NCLEX Practice Exam for Psychiatric Nursing 1

1. Mental health is defined as:

  1. The ability to distinguish what is real from what is not.
  2. A state of well-being where a person can realize his own abilities can cope with normal stresses of life and work productively.
  3. Is the promotion of mental health, prevention of mental disorders, nursing care of patients during illness and rehabilitation
  4. Absence of mental illness

2. Which of the following describes the role of a technician?

  1. Administers medications to a schizophrenic patient.
  2. The nurse feeds and bathes a catatonic client
  3. Coordinates diverse aspects of care rendered to the patient
  4. Disseminates information about alcohol and its effects.

3. Liza says, “Give me 10 minutes to recall the name of our college professor who failed many students in our anatomy class.” She is operating on her:

  1. Subconscious
  2. Conscious
  3. Unconscious
  4. Ego

4. The superego is that part of the psyche that:

  1. Uses defensive function for protection.
  2. Is impulsive and without morals.
  3. Determines the circumstances before making decisions.
  4. The censoring portion of the mind.

5. Primary level of prevention is exemplified by:

  1. Helping the client resume self care.
  2. Ensuring the safety of a suicidal client in the institution.
  3. Teaching the client stress management techniques
  4. Case finding and surveillance in the community

6. Situation: In a home visit done by the nurse, she suspects that the wife and her child are victims of abuse. Which of the following is the most appropriate for the nurse to ask?

  1. “Are you being threatened or hurt by your partner?
  2. “Are you frightened of you partner”
  3. “Is something bothering you?”
  4. “What happens when you and your partner argue?”

7. The wife admits that she is a victim of abuse and opens up about her persistent distaste for sex. This sexual disorder is:

  1. Sexual desire disorder
  2. Sexual arousal Disorder
  3. Orgasm Disorder
  4. Sexual Pain Disorder

8. What would be the best approach for a wife who is still living with her abusive husband?

  1. “Here’s the number of a crisis center that you can call for help .”
  2. “Its best to leave your husband.”
  3. “Did you discuss this with your family?”
  4. “ Why do you allow yourself to be treated this way”

9. Which comment about a 3 year old child if made by the parent may indicate child abuse?

  1. “Once my child is toilet trained, I can still expect her to have some”
  2. “When I tell my child to do something once, I don’t expect to have to tell”
  3. “My child is expected to try to do things such as, dress and feed.”
  4. “My 3 year old loves to say NO.”

10. The primary nursing intervention for a victim of child abuse is:

  1. Assess the scope of the problem
  2. Analyze the family dynamics
  3. Ensure the safety of the victim
  4. Teach the victim coping skills

11. Situation: A 30 year old male employee frequently complains of low back pain that leads to frequent absences from work. Consultation and tests reveal negative results. The client has which somatoform disorder?

  1. Somatization Disorder
  2. Hypochondriaisis
  3. Conversion Disorder
  4. Somatoform Pain Disorder

12. Freud explains anxiety as:

  1. Strives to gratify the needs for satisfaction and security
  2. Conflict between id and superego
  3. A hypothalamic-pituitary-adrenal reaction to stress
  4. A conditioned response to stressors

13. The following are appropriate nursing diagnosis for the client EXCEPT:

  1. Ineffective individual coping
  2. Alteration in comfort, pain
  3. Altered role performance
  4. Impaired social interaction

14. The following statements describe somatoform disorders:

  1. Physical symptoms are explained by organic causes
  2. It is a voluntary expression of psychological conflicts
  3. Expression of conflicts through bodily symptoms
  4. Management entails a specific medical treatment

15. What would be the best response to the client’s repeated complaints of pain:

  1. “I know the feeling is real tests revealed negative results.”
  2. “I think you’re exaggerating things a little bit.”
  3. “Try to forget this feeling and have activities to take it off your mind”
  4. “So tell me more about the pain”

16. Situation: A nurse may encounter children with mental disorders. Her knowledge of these various disorders is vital. When planning school interventions for a child with a diagnosis of attention deficit hyperactivity disorder, a guide to remember is to:

  1. provide as much structure as possible for the child
  2. ignore the child’s overactivity.
  3. encourage the child to engage in any play activity to dissipate energy
  4. remove the child from the classroom when disruptive behavior occurs

17. The child with conduct disorder will likely demonstrate:

  1. Easy distractibility to external stimuli.
  2. Ritualistic behaviors
  3. Preference for inanimate objects.
  4. Serious violations of age related norms.

