REFRESHER PHASE

POST TEST
PSYCHIATRIC NURSING
Prepared By: Prof. Archie D. ALviz, RN, RM, MAN
NOV 2023 Philippine Nurse Licensure Examination Review
c. Delusions for clients suffering from schizophrenia
1. Seng, a 24-year-old client is experiencing an acute d. Obsessive-compulsive disorder (OCD) to reduce
schizophrenic episode. She has vivid hallucinations ritualistic behavior
that are making him agitated. The nurse's best 7. Orly, a client with borderline personality disorder becomes
response at this time would be to: angry when he is told that today's psychotherapy session
a. take the client's vital signs. with the nurse will be delayed 30 minutes because of an
b. explore the content of the hallucinations. emergency. When the session finally begins, the client
c. tell him his fear is unrealistic. expresses anger. Which response by the nurse would be
d. engage the client in reality-oriented activities. most helpful in dealing with the client's anger?
2. Ofel, a client with paranoid type schizophrenia becomes A. "If it had been your emergency, I would have
angry and tells the nurse to leave her alone. The nurse made the other client wait."
should: B. "I know it's frustrating to wait. I'm sorry this
a. tell her that she'll leave for now but will happened."
return soon. C. "You had to wait. Can we talk about how
b. ask her if it's okay if she sits quietly with him. this is making you feel right now?"
c. ask her why he wants to be left alone. D. "I really care about you and I'll never let this
d. tell her that she won't let anything happen to happen again.”
him. 8. How soon after chlorpromazine (Thorazine)
3. Ruth, a client begins taking haloperidol (Haldol). After administration should the nurse expect to see a client's
a few days, she experiences severe tonic contractures of delusional thoughts and hallucinations eliminated?
muscles in the neck, mouth, and tongue. The nurse a. Several minutes
should recognize this as: b. Several hours
a. psychotic symptoms. c. Several days
b. parkinsonism. d. Several weeks
c. akathisia. 9. Lhoy, a client receiving haloperidol (Haldol) complains of a
d. dystonia. stiff jaw and difficulty swallowing. The nurse's first action is
to:
4. Ed, a psychotic client reports to the evening nurse that the
day nurse put something suspicious in his water with his A. reassure the client and administer as needed
medication. The nurse replies, "You're worried about your lorazepam (Ativan) I.M.
medication?" The nurse's communication is: B. administer as needed dose of benztropine
a. an example of presenting reality. (Cogentin) I.M. as ordered.
b. reinforcing the client's delusions. C. administer as needed dose of benztropine
(Cogentin) by mouth as ordered.
c. focusing on emotional content.
d. a nontherapeutic technique called mind D. administer as needed dose of haloperidol
(Haldol) by mouth.
reading.
10. Jiffery, a client with a diagnosis of paranoid
5. Prometheus is admitted to the inpatient unit of
schizophrenia comments to the nurse, "How do I
the mental health center with a diagnosis of
know what is really in those pills?" Which of the
paranoid schizophrenia. He's shouting that the
following is the best response?
the government of France is trying to assassinate
A. Say, "You know it's your medicine."
him. Which of the following responses is most
B. Allow him to open the individual wrappers
appropriate?
of the medication.
a. "I think you're wrong. France is a friendly C. Say, "Don't worry about what is in the pills.
country and an ally of the United States. Their It's what is ordered."
government wouldn't try to kill you."
D. Ignore the comment because it's probably a joke.
b. "I find it hard to believe that a foreign
11. The nurse is caring for Guy, a client with schizophrenia
government or anyone else is trying to hurt you.
who experiences auditory hallucinations. The client appears to
You must feel frightened by this." be listening to someone who isn't visible. He gestures, shouts
c. "You're wrong. Nobody is trying to kill you." angrily, and stops shouting in mid-sentence. Which nursing
d. "A foreign government is trying to kill you? Please intervention is the most appropriate?
tell me more about it." a. Approach the client and touch him to get his
6. Propranolol (Inderal) is used in the mental health setting attention.
to manage which of the following conditions? b. Encourage the client to go to his room where
a. Antipsychotic-induced akathisia and anxiety he'll experience fewer distractions.
b. The manic phase of bipolar illness as a mood c. Acknowledge that the client is hearing voices
stabilizer but make it clear that the nurse doesn't hear
these voices.

