SAS 1

1. A mental health nurse who exercises supervision over other nurses in providing coordination of care to a client
diagnosed with a mental disorder is performing which particular role?
A. Researcher C. Case Manager
B. Care Provider D. Patient Advocate

2. The nurse is teaching a client important life skill that can be useful around the house when he leaves the mental health
facility. The nurse is performing which function?
A. Case Management C. Self - Care Activities
B. Counselling D. Milieu Therapy

3. An individual who prefers to be alone and isolated may be at risk for mental disorders because which factor affecting
mental health is impaired?
A. Interpersonal factors C. Family factors
B. Social - cultural factors D. Individual factors

4. According to the American Psychiatric Association, which is not a possible cause of mental disorder:
A. Death of a parent C. Rape
B. Loss of a limb D. A complete family

5. According to the World Health Organization, health involves wellness of the following human aspects, EXCEPT:
A. Physical C. Social
B. Mental D. Economic

6. A nurse who is directly responsible for providing care to an individual client such as administering medication or teaching
a life skill is performing which vital role of the mental health nurse?
A. Case Manager C. Care Provider
B. Researcher D. Patient Advocate

7. The nurse advises a client to join yoga classes as a method to relieve stress would be fulfilling the function of:
A. Health Teaching C. Milieu Therapy
B. Counselling D. Psychotherapy

8. When a client presents at the Emergency Room with peculiar behaviors and a strong desire for self - harm, the
diagnosis of the specific mental disorder of that client will have to be based on:
A. Client verbalization C. Client history
B. Client behaviour D. Criteria from DSM V

9. A client develops a trusting relationship with a nurse he picture as his brother. The nurse helps the client feed himself as
he functions as a:
A. Leader C. Resource Person
B. Stranger D. Surrogate

10. Nurse C is investigating the effect of a new antipsychotic medication administered to the Schizophrenic clients in
Pavilion 3 of a psychiatric unit. He is playing the role of:
A. Advocate C. Researcher
B. Counsellor D. Surrogate

SAS 2

1. Benjamin Rush, the father of modern psychiatry utilized all of the following in the treatment of mental illness except:
A. gyrator C. trephining
B. hot baths D. tranquilizer chair

2. Dorothea Dix emphasized that all the following should be provided by an asylum except:
A. Medication C. Adequate Shelter
B. Nutritious Food D. Warm Clothing

3. In the 1950’s, this was the first medication developed to treat mania:
A. Chlorpromazine C. Haloperidol
B. Lithium D. Sertraline

4. In the late 1700’s this facility was developed to provide a safe environment for people with mental illness:
A. Asylum C. Mental Hospital
B. Sanitarium D. State Hospital

5. Aristotle theorized that the imbalance of 4 elements caused mental illness EXCEPT which one:
A. Food C. Yellow Bile
B. Blood D. Water

6. This refers to the practice of reducing emphasis on mental health care from inpatient facilities to community treatment
centers:
A. Sanitarium C. Managed Care
B. Deinstitutionalization D. Primary Care

7. He had written the book, “The Mind That Found Itself”, from his experiences as a depressed client in 1908.
A. Clifford Beers
B. William Tuke
C. Phillipe Pinel
D. Eugene Blueler
8. This organization began the requirement for related learning experience in the psychiatric setting for students:
A. American Nurses Association
C. National League for Nursing
B. International Council of Nursing
D. America Psychiatric Nursing Association
9. During the ancient times, persons with mental illness who exhibit behaviours that harm others were:
A. Hospitalized C. Imprisoned
B. Worshipped D. Prayed For

10. This book emphasized that the treatment of persons with mental illness should focus on psychosocial strengths and
needs:
A. Mental Health Nursing Management C. Interpersonal Relations in Nursing
B. Nursing Therapy D. Interpersonal Techniques: The Crux of Psychiatric Nursing

SAS 3

1. This theory of development focuses on the rogenous zones of the body.

A. Cognitive Theory C. Interpersonal Theory
B. Psychosexual Theory D. Psychosocial Theory

2. Under Eriksons’s Psychosocial Theory, an individual who expresses a sense of satisfaction with his decisions and
actions in life is under which stage?
A. Intimacy vs. Isolation C. Ego Integrity vs. Despair
B. Trust vs. Mistrust D. Initiative vs. Guilt