18. Ritalin is the drug of choice for chidren with ADHD. The side effects of the following may be noted:

  1. increased attention span and concentration
  2. increase in appetite
  3. sleepiness and lethargy
  4. bradycardia and diarrhea

19. School phobia is usually treated by:

  1. Returning the child to the school immediately with family support.
  2. Calmly explaining why attendance in school is necessary
  3. Allowing the child to enter the school before the other children
  4. Allowing the parent to accompany the child in the classroom

20. A 10 year old child has very limited vocabulary and interaction skills. She has an I.Q. of 45. She is diagnosed to have Mental retardation of this classification:

  1. Profound
  2. Mild
  3. Moderate
  4. Severe

21. The nurse teaches the parents of a mentally retarded child regarding her care. The following guidelines may be taught except:

  1. overprotection of the child
  2. patience, routine and repetition
  3. assisting the parents set realistic goals
  4. giving reasonable compliments

22. The parents express apprehensions on their ability to care for their maladaptive child. The nurse identifies what nursing diagnosis:

  1. hopelessness
  2. altered parenting role
  3. altered family process
  4. ineffective coping

23. A 5 year old boy is diagnosed to have autistic disorder. Which of the following manifestations may be noted in a client with autistic disorder?

  1. argumentativeness, disobedience, angry outburst
  2. intolerance to change, disturbed relatedness, stereotypes
  3. distractibility, impulsiveness and overactivity
  4. aggression, truancy, stealing, lying

24. The therapeutic approach in the care of an autistic child include the following EXCEPT:

  1. Engage in diversionary activities when acting -out
  2. Provide an atmosphere of acceptance
  3. Provide safety measures
  4. Rearrange the environment to activate the child

