Download Psych Assessment Test

PROFESSIONAL SERVICES
CLINICAL DIVISION
PSYCH ASSESSMENT TEST
1.
A 5-year-old girl admitted to the hospital for arm fractures and multiple bruises is a reported
victim of child abuse by her mother. The nurse observes the child’s behavior after she is
hospitalized. Which of the following psychosocial characteristics would the nurse be likely
to see her exhibit?
a)
b)
c)
d)
2.
The nurse is caring for a 6-year-old girl admitted for burns to her arms and back. Her case is
being investigated as a child abuse by authorities. The child is mute during routine care
procedures and is often later found crying. An important goal in providing car to this client
would be to:
a)
b)
c)
d)
3.
Provide a variety of stimulation by having several nurses take care of the child
Provide a non-threatening, nurturing environment
Discourage the child from expressing thoughts and feeling about the abuse
Have the child’s parents present during care activities
The nurse is discussing family history and family dynamics with the parent of a child who
may be abused. Which of the following information would increase the nurse’s suspicion of
potential child abuse?
a)
b)
c)
d)
4.
Her behavior is appropriate to the social situation
She seeks frequent parental contact
She had accelerated achievement of developmental tasks
She has minimal socialization with peers
The parent has a high energy level
The parent has several children
The parent’s childhood was characterized by abuse
The parent has a low socioeconomic status
A 7-year-old boy is hospitalized with a diagnosis of autism. The nurse observes the child on
admission. Which of the following information regarding his behavior would confirm that
he is an autistic child?
a)
b)
c)
d)
Lack of interest in inanimate objects
Dislike of routine
Unresponsive to others
Below average intelligence
5.
A 6-year-old boy is admitted to the hospital with the diagnosis of autism. The nurse is
interested in helping the child to feel more secure on the unit. The most appropriate
intervention for the nurse would be to:
a)
b)
c)
d)
6.
A 6-year old boy who was recently admitted to the hospital with a diagnosis of autism grabs
a toy and hits another child. The most appropriate response to the child’s attempts to hurt
himself or others is to:
a)
b)
c)
d)
7.
Isolate him for 24 hours
Encourage him to explain his angry thoughts
Assume a non-punitive attitude and stop the attempt to hurt himself or others
Call his parents to get their input
An 8-year old boy has recently been diagnosed with attention-deficit hyperactive disorder by
his pediatrician. He and his parents come to the pediatric clinic together. Which of the
following behaviors would the nurse most likely to observe from the child?
a)
b)
c)
d)
8.
Have the same nurses provide care
Administer Ritalin to control hyperactivity
Discourage peer contact
Allow him to control his own eating and sleeping patterns
Lethargy
Preoccupation with body parts
Very poor verbal skills
Short attention span
In providing care to a school-age child with attention-deficit hyperactive disorder, the most
effective intervention would be to:
a) Increase environmental stimulation and peer interaction
b) Administer drug therapy (i.e. methylphenidate <Ritalin>) and use behavior
modification techniques
c) Provide parental education and diet therapy
d) Encourage delayed achievement of normal developmental tasks
9.
A 6-year old girl is recently diagnosed as mildly retarded. An important aspect in the
nursing care of a mildly mentally retarded child is to:
a) Encourage her parents to concentrate on the child rather than on the family at this
time
b) Delay extensive diagnostic studies until the child is older
c) Modify the child’s environment to promote independence and impulse control
d) Provide 1:1 tutorial education and minimize peer interaction
10. The nurse realizes that the most effective way to promote positive behavioral change in a 30year old man with severe mental retardation is:
a)
b)
c)
d)
Provide simple, concrete explanations of behavior to be learned
Have client role play new behaviors with the nurse
Provide systematic habit training
Encourage independence
11. A 13-year old boy has a history of conduct disorder. In obtaining a nursing history, which of
the following would not be a characteristic of this disorder?
a)
b)
c)
d)
Reports incidences of fire setting
Has a best friend of several years
Displays physically aggressive behavior toward others
Manipulates others for own gain
12. A nurse conducts an assessment of the dynamics in the family of a young man with a
conduct disorder. Which of the following patterns would be considered a predisposing
factor in the development of the disorder?
a)
b)
c)
d)
The parents have very high expectation of their children
There is inconsistent limit setting with harsh discipline
The parents are over involved with the child
The parents have no other children
13. A 14-year old girl is being evaluated for anorexia nervosa. Which of the following would
indicate to the nurse that the teenager displays symptoms of anorexia nervosa?