3. This theory postulates that sexuality and sexual energy play a major factor on how an individual acts and behaves
towards others and the environment:
A. Psychosexual Theory C. Expressive Sexuality Theory
B. Hierarchy of Needs D. Psychosocial Theory

4. A child proudly displays to his mother the good marks he obtained during activities while in school. Based on Erikson’s
Psychosocial Theory, the child belongs to what stage?
A. Industry vs. Inferiority C. Trust vs. Mistrust
B. Initiative vs. Guilt D. Autonomy vs. Shame and Doubt

5. An adult who engages in nail biting behaviours during stressful situations may have unresolved issues during which
stage of psychosexual engagement?
A. Phallic Stage C. Oral Stage
B. Latency Stage D. Genital Stage
6. Under Maslow’s Hierarchy of Needs, an individual who at work has not fulfilled/achieve which stage?
A. Love and Belongingness C. Physiologic Needs
B. Self – Actualization D. Esteem Needs

7. An individual who has decided to marry his/her partner is in what stage under the Psychosocial Theory:
A. Preschool C. Young Adult
B. Toddler D. Middle Adult

8. Toilet training children is performed at this stage of the Psychosexual Theory:

A. Latent Stage C. Anal Stage
B. Genital Stage D. Phallic Stage

9. Jojo, an 8 -year old boy wants his piggy bank full by Christmas so he tells his dad every day to give him coins. This is a
characteristic of one of Piaget’s Cognitive stage:
A. Concrete Operations C. Pre-Operations
B. Formal Operations D. Sensorimotor

10. A child who begins to build a group of friends in school and around the neighborhood is now under whichcognitive
stage of development?
A. Preoperational Stage C. Concrete Operations Stage
B. Formal Operations Stage D. Sensorimotor Stage

SAS 4

1. A nurse who is able adequately determine what the client is feeling through listening from the client and sensing the true
meaning of the client’s words is practicing which component of therapeutic relationship?
A. Empathy C. Positive Regard
B. Self – Awareness D. Genuine Interest

2. This refers to a nurse’s personal set of standards about what is right and wrong when dealing with the client or other
members of the healthcare team is:
A. Beliefs C. Values
B. Attitudes D. Self – awareness

3. When the nurse who aims to build trust with the client is conscious about his/her words being translated into action is
practicing?
A. Positive Regard C. Attitudes
B. Congruence D. Acceptance

4. The nurse who patiently cares for his/her client and does not judge the client based on displayed behaviors is displaying
which important component of the therapeutic relationship?
A. Trust C. Positive Regard
B. Genuine Interest D. Acceptance

5. When a nurse caring for a client with a mental illness/disorder has a good grasp of his/her own attitude, values, beliefs
and feelings, the nurse has achieved:
A. Self – awareness C. Acceptance
B. Trust D. Genuine Interest

6. These are ideas that the nurse holds to be true when caring for the client with a mental illness/disorder:
A. Attitudes C. Values
B.Beliefs D. Self – awareness

7. A nurse who displays actions that are inconsistent with his/her words and display unexpected behaviors is not able to
build:
A. Positive Regard C. Self - awareness
B. Genuine Interest D. Trust

8. Effective therapeutic use of self by the nurse requires that the nurse must be:
A. Capable of complete assessment C. Responds to the client according to the client’s needs
B. Knowledgeable on psychopharmacology D. Expert in psychotherapy

9. Appreciating the client as a person who has specific needs and worthy of respect is displaying which component?
A. Positive Regard C. Trust
B. Genuine Interest D. Empathy

10 . Effective therapeutic use of self can only be achieved when the nurse has:
A. Empathy C. Positive Regard
C. Self – awareness D. Genuine Interest
SAS 5

1. During the course of the interaction, the nurse shares to the client that they have the same favorite color and food to
establish a closer working relationship between the two of them. This is an example of the use of:
A. Nurse – Client Contracts C. Self - disclosure
B. Establishing Rapport D. Maintaining the relationship