TOP RANK REVIEW ACADEMY, INC. Page 1 | 4

 d. Ask the client to describe what the voices are The client's husband expresses concern over whether his wife
saying. will continue to take her daily prescribed medication. The
12. Yesterday, James, a client with schizophrenia began nurse should inform him that:
treatment with haloperidol (Haldol). Today, the nurse a. his concern is valid but his wife is an adult
notices that the client is holding his head to one side and and has the right to make her own decisions.
complaining of neck and jaw spasms. What should the b. he can easily mix the medication in his wife's
nurse do? food if she stops taking it.
a. Assume that the client is posturing. c. his wife can be given a long-acting
b. Tell the client to lie down and relax. medication that is administered every 1 to 4
c. Evaluate the client for adverse reactions to weeks.
haloperidol. d. his wife knows she must take her medication
d. Put the client on the list for the physician to as prescribed to avoid future hospitalizations.
see tomorrow 20. Benztropine (Cogentin) is used to treat the
13. Alvin, a client with paranoid schizophrenia has been extrapyramidal effects induced by antipsychotics. This
experiencing auditory hallucinations for many years. One drug exerts its effect by:
approach that has proven to be effective for hallucinating a. decreasing the anxiety causing muscle
clients is to: rigidity.
a. take an as-needed dose of b. blocking the cholinergic activity in the
psychotropic medication whenever they central nervous system (CNS).
hear voices. c. increasing the level of acetylcholine in the
b. practice saying "Go away" or "Stop" when they CNS.
hear voices. d. increasing norepinephrine in the CNS.
c. sing loudly to drown out the voices and provide a 21. Aida, a client is admitted to the inpatient unit of
distraction. the mental health center with a diagnosis of paranoid
d. go to their room until the voices go away. schizophrenia. She's shouting that the government of
14. Violet, a client with catatonic schizophrenia is mute, can't France is trying to assassinate her. Which of the
perform activities of daily living, and stares out the window for following responses is most appropriate?
hours. What is the nurse's first priority? a. "I think you're wrong. France is a friendly
a. Assist the client with feeding. country and an ally of the United States.
b. Assist the client with showering. Their government wouldn't try to kill you."
c. Reassure the client about safety. b. "I find it hard to believe that a foreign
d. Encourage socialization with peers. government or anyone else is trying to hurt
15. Mai-mai, a client tells the nurse that the television you. You must feel frightened by this.
newscaster is sending a secret message to her. The nurse c. "You're wrong. Nobody is trying to kill
suspects the client is experiencing: you."
a. a delusion. d. "A foreign government is trying to kill
b. flight of ideas. you? Please tell me more about it."
c. ideas of reference. 22. A dopamine receptor agonist such as
d. a hallucination. bromocriptine (Parlodel) relieves muscle rigidity
16. The nurse knows that the physician has ordered the liquid caused by antipsychotic medication by:
form of the drug chlorpromazine (Thorazine) rather than the a. blocking dopamine receptors in the central nervous
tablet form because the liquid: system (CNS).
a. has a more predictable onset of action. b. blocking acetylcholine in the CNS.
b. produces fewer anticholinergic effects. c. activating norepinephrine in the CNS.
c. produces fewer drug interactions. d. activating dopamine receptors in the CNS.
d. has a longer duration of action. 23. Most antipsychotic medications exert which of following
17. Gay-gay, a client who has been hospitalized with effects on the central nervous system (CNS)?
disorganized type schizophrenia for 8 years can't complete a. Stimulate the CNS by blocking postsynaptic
activities of daily living (ADLs) without staff direction and dopamine, norepinephrine, and serotonin receptors.
assistance. The nurse formulates a nursing diagnosis of b. Sedate the CNS by stimulating serotonin at the
Self-care deficient: Dressing/grooming related to inability to synaptic cleft.
function without assistance. What is an appropriate goal for c. Depress the CNS by blocking the postsynaptic
this client? transmission of dopamine, serotonin, and
a. "Client will be able to complete ADLs independently norepinephrine.
within 1 month." d. Depress the CNS by stimulating the release of
b. "Client will be able to complete ADLs with only acetylcholine.
verbal encouragement within 1 month." 24. Frowline, a client is admitted to the psychiatric unit of a
c. "Client will be able to complete ADLs with local hospital with chronic undifferentiated schizophrenia.
assistance in organizing grooming items and During the next several days, the client is seen laughing,
clothing within 1 month." yelling, and talking to herself. This behavior is characteristic
d. "Client will be able to complete ADLs of:
with complete assistance within 1 a. delusion.
month." b. looseness of association.
18. The nurse is planning care for Chester,a c. illusion.
client admitted to the psychiatric unit with a d. hallucination.
diagnosis of paranoid schizophrenia. Which 25. Which of the following medications would the nurse
nursing diagnosis should receive the highest expect the physician to order to reverse a dystonic reaction?
priority? a. prochlorperazine (Compazine)
a. Risk for violence toward self or others b. diphenhydramine (Benadryl)
b. Imbalanced nutrition: Less than body c. haloperidol (Haldol)
requirements d. midazolam (Versed)
c. Ineffective family coping 26. A schizophrenic client states, "I hear the voice of King
d. Impaired verbal communication Tut." Which response by the nurse would be most
19. The nurse is preparing for the discharge of Charlie, a therapeutic?
client who has been hospitalized for paranoid schizophrenia. a. "I don't hear the voice, but I know you hear