a)
b)
c)
d)
She has episodes of overeating and excessive weight gain
She expresses a positive body image
She has had severe weight loss due to self-imposed dieting
She refuses to discuss food
14. The nurse is obtaining a history from a 16-year old girl. Which of the following might
indicate that the client has symptoms of bulimia?
a)
b)
c)
d)
Binge eating and self-induced vomiting
Severe weight loss due to metabolic dysfunction
Hypertension and hyperglycemia
Diaphoresis and vasodilation
15. The nurse is caring for a 13-year old girl with a diagnosis of anorexia nervosa. The nurse
uses her understanding of psychodynamic and family influences in the development of
anorexia nervosa to guide her planning. That understanding is reflected in which of the
following goals?
a) Client will be able to interact effectively with peer group
b) Client will be able to interact with staff using appropriate behaviors
c) Client will demonstrate ability to cope with issues of control in a more adaptive
manner
d) Client will articulate high expectations for herself
16. The nurse is evaluating the progress of a 17-year old girl admitted with a diagnosis of
bulimia. Which of the following behaviors would indicate that the client had progressed?
a)
b)
c)
d)
Her conversations focus of food
She identifies healthy ways of coping with anxiety
She spends time alone in her room after each meal
Family contact around food times is minimal
17. The nurse is caring for a newly admitted 19-year old man with a history of abuse of street
drugs. She observes that he is restless and irritable shortly after having received a visit from
friends. The nurse suspects the client may have taken drugs brought in by the friends.
Information that is priority for the nurse to assess in a client suspected of use of drugs is:
a)
b)
c)
d)
Characteristics of his feces
His hemoglobin
His level of consciousness
The color of his nail beds
18. The nurse interview as 18-year old woman in the mental health clinic who has a history of
drug use and asks for help. In planning treatment, the most important information for the
nurse to obtain initially is:
a)
b)
c)
d)
How the client pays for the drug(s) being used
Her current height and weight
Her family’s response to her drug use
The types, quantity, and frequency of the drug (s) used
19. A nurse is obtaining an admission history on a 22-year old man admitted for a major
depressive episode and alcohol abuse. The nurse learns that the client had been drinking 2-3
six packs of beer a day for the last year and recently lost his job. His wife and 5-month old
son moved into her mother’s home 2 weeks ago. In further discussing his alcohol abuse the
client states: “I wouldn’t drink so much if my wife hadn’t nagged me constantly about
getting a better job, making more money. I was never good enough for her.” The nurse
recognizes that his statement most likely suggests:
a)
b)
c)
d)
A dysfunctional family
The client is in denial about his alcohol problem
The stressors were too much for this man
The client will have a better prognosis if she remains separated from his wife.
20. A 7-year old girl with a diagnosis of separation anxiety disorder has been admitted to an
inpatient psychiatric adolescent unit for further evaluation. Which of the following
behaviors would the nurse recognize as a common characteristic of this disorder?
a) She isolates herself in her room and has minimal interaction with adults
b) She adjusts quickly to the unit and exhibits deep attachment to her primary nurse
c) She becomes acutely anxious whenever her mother visits but is relaxed after her
mother leaves
d) She is preoccupied and anxious on the unit, clings to her mother when she visits, and
becomes agitated and out of control when her mother leaves
21. A primary intervention in caring for a school-age girl with a diagnosis of separation anxiety
disorder who requires hospitalization would be:
a) Do not allow the child to verbalize her fears and worries
b) Establish trust by interacting with the child in a calm manner communicating
genuine positive regard
c) Discourage peer interaction because it contributes to her anxiety
d) Discourage the mother from visiting because it is too upsetting when she leaves
22. In an initial interview with a 24-year old man with a diagnosis of generalized anxiety
disorder, the nurse could expect to observe which of the following behaviors?
a)
b)
c)
d)
Irritability, difficulty concentration on the interview
Future orientation
Increased assertiveness
Grandiose ideation
23. The nurse is caring for a 24-year old man with generalized anxiety disorder. In assisting the
client to be less anxious, which of the following nursing actions would be most appropriate?
a)
b)
c)
d)
Maintaining a calm and supportive manner while interacting
Encouraging the client to cry
Administering major tranquilizing drugs
Beginning intensive psychotherapy
24. Medication is sometimes needed with clients who have generalized anxiety disorder. Which
of the following would be a likely drug that the nurse would administer?