25. According to Piaget a 5 year old is in what stage of development:

  1. Sensory motor stage
  2. Concrete operations
  3. Pre-operational
  4. Formal operation
Answers and Rationales
  1. Answer: (B) A state of well-being where a person can realize his own abilities can cope with normal stresses of life and work productively. Mental health is a state of emotional and psychosocial well being. A mentally healthy individual is self aware and self directive, has the ability to solve problems, can cope with crisis without assistance beyond the support of family and friends fulfill the capacity to love and work and sets goals and realistic limits. A. This describes the ego function reality testing. C. This is the definition of Mental Health and Psychiatric Nursing. D. Mental health is not just the absence of mental illness.
  2. Answer: (A) Administers medications to a schizophrenic patient. Administration of medications and treatments, assessment, documentation are the activities of the nurse as a technician. B. Activities as a parent surrogate. C. Refers to the ward manager role. D. Role as a teacher.
  3. Answer: (A) Subconscious. Subconscious refers to the materials that are partly remembered partly forgotten but these can be recalled spontaneously and voluntarily. B. This functions when one is awake. One is aware of his thoughts, feelings actions and what is going on in the environment. C. The largest potion of the mind that contains the memories of one’s past particularly the unpleasant. It is difficult to recall the unconscious content. D. The conscious self that deals and tests reality.
  4. Answer: (D) The censoring portion of the mind. The critical censoring portion of one’s personality; the conscience. A. This refers to the ego function that protects itself from anything that threatens it.. B. The Id is composed of the untamed, primitive drives and impulses. C. This refers to the ego that acts as the moderator of the struggle between the id and the superego.
  5. Answer: (C) Teaching the client stress management techniques .Primary level of prevention refers to the promotion of mental health and prevention of mental illness. This can be achieved by rendering health teachings such as modifying ones responses to stress. A. This is tertiary level of prevention that deals with rehabilitation. B and D. Secondary level of prevention which involves reduction of actual illness through early detection and treatment of illness.
  6. Answer: (A) “Are you being threatened or hurt by your partner? The nurse validates her observation by asking simple, direct question. This also shows empathy. B, C, and D are indirect questions which may not lead to the discussion of abuse.
  7. Answer: (A) Sexual desire disorder . Has little or no sexual desire or has distaste for sex. B. Failure to maintain the physiologic requirements for sexual intercourse. C. Persistent and recurrent inability to achieve an orgasm. D. Also called dyspareunia. Individuals with this disorder suffer genital pain before, during and after sexual intercourse.
  8. Answer: (A) “Here’s the number of a crisis center that you can call for help .” Protection is a priority concern in abuse. Help the victim to develop a plan to ensure safety. B. Do not give advice to leave the abuser. Making decisions for the victim further erodes her esteem. However discuss options available. C. The victim tends to isolate from friends and family. D. This is judgmental. Avoid in anyway implying that she is at fault.
  9. Answer: (B) “When I tell my child to do something once, I don’t expect to have to tell” . Abusive parents tend to have unrealistic expectations on the child. A,B and C are realistic expectations on a 3 year old.
  10. Answer: (C) Ensure the safety of the victim . The priority consideration is the safety of the victim. Attend to the physical injuries to ensure the physiologic safety and integrity of the child. Reporting suspected case of abuse may deter recurrence of abuse. A,B and D may be addressed later.
  11. Answer: (D) Somatoform Pain Disorder . This is characterized by severe and prolonged pain that causes significant distress. A. This is a chronic syndrome of somatic symptoms that cannot be explained medically and is associated with psychosocial distress. B. This is an unrealistic preoccupation with a fear of having a serious illness. C. Characterized by alteration or loss in sensory or motor function resulting from a psychological conflict.
  12. Answer: (B) Conflict between id and superego . Freud explains anxiety as due to opposing action drives between the id and the superego. A. Sullivan identified 2 types of needs, satisfaction and security. Failure to gratify these needs may result in anxiety. C. Biomedical perspective of anxiety. D. Explanation of anxiety using the behavioral model.
  13. Answer: (D) Impaired social interaction . The client may not have difficulty in social exchange. The cues do not support this diagnosis. A. The client maladaptively uses body symptoms to manage anxiety. B. The client will have discomfort due to pain. C. The client may fail to meet environmental expectations due to pain.
  14. Answer: (C) Expression of conflicts through bodily symptoms . Bodily symptoms are used to handle conflicts. A. Manifestations do not have an organic basis. B. This occurs unconsciously. D. Medical treatment is not used because the disorder does not have a structural or organic basis.
  15. Answer: (A) “I know the feeling is real tests revealed negative results.” . Shows empathy and offers information. B. This is a demeaning statement. C. This belittles the client’s feelings. D. Giving undue attention to the physical symptom reinforces the complaint.
  16. Answer: (A) provide as much structure as possible for the child . Decrease stimuli for behavior control thru an environment that is free of distractions, a calm non –confrontational approach and setting limit to time allotted for activities. B. The child will not benefit from a lenient approach. C. Dissipate energy through safe activities. 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. A. This is characteristic of attention deficit disorder. B and C. These are noted among children with autistic disorder.
  18. Answer: (A) increased attention span and concentration . The medication has a paradoxic effect that decrease hyperactivity and impulsivity among children with ADHD. 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. A. This will not help in relieving the anxiety due separation from a significant other. C. and 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. D. Thiswill not help the child overcome the fear
  20. Answer: (C) Moderate . The child with moderate mental retardation has an I.Q. of 35-50 Profound Mental retardation has an I.Q. of below 20; Mild mental retardation 50-70 and 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. B,C, and D Children with mental retardation have 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 parent’s inability to care for the child. A. This refers to lack of choices or inability to mobilize one’s resources. C. Refers to change in family relationship and function. 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. A. These manifestations are noted in Oppositional Defiant Disorder, a disruptive disorder among children. C. These are manifestations of Attention Deficit Disorder 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. A. Angry outburst can be rechannelled through safe activities. B. Acceptance enhances a trusting relationship. C. Ensure safety from self-destructive behaviors like head banging and hair pulling.
  25. Answer: (C) Pre-operational . Pre-operational stage (2-7 years) is the stage when the use of language, the use of symbols and the concept of time occur. A. Sensory-motor stage (0-2 years) is the stage when the child uses the senses in learning about the self and the environment through exploration. B. Concrete operations (7-12 years) when inductive reasoning develops. D. Formal operations (2 till adulthood) is when abstract thinking and deductive reasoning develop.