2. A client shows resistance to the nurse during the interaction due to past negative experience with another nurse. The
client ignores the nurse during the interaction and does not participate in therapy. This phenomenon is known as:
A. Countertransference C. Poor Therapeutic Communication
B. Transference D. Lack of Rapport

3. When the client begins to show positive self – regard, this phase has already been reached:
A. Termination C. Orientation
B. Working – Problem Identification D. Working – Exploitation

4. Nurse Angelo has started working on building a therapeutic relationship with an identified client. During the course of the
initial interaction, the client states that he is not comfortable talking about his line of work. Nurse Angelo replies that he will
not force the client to talk about things he does not want to talk about. This is an example of:
A. Nurse – Client Contracts C. Establishing Rapport
B. Confidentiality D. Self – disclosure

5. The nurse is listening attentively to the client to ensure proper assessment and begin building rapport between the two
of them is performing a task in which phase:
A. Termination Phase C. Working - Exploitation
B. Working – Problem Identification D. Orientation Phase

6. A client who has become more open and warmer when communicating with the nurse is now in which phase:
A. Orientation Phase C. Working - Exploitation
B. Termination Phase D. Working – Problem Identification

7. The nurse who is reviewing the client’s medical history and list of medications is performing tasks in whichphase:
A. Working – Exploitation C. Termination Phase
B. Orientation Phase D. Working – Problem Identification

8. When Nurse Elwood outlines to his client his specific responsibilities during the initial phases of therapeutic relationship,
he is performing:
A. Nurse – Client Contract C. Establishing Rapport
B. Self – disclosure D. Observing Confidentiality

9. The client who is able to link certain stressors which are causing to his problematic behaviors is now in which phase:
A. Working – Problem Identification C. Orientation Phase
B. Working – Exploitation D. Termination Phase

10. Expectation setting between the nurse and client occurs in which phase of the therapeutic relationship:
A. Termination Phase C. Working – Problem Identification
B. Working – Exploitation D. Orientation Phase

SAS 6
1. The nurse is talking to a client. The client abruptly says to the nurse, “The moon is full. Astronauts walk on the moon.
Walking is a good health habit.” The client’s behavior most likely indicates:
A. Flight of Ideas B. Neologisms C. Dissociation D. Word Salad

2. A client on an in-patient psychiatric ward refuses to take medications because, “The pill has a special code written on it
that will make it poisonous.” What kind of delusion is the client experiencing?
A. An erotomanic delusion C. A somatic delusion
B. A persecutory delusion D. A grandiose delusion

3. Patient Rodney states “I am the president of the Philippines!” This statement indicates what type ofdelusion?
A. Ideas of reference B. Paranoid C. Grandiose D. Nihilistic

4. Patient Betty currently admitted to a mental health facility. While joining an art therapy session, the patient suddenly
laughed out aloud ran to a corner an began crying. As the nurse on duty, you would recognize this affect as:
A. Labile B. Blunt C. Flat D. Inappropriate

5. The nurse is conducting an ongoing assessment of a client with schizophrenia. While performing the interview, the
client suddenly stood up from the chair, smiles and began running around calling out the name of his wife. The nurse
interprets that the client has a:
A. Tactile Hallucination B. Kinesthetic Hallucination C. Auditory Hallucination D. Visual Hallucination

6. When in an assessment interview a client suddenly stops talking, opens his mouth and walks to a corner, this
disturbance in the thought process in interpreted by the nurse as:
A. Racing B. Obsessional C. Loose D. Blocked

7. Nurse Elwood notices that his client who is in bed has one arm raised and one leg flexed for over an hour interprets
this to indicate that the client has/is in:
A. Psychomotor Retardation C. Hallucinations
B. Waxy Flexibility D. Automatisms

8. Michelle’s mother told Nurse Calvin that two days prior to her daughter’s admission, she noticed that she keeps on
smiling when she talked about her failure to pass the training for call center agent. The nurse recognize this as:
A. Blunted affect C. Flat affect
B. Inappropriate affect D. Restricted affect

9. Being able to change one’s behavior and decisions based on sound interpretation of the situation is:
A. Thought Content C. Insight
B. Mood D. Judgment

10. A client admitted at the mental health facility, has been shouting out aloud claiming that he is the “one true god”, is
likely undergoing an:
A. Grandiose Delusion C. Somatic Delusion
B. Religious Delusion D. Nihilistic Delusion
.