a)
b)
c)
d)
Thorazine (chlorpromazine)
Lorazepam
Tofranil (imipramine)
Noctec (chloral hydrate)
25. The nurse is caring for a 35-year old woman with agoraphobia. Which of the following
behaviors would the nurse expect to observe in the client?
a)
b)
c)
d)
The client is afraid of talking to other people
The client is afraid to leave her home
The client is afraid of pain
The client is afraid of fire
26. In implementing treatment for a client with a phobic disorder, nursing actions include:
a)
b)
c)
d)
Insight-oriented psychotherapy
Administering lithium
Desensitization treatment
Crisis intervention
27. In providing care to a client with an obsessive-compulsive disorder, the nurse recognizes that
the client’s frequent, intensive, and extensive hand washing is an attempt to:
a)
b)
c)
d)
Relieve underlying anxiety
Give herself a sense of control over her life
Increase her self-esteem
Reduce the possibility of infection
28. The goals of nursing care for a client admitted to a psychiatric unit with obsessivecompulsive disorder should be that will:
a)
b)
c)
d)
Demonstrate frequent decision making
Experience a variety of environmental stimuli
Have time and opportunity to complete rituals
Demonstrate improvement in behavior within 1 week
29. The nurse is caring for a 30-year old woman admitted with a diagnosis of PTSD. Three
months ago, the client had found the body of her husband, who had hung himself, in their
basement. The nurse could expect her to exhibit all but which of the following behaviors:
a)
b)
c)
d)
Recurrent distressing dreams
Irritability and outbursts of anger
Inability to look at husband’s picture
Discussing plans to remarry someday
30. The nurse is caring for a client admitted 1 week ago with a diagnosis of PTSD. Today he
begins to describe the traumatic event that occurred in his life 6 months ago. The best
response by the nurse would be to:
a)
b)
c)
d)
Allow the client to describe the event and listen empathically
Change the subject because the topic is clearly upsetting the client
Tell the client that the event was not as bad as he remembers it
Encourage the client to share his experience in the therapeutic group meeting
31. The nurse is caring for a 55-year old client with a diagnosis of somatoform disorder. He had
had a through physical exam and has been told he does not have a cardiac pathology. The
client complains of chest pain. The electrocardiogram is fine with no changes noted. The
nurse should expect that somatoform disorders will be characterized by:
a)
b)
c)
d)
Preoccupation with sexuality
Fear of high places
Preoccupation with inanimate objects
Preoccupation with own health
32. A 45-year old man is recently admitted with a diagnosis of somatoform disorder. He is
convinced he has a serious heart problem. He takes his pulse frequently. One of the primary
goals of his nursing care is to:
a)
b)
c)
d)
Challenge the validity of his physical symptoms
Coordinate diagnostic testing to rule out an organic basis for the symptoms
Encourage his dependency needs
Discourage family participation in treatment
33. The morning she is to leaver for college, a client finds her legs suddenly paralyzed. After an
extensive diagnostic workup, no organic basis is found for the paralysis, which does not
conform to neurological pathways as the cause. She diagnosed as having conversion
disorder and admitted to the psychiatric unit. Which of the following nursing actions is most
appropriate in caring for the client?
a)
b)
c)
d)
Promote her dependence to decrease her anxiety
Explain to her that her paralysis is not real
Encourage her to discuss her feelings about losing the use of her legs
Avoid reinforcing or focusing on her paralysis
34. A 20-year old client is newly admitted to a psychiatric unit for conversion disorder. The
nurse does an admission assessment and finds that he shows little emotion about his sudden
inability to feel sensations in both arms. The nurse recognizes this as a common chracteristic
in clients with the conversion disorder known as:
a)
b)
c)
d)
La belle indifference
Fugue state
Secondary gain
Akathesia
35. A 24-year old woman is brought tot the crisis clinic. Her family states that she cries all the
time, and does not leave the house very often. She is evaluated for a depressive episode.