TOP RANK REVIEW ACADEMY, INC. Page 2 | 4

 what sounds like a voice." d. Being compassionate and empathetic.
b. "You shouldn't focus on that voice." 33. The nurse is assessing Renee’s methods of coping. A
c. "Don't worry about the voice as long as it patient who is being abused would be least likely to
doesn't belong to anyone real." demonstrate which of the following?
d. "King Tut has been dead for years." a. Self-blame.
27. Daryl, a client has been receiving chlorpromazine b. Alcohol abuse.
(Thorazine), an antipsychotic, to treat his psychosis. Which c. Assertiveness.
findings should alert the nurse that the client is experiencing d. Suicidal thoughts.
pseudoparkinsonism? 34. One of the myths about sexual abuse of young
a. Restlessness, difficulty sitting still, and pacing children is that it usually involves physically violent acts.
b. Involuntary rolling of the eyes Which of the following behaviors is more likely to be
c. Tremors, shuffling gait, and masklike face used by the abusers?
d. Extremity and neck spasms, facial grimacing, a. Asking for the child’s consent for sex.
and jerky movements b. Coercion as a result of the trusting
28. For several years, a client with chronic schizophrenia relationship.
has received 10 mg of fluphenazine hydrochloride c. Tying the child down.
(Prolixin) by mouth four times per day. Now the client d. Bribery with money.
has a temperature of 102° F (38.9° C), a heart rate of 35. Aura is suspected of being sexually abused because she
120 beats/minute, a respiratory rate of 20 demonstrates the self-destructive behaviors of head banging
and self-mutilation. Which of the following behaviors would
breaths/minute, and a blood pressure of 210/140 mm the nurse also commonly expect to assess?
Hg. Because the client also is confused and incontinent, a. Substance abuse.
the nurse suspects malignant neuroleptic syndrome. b. Overcontrol of anger.
What steps should the nurse take? c. Truancy and running away.
a. Give the next dose of fluphenazine, call the d. Inability to play.
physician, and monitor vital signs. 36. Desiree who has been sexually abused has difficulty
b. Withhold the next dose of fluphenazine, call putting feelings into words. Which of the following would the
the physician, and monitor vital signs. nurse employ with the child?
c. Give the next dose of fluphenazine and restrict a. Role-playing.
the client to the room to decrease stimulation. b. Giving the patient’s drawings to the
d. Withhold the next dose of fluphenazine, abuser.
administer an antipyretic agent, and c. Engaging in play therapy.
increase the client's fluid intake. d. Reporting the abuse to a prosecutor.
29. Gelyn, a schizophrenic client with delusions tells 37. When developing a teaching plan for a high school health
the nurse, "There is a man wearing a red coat who's class about anorexia nervosa, which of the following would
out to get me." The client exhibits increasing anxiety the nurse include as the primary group affected by this
when focusing on the delusions. Which of the disease?
following would be the best response? a. Women, age at onset between 12 to 20
a. "This subject seems to be troubling you. Let's years.
walk to the activity room." b. Men, onset during the college years.
b. "Describe the man who's out to get you. c. Women, onset typically after 30 years of
What does he look like?" age.
c. "There is no reason to be afraid of that man. d. Men, onset before 20 years of age.
This 38. When assessing Edna, a patient with anorexia
d. "There is no need to be concerned with a nervosa, the nurse would expect to find which of the
man hospital is very secure." who isn't even following?
real." a. Lanugo, hypothermia, and hypotension.
30. Important teaching for women in their childbearing b. Constipation, dysmenorrheal, and
years who are receiving antipsychotic medications hypertension.
includes which of the following? c. Diarrhea, dry skin and menorrhagia.
a. Occurrence of increased libido due to d. Hyperthermia, oliguria and bradycardia.
medication adverse effects 39. Krisha, diagnosed with bulimia tells the nurse that she
b. Increased incidence of dysmenorrhea while eats excessively when she is upset and then vomits so she
taking the drug won’t gain a lot of weight. Which of the following nursing
c. Continuing previous use of contraception diagnostic categories would be most appropriate for her?
during periods of amenorrhea a. Ineffective coping.
d. Instruction that amenorrhea is irreversible b. Imbalanced nutrition: more than body requirements.
31. Tic-tic, a client is admitted to a psychiatric facility c. Anxiety.
with a diagnosis of chronic schizophrenia. The history d. Disabled family coping.
indicates that the client has been taking neuroleptic 40. During the initial interview, Kriszel who has a
medication for many years. Assessment reveals unusual compulsive eating disorder remarks, “I can’t stand
movements of the tongue, neck, and arms. Which myself and the way I look.” Which of the following statements
condition should the nurse suspect? by the nurse would be most therapeutic?
a. Tardive dyskinesia a. “Don’t worry, you’ll soon be back in shape.”
b. Dystonia b. “Tell me more about your feelings.”
c. Neuroleptic malignant syndrome c. “Everyone who has the same problem feels like
d. Akathisia you do.”
32. When planning the care for Gerly who is abused, d. “I don’t think you look bad at all.”
which of the following measures would be most 41. Josh, a 3-year-old child is brought into the physician’s
important to include? office by her parents who are concerned by his behavior. They
a. Helping the patient develop a safety plan. state that he resists their affection, twirls around frequently,
b. Explaining to the patient her personal and and refuses to respond to other children and adults. Based on
legal rights. the analysis of these behaviors, which of the following would
c. Teaching her about abuse and the cycle of the nurse suspect?
violence. a. Tourette syndrome.
b. Schizophrenia.