SAS 7

1. When a nurse asks the client questions that seek to go deeper into a particular topic or idea is utilizing which
therapeutic communication technique:
A. Exploring C. Restating
B. General Leads D. Seeking Information

2. Which therapeutic communication technique is being used in this nurse-client interaction?

Client: “When I am anxious, the only thing that calms me down is alcohol.”
Nurse: “Other than drinking, what alternatives have you explored to decrease anxiety?”
A. Reflecting C. Making observations
B. Formulating a plan of action D. Giving recognition

3. Nurse Patrick is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offeringa
“general lead”?
A. “Do you know why you are here?”
B. “Are you feeling depressed or anxious?”
C. “Yes, I see. Go on.”
D. “Can you chronologically order the events that led to your admission?”

4. A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and
medication stabilization. Which therapeutic communication technique used by the nurse is an example of a broad
opening?
A. “What occurred prior to the rape, and when did you go to the emergency department?”
B. “What would you like to talk about?”
C. “I notice you seem uncomfortable discussing this.”
D. “How can we help you feel safe during your stay here?”

5. A nurse is assessing a client diagnosed with schizophrenia for the presence of hallucinations. Which therapeutic
communication technique used by the nurse is an example of making observations?
A. “You appear to be talking to someone I do not see.”
B. “Please describe what you are seeing.”
C. “Why do you continually look in the corner of this room?”
D. “If you hum a tune, the voices may not be so distracting.”

6. When interviewing a client, which nonverbal behavior should a nurse employ?

A. Maintaining indirect eye contact with the client
B. Providing space by leaning back away from the client
C. Sitting squarely, facing the client
D. Maintaining open posture with arms and legs crossed

7. In terminating the therapeutic relationship with Mario prior to his discharge, Nurse Arianne should do one of the
following:
A. Discourage discussion of past relationship
B. Focus less and less on the expression of feelings as termination of relationship nears
C. Allow him to express his feelings about leaving the hospital
D. Discuss opportunities for future relationship

8. When the nurse asks the client to make a brief comparison of his/her actions, the therapeutic technique being employed
is:
A. Giving Recognition C. Offering Self
B. Encouraging Comparison D. Restating

9. A male nurse is caring for a client. The client states, “You know, I’ve never had a male nurse before.” The nurse’s best
reply would be:
A. “Does it bother you to have a male nurse?”
B. “There aren’t many of us; we’re a minority.”
C. “How do you feel about having a male nurse?”
D. “You sound upset. Would you prefer a female nurse?”

10. When formulating goals of care for the client with a mental illness/disorder, these must be:
A. Nurse – centered C. Client-centered
B. Nurse manager – centered D. Family-centered

SAS 8

1. A nursing instructor is teaching about Electroconvulsive therapy to students. Which response by the students indicates
that learning has occurred?
A. “During ECT, a state if euphoria is induced.”
B. “ECT induces a grand mal seizure.”
C. “During ECT a state of catatonia is induced.”
D. “ECT induces a petit mal seizure.”

2. After receiving two of nine electroconvulsive therapy (ECT) treatments, a client states, "I can't even remember eating
breakfast, so I want to stop the ECT treatments." Which is the most appropriate nursing reply?
A. "After you begin the course of treatments, you must complete all of them."
B. "You'll need to talk with your doctor about what you're thinking."
C. "It is within your right to discontinue the treatments, but let's talk about your concerns."
D. "Memory loss is a rare side effect of the treatment. I don't think it should be a concern."

3. Immediately after an initial electroconvulsive therapy (ECT) treatment a client states, "I'm not hungry and just want to
stay in bed and sleep." Based on this information, which is the most appropriate nursing intervention?
A. Allow the client to remain in bed.
B. Encourage the client to join the milieu to promote socialization.
C. Obtain a physician's order for parenteral nutrition.
D. Involve the client in physical activities to stimulate circulation.