The nurse could expect to observe which of the following behaviors if the client is depressed?
a)
b)
c)
d)
Sexual preoccupation
Psychomotor retardation
Hyperexcitability
Excessive talking
36. The nurse is developing a care plan for a severely depressed 35-year old woman with four
small children. Which of the following would not be an appropriate goal for this client?
a)
b)
c)
d)
Client will not harm self
Client will be able to verbalize positive aspects about herself
Client will participate in unit activities
Client will focus on self and not family
37. The nurse administers nortriptyline (Aventyl) 75 mg a day to a client admitted with major
depression. After 4 days, the client states that the medication is not helping her. The best
nursing response to this client would be:
a) “It can take up to 4 weeks for the medication to bring about an improvement in
symptoms.”
b) “Cheer up. You need to try to have a more positive attitude toward the medication.”
c) “I’ll tell the doctor. She may need to change the medicine.”
d) “Try not to dwell on the symptoms. It’s time for group.”
38. A 60-year old woman who is hospitalized with pneumonia is due to be discharged
tomorrow. The nurse notices that she has not touched her food. The client states, “I don’t
feel hungry. I don’t know what the point is. I don’t know why God spared me. I don’t have
the energy to keep going on.” The best nursing response would be:
a)
b)
c)
d)
“Now don’t talk like that. You’ll feel better when you go home.”
“It’s normal to feel sad leaving the nurses after we’ve been so good to you.”
“You sound very sad today. Tell me a little more about how you’re feeling.”
“I’ll tell the doctor that you’ve lost your appetite and feel weak. It might be the
medicine.”
39. A 55-year old woman is scheduled for ECT the next morning. The nurse knows that ECT is
most commonly prescribed for:
a)
b)
c)
d)
Disorganized schizophrenia
Major depression
Antisocial personality disorder
Dissociative disorder
40. A male client is scheduled for ECT in the morning. He asks, “What am I going to be like after
the treatment?” The best nursing response would be:
a) “You will go to the intensive care unit. But it all goes well you should return to our
psychiatric unit in a day or two.”
b) “You will be in ECT recovery room for about an hour until the anesthesia wears off,
and you will be awake and oriented and can get out of bed. You may experience
some confusion, which is temporary.”
c) “You will be in ECT recovery room for about an hour until the anesthesia wears off.
When you awake you’ll fell much better than you have been feeling.”
d) “It must be frightening to be getting ECT. Tell me more about your fears.”
41. A 38-year old man is diagnosed with a paranoid personality disorder. He has been coming
to the mental health clinic since his wife divorced him. He thinks that his wife left him
because her coworkers demanded it. The nurse is aware that paranoid personality disorders
are most frequently characterized by:
a)
b)
c)
d)
Hearing voices
Rigid, hypersensitive, and suspicious behavior
Engaging in social skills
Motivation to seek treatment
42. One nursing goal in the care plan for a client with paranoid personality disorder is
promoting consensual validation of reality. Which of the following nursing actions would be
most appropriate to achieve this goal?
a)
b)
c)
d)
Reinforce reality but avoid arguing with the client about his perceptions
Use humor to challenge his perceptions
Discourage him from verbalizing his perceptions
Administer antidepressant drugs to decrease his depression
43. The nurse is developing a care plan for a client with a paranoid personality disorder. He has
been hospitalized after repeatedly yelling and calling police day and night on his neighbors,
whom he suspects of plotting to have him removed from his home. The nurse wishes to
assist the client to be less socially isolated. Which of the following goals would be most
applicable?
a)
b)
c)
d)
Share his belongings with others
Engage in group activities and share his feelings freely
Have as much control as possible over his environment
Participate in solitary activities
44. A 22-year old woman has been diagnosed with a schizoid personality disorder. Her
frequently problems with family and employer have brought her to the crises clinic. She
states that her employer is a real tyrant. The nurse knows that a common characteristic of
schizoid personality disorder is:
a)
b)
c)
d)
Lethargy
Sexual preoccupation
Two personalities
Tendency to withdraw from others
45. The nurse wishes to establish a supportive therapeutic relationship with a 22-year old
woman with a diagnosis of schizoid personality disorder. In developing a plan of care, it is
most important for the nurse to:
a)
b)
c)
d)
Allow the client’s need for distance in a relationship
Minimize affiliative needs
Encourage her to participate in intensive group therapy
Assign different nurses each day until she finds one to whom she can relate
46. A 22-year old woman is admitted with a diagnosis of schizoid personality disorder. The
nurse assesses that her family does not seem interested in being involved in her care. Which
of the following behaviors would the nurse want to promote in the family?
