A. achievement                                                        C. influence
      B. reference                                                            D. grandeur

80. The defense mechanism utilized by manic patients to cover up depression is:
      A. displacement                                                       C. compensation
      B. denial                                                                  D. reaction formation 

Situation 17: The nurse observed that Marie, age 28 years old had not been participating in activity therapies.

81. Which of the following remarks from the nursing attendants indicates a need for further teaching and observation?
      A. Marie made no response to an invitation to play
      B. Marie preferred to sit at the bench and watch the ballgame
      C. Marie is aloof and indifferent to co-patients
      D. Marie read a book while other patients played a ballgame

82. Marie said “I don’t like to be a part of it. Look, they are being laughed at because they are singing and acting like children”. The nurse notes that in order for the activity therapy to be therapeutic:
      A. the staff should decide solely what activities to be done and what rules apply
      B. patients should be allowed solely to decide what they want to do on their own
      C. ballgames should be limited to male patients only
      D. age and needs of patient should be considered in the choice of games

83. To encourage active participation among patients, it is BEST to plan activities they can engage in through a:
      A. one to one interaction                                      C. checklist
      B. community meeting                                              D. feedback evaluation forum

84. In planning activities for the patients, it is essential to consider FOREMOST:
      A. safety and security                                          C. novelty and creativity
      B. variety and fun                                                    D. excitement and challenge

85. Adults, “ singing and acting like children” is a form of:
      A. displacement                                                       C. sublimation
      B. regression                                                        D. compensation

Situation 18: A research was conducted on. “ The effects of the nurse expressive role in the reduction of anxiety in patients who will undergo nasogastric tube insertion”.

86. The research is experimental which means that utilized:
       A. an interview scheduled                                        C. a questionnaire
       B. a survey                                                             D. control and experimental groups

87. The independent variable is:
       A. patients                                                              C. reduction of anxiety
       B. expressive role                                               D. nasogastric insertion

88. The dependent variable is:
       A. nasogastric ingestion                                           C. expressive role
       B. patients                                                              D. reduction of anxiety

89. This study was done to check the procedures of the research:
       A. protest study                                                      C. pilot study
       B. proposal                                                             D. test-retest

90. Which of the following is NOT a characteristic of experimental research?
       A. value plays a significant part in research
       B. research ideas are capable of being tested
       C. results of tests made on the groups are compared
       D. research subjects are randomly selected and placed into groups for the purpose of manipulation

Situation 19: The client is walking to and fro along the hospital corridor and swinging her hands. She thinks she is going crazy. She is having palpitations, rapid pulse and hyperventilation.

91. Your nursing intervention should be to:
       A. encourage her to participate in an ongoing activity in the ward
       B. stay with her in a calm environment
       C. tell her to stop thinking that she is going crazy
       D. isolate the client in a quiet room

92. Which of the following is a behavioral manifestation of anxiety?
       A. hyperventilation                                                  C. panic
       B. tachycardia                                                         D. rapid pulse


93. Which of the following statements about anxiety is NOT true?
       A. anxiety is contagious
       B. repressed unresolved conflicts create anxiety
       C. anxiety at any level is destructive, hence a threat to a persons well being
       D. reactions to a perceived threat maybe real or imaginary

94. There is increased tension and reduced ability to perceive and communicate, hence “selective attention” in this level of anxiety:
       A. moderate                                                         C. panic
       B. severe                                                               D. mild

95. This medication is indicated for anxious patients:
       A. Tofranil (Imipramine HCL)                                   C. Valium (Diazepam)
       B. Haldol (Haloperidol)                                            D. Thorazine (Chlorpromazine)

Situation 20: Andy, 30 years old, was admitted to the Psychiatric Ward because of religious preoccupation, deterioration in self-care and disturbed thoughts. He believes that he has committed a lot of sins. He is threatened by people reaching out to him. His fasting for several days was not sufficient for him to feel forgiven.

96. Andy is demonstrating:
       A. religious delusion                                            C. somatic delusion
       B. delusion of grandeur                                            D. delusion of being controlled

97. A delusion is:
       A. psychomotor disturbance                         C. disturbance of thought
       B. mood disturbance                                                D. disturbance of perception

98. The nursing goal for Andy is to:
       A. have him see a priest for confession
       B. encourage him to pray to atone for his sins
       C. help him develop a positive self image
       D. socialize him with a group to keep him in touch with reality

99. As Andy talks about his sins that he believes make people look down upon him. It is BEST to:
       A. agree with him and sympathize how sinful he has really been
       B. explore the nature of his sins
       C. explain that he is depreciating himself too much
       D. acknowledge how he feels and focus on reality oriented topics

100. The psychosocial task that Andy needs to work on is a sense of:
       A. identity                                                               C. autonomy
       B. trust                                                                   D. intimacy 

CLICK HERE PART 1 (1 - 50) 'NP5 Nursing Board Exam December 2006 Answer Key 'Nursing Care of Client with Physiological and Psychosocial Alteration'

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