4. A nurse administers ordered preoperative glycopyrrolate (Robinul) 30 minutes prior to a client's electroconvulsive
therapy (ECT) treatment. What is the rationale for administering this medication?
A. Robinul decreases anxiety during the ECT procedure.
B. Robinul induces an unconscious state to prevent pain during the ECT procedure.
C. Robinul prevents severe muscle contractions during the ECT procedure.
D. Robinul decreases secretions to prevent aspiration during the ECT procedure.

5. A nursing instructor is teaching about the medications given prior to and during electroconvulsive therapy (ECT)
treatments. Which student statement indicates that learning has occurred?
A. "Atropine (Atro-Pen) is administered to paralyze skeletal muscles during ECT."
B. "Succinylcholine chloride (Anectine) decreases secretions to prevent aspiration."
C. "Thiopental sodium (Pentothal) is a short-acting anesthesia to render the client unconscious."
D. "Glycopyrrolate (Robinul) is given to prevent severe muscle contractions during seizure."

6. Immediately after electroconvulsive therapy, in which position should a nurse place the client?
A. On his or her side to prevent aspiration
B. In a Semi-Fowler's position to promote oxygenation
C. In a Trendelenburg's position to promote blood flow to vital organs
D. In prone position to prevent airway blockage

7. After receiving two of nine electroconvulsive therapy (ECT) treatments, a client states, "I can't even remember eating
breakfast, so I want to stop the ECT treatments." Which is the most appropriate nursing reply?
A. "After you begin the course of treatments, you must complete all of them."
B. "You'll need to talk with your doctor about what you're thinking."
C. "It is within your right to discontinue the treatments, but let's talk about your concerns."
D. "Memory loss is a rare side effect of the treatment. I don't think it should be a concern."
8. What is considered as the gold standard for confirmation of seizure in ECT?
A. Cuff method
B. Electroencephalogram (EEG)
C. Electromyogram (EMG)
D. Galvanic Skin Response (GSR)

9. The most persistent adverse effect of Electroconvulsive Therapy is:

A. Retrograde Amnesia
B. Fractures
C. Seizures
D. Hypertension

10. The most common indication of Electroconvulsive Therapy is:

A. Schizophrenia
B. Generalized Anxiety Disorder
C. Manic episodes
D. Major depression

SAS 9
1. The nurse is planning to utilize bibliotherapy for a client with a mild mood – related condition. The nurse selects a few
books regarding yoga and stress – relief. This type of bibliotherapy is called:
A. Creative Bibliotherapy C. Prescriptive Bibliotherapy
B. Books on Prescription D. General Bibliotherapy

2. A form of group therapy which uses the family as a therapeutic tool for the client the dynamics of his/her
psychopathology and develop problem – solving skills as a group.
A. Milieu Therapy C. Remotivation Therapy
B. Family Therapy D. Music Therapy

3. During this stage of Remotivation Therapy, the nurse asks the client questions which are about the relatedness of the
current therapy session to life:
A. Appreciation of the Work of the World C. Climate of Acceptance
B. Climate of Appreciation D. Bridge to the Real World

4. A kind of therapy which features a therapist allowing the client to express him/herself through singing, composing songs
or just listening to them.
A. Song Therapy C. Dance Therapy
B. Music Therapy D. Sound Therapy

5. A nurse selected a teenage novel for the bibliotherapy of an adolescent with a mild depression. This type of
bibliotherapy is:
A. Creative Bibliotherapy C. Prescriptive Bibliotherapy
B. Books on Prescription D. General Bibliotherapy

6. A client is placed in a structured facility with a small number of patients and provided therapy designed to develop life
skills and functional behavior. This therapy is:
A. Art Therapy C. Remotivation Therapy
B. Milieu Therapy D. Adult Play Therapy

7. A nurse therapists brings the child who has just experienced physical abuse to a playground and allows the child to
freely play with all the different toys with only limited instruction is using which type of play therapy:
A. Directive Play Therapy C. Nondirective Play Therapy
B. Single Directional Play Therapy D. Multi - Nondirectional Play Therapy