TOP RANK REVIEW ACADEMY, INC. Page 3 | 4

 c. ADHD. 50. When monitoring Howard, a male client recently admitted
d. Autism. for treatment of cocaine addiction, the nurse notes sudden
42. The nurse is with the parents of Kevin, a 16- yearold boy increase in the arterial blood pressure and heart rate. To
who recently attempted suicide. The nurse cautions the correct these problems, the nurse expects the physician to
parents to be especially alert for which of the following in their prescribe:
son? a. Norepinephrine (Levophed) and lidocaine
a. Decision to try out for an extracurricular activity. (Xylocaine)
b. Giving away valued personal items. b. Nifedipine (Procardia) and lidocaine
c. Desire to spend more time with friends. c. Nitroglycerin (Nitro-Bid IV) and esmolol (Brevibloc)
d. Expression of a desire to date. d. Nifedipine and nitroglycerin
43. The nurse at the mental health clinic is meeting a new
patient who is Kezia, a 7-year-old girl with Tourette
syndrome. Which of the following would the nurse expect to
assess?
a. Isolated verbal tics.
b. Alternating simple and complex motor tics.
c. Multiple motor and verbal tics.
d. Primarily motor tics.
44. Which of the following medications would the nurse
anticipate administering as a treatment for tic disorders,
including Tourette disorder?
a. Lithium.
b. Clonidine.
c. Chlorpromazine.
d. Imipramine.
45. When assessing Toni, a 17-year-old male patient with
depression for suicide risk, which of the following questions
would be best?
a. “Are you thinking about killing yourself?”
b. “What movies about death have you watched
lately?”
c. “Can you tell me what you think about
suicide?”
d. “Has anyone in your family ever committed
suicide?”
46. Which of the following would the nurse expect to
include in the teaching plan for the parents of Kyle
who is receiving methylphenidate (Ritalin)?
a. Allowing concurrent use of any over-the
counter medications with this drug.
b. Giving the medication at the same time every
evening.
c. Having the child take two doses at the same
time if the last dose was missed.
d. Giving the single-dose form of the
medication early in the day.

47. During the assessment stage, Sweet, a client with

schizophrenia leaves his arm in the air after the nurse has
taken his blood pressure. His action shows evidence of:
a. somatic delusions.
b. waxy flexibility.
c. neologisms.
d. nihilistic delusions.
48. Salty, a client in the manic phase of bipolar disorder
constantly belittles other clients and demands special favors
from the nurses. Which nursing intervention would be most
appropriate for this client?
a. Ask other clients and staff members to ignore
the client's behavior.
b. Set limits with consequences for
belittling or demanding behavior.
c. Offer the client an antianxiety drug when
belittling or demanding behavior occurs.
d. Offer the client a variety of stimulating
activities to distract him from belittling or
making demands of others.
49. Bitter, a client diagnosed with depression tells the
nurse, "I won't allow myself to cry because it upsets
the whole family when I cry." This is an example of:
a. manipulation.
b. insight.
c. rationalization.
d. repression.

TOP RANK REVIEW ACADEMY, INC. Page 4 | 4