a)
b)
c)
d)
Challenge her “loner” behavior
Encourage her to continue in treatment because her condition is long-term
Expect a full recovery within the near future
Have weekly family meeting in which the family discusses her behavior
47. A 21-year old man has frequent problems with the local police. He is admitted to the
psychiatric unit following an attempted hanging while in jail awaiting trial on burglary
charges. The nurse is that clients with antisocial personality disorders are frequently
characterized by:
a)
b)
c)
d)
Below average intelligence, high sexual needs
Religious preoccupation, grandiose ideas
Need for immediate gratification, low tolerance for frustration
Ability to learn from experience, criminal records
48. A 28-year old male client with a history of antisocial personality disorder is admitted to the
psychiatric unit because of a suicide attempt while in jail awaiting trial for assault. The client
acts very disinterested in treatment and has developed a rapport with several clients whom
he is influencing in negative ways. In evaluating his progress, the nurse recognizes that he:
a)
b)
c)
d)
Could make behavioral changes within a short time if motivated
May not be motivated to change his behavior or lifestyle
Manipulates other but does manipulate family members
Usually requires intensive psychotropic drug therapy, which he refuses
49. The nurse is planning the care of a 30-year old man admitted to the psychiatric unit for courtmandated treatment for alcohol dependence. The client has a diagnosis of antisocial
personality disorder as documented in previous court-mandated psychiatric evaluations.
The nurse recognizes that an important part of this client’s plan will be to:
a)
b)
c)
d)
Encourage him to set limits on his own behavior
Establish clear, consistent limits on acting-out behaviors
Minimize peer interactions
Expect full family participation in effective treatment
50. A 29-year old client has been admitted to the psychiatric unit with a diagnosis of paranoid
schizophrenia because of strange behaviors that alarmed his neighbors. The nurse would
expect him to exhibit which behavior?
a)
b)
c)
d)
Psychomotor retardation and posturing
Regressed, childlike behavior
Euphoric mood and sexual acting out
Extreme suspiciousness, delusions and hallucinations
51. A 30-year old man with a diagnosis of paranoid schizophrenia is admitted to the psychiatric
unit with an acute exacerbation of his illness. He had stopped taking his medication and
ceased his bimonthly visits to the outpatient department. He is restarted on his medication.
The drug most commonly ordered for his illness is:
a)
b)
c)
d)
Lorazepam
Haldol
Amitriptyline (Elavil)
Isocarboxazid (Marplan)
52. A 22-year old client with a diagnosis of undifferentiated schizophrenia is being treated with
haloperidol 5mg bid. He was estranged from his father for several years. Recently he has
been spending some time with his father. His father comes with him to an appointment at
the mental health clinic and asks the nurse what the haloperidol is for. The nurse explains
that haloperidol is given to:
a)
b)
c)
d)
Reduce extrapyramidal symptoms
Prevent neuroleptic malignant syndrome
Decrease psychotic symptoms
Assist with sleep
53. A 20-year old woman has recently been diagnosed with paranoid schizophrenia. She has
been started on Haldol and seems to be responding less to hallucinations. She has begun to
attend an art group for brief periods each day. In planning care to assist the client to be more
connected to reality, the nurse should:
a)
b)
c)
d)
Reinforce perceptions and thinking that are in touch with reality
Challenge her expressions of distorted thinking
Use peer pressure to discourage delusions
Ignore distorted thinking and bizarre behavior
54. The nurse is providing care for a client who is taking haloperidol 2 mg bid and has an order
for benzotropine (Cogentin) 1 mg bid prn. Which of the following nursing assessments
would indicate a need for benzotropine?
a)
b)
c)
d)
The client’s level of agitation increases
The client develops tremors and drooling
The client complains of a headache
The client has difficulty falling asleep
55. A 23-year old female client has been admitted to the inpatient psychiatric unit with a
diagnosis of catatonic schizophrenia. She appears weak and pale. The nurse would expect to
observe which behaviors in this client?
a)
b)
c)
d)
Scratching, catlike motions of the extremities
Exaggerated suspiciousness, excessive food intake
Stuporous withdrawal, hallucinations, and delusions
Sexual preoccupation, word salad
56. The nurse is collecting data to plan the care of a 21-year old woman with a diagnosis of
catatonic scizophrenia. The nurse would likely observe that this client:
a)
b)
c)
d)
Has excessive weight gain
Appears overhydrated
Is hyperreactive to stimuli
Stands, sits, or lies immobile