8. This type of therapy allows the client to express him/herself through creativity and creative works which are helpful for
those with suffering from intense trauma:
A. Art Therapy C. Music Therapy
B. Play Therapy D. Psychospiritual Therapy

9. When the nurse therapist choose a specific set of play things to elicit a desired response from a traumatized child is
using which type of play therapy:
A. Directive Play Therapy C. Nondirective Play Therapy
B. Single Directional Play Therapy D. Multi - Nondirectional Play Therapy

10. This therapy involves simultaneously engaging the body, mind, and spirit in healing mental health issues, moving
beyond problematic life patterns, and overcoming traumatic life experiences:
A. Milieu Therapy C. Art Therapy
B. Play Therapy D. Psychospiritual Therapy

SAS 10

1. The nurse is teaching a client taking an MAOI about foods with tyramine that he or she should avoid. Which of the
following statements indicates that the client needs further teaching?
A. “I’m so glad I can have pizza as long as I don’t order pepperoni.”
B. “I will be able to eat cottage cheese without worrying.”
C. “I will have to avoid drinking nonalcoholic beer.”
D. “I can eat green beans on this diet.”
2. A client who has been depressed and suicidal started taking a tricyclic antidepressant 2 weeks ago and is now ready to
leave the hospital to go home. Which of the following is a concern for the nurse as discharge plans are finalized?
A. The client may need a prescription for diphenhydramine (Benadryl) to use for side effects.
B. The nurse will evaluate the risk for suicide by overdose of the tricyclic antidepressant.
C. The nurse will need to include teaching regarding the signs of neuroleptic malignant syndrome.
D. The client will need regular laboratory work to monitor therapeutic drug levels.

3. The signs of lithium toxicity include which of the following?

A. Sedation, fever, restlessness
B. Psychomotor agitation, insomnia, increased thirst
C. Elevated WBC count, sweating, confusion
D. Severe vomiting, diarrhea, weakness

4. Which of the following is a concern for children taking stimulants for ADHD for several years?
A. Dependence on the drug C. Growth suppression
B. Insomnia D. Weight Gain
Answer: C

5. The nurse is caring for a client with schizophrenia who is taking haloperidol (Haldol). The client complains of
restlessness, cannot sit still, and has muscle stiffness. Of the following prn medications, which will the nurse administer?
A. Haloperidol (Haldol) 5 mg p.o.
B. Benztropine (Cogentin) 2 mg p.o.
C. Propranolol (Inderal) 20 mg p.o.
D. Trazodone 50 mg p.o.

6. Client teaching for lamotrigine (Lamictal) should include which of the following?
A. Eat a well-balanced diet to avoid weight gain.
B. Report any rashes to your doctor immediately.
C. Take each dose with food to avoid nausea.
D. This drug may cause psychological dependence.

7. Which of the following physician orders would the nurse question for a client who has stated “I’m allergic to
phenothiazines?”
A. Haldol 5 mg p.o. bid
B. Navane 10 mg p.o. bid
C. Prolixin 5 mg p.o.tid
D. Risperdal 2 mg bid

8. Clients taking which of the following types of psychotropic medications need close monitoring of their cardiac status?
A. Antidepressants B. Antipsychotics C. Mood stabilizers D. Stimulants

9. What is the major side effect of Selective Serotonin Reuptake Inhibitor (Prozac)?
A. Loss of sexual desire C. Loss of hair
B. Weight loss D. Weight gain

10. Antipsychotics do which of the following?

A. Alleviate major positive symptoms (such as thought disorder and hallucinations)
B. Alleviate major negative symptoms (such as social withdrawal)
C. Reducing the burden of institutional care
D. All of the above

SAS 11

1. A client who abuses alcohol and illegal drugs tells a nurse that he only uses substances because of his stressful
marriage and difficult job. Which defense mechanisms is this client using?
A. Sublimation C. Projection
B. Displacement D. Rationalization
.
2. Mr. Cruz, an attorney who throws books and furniture around the office after losing a case is referred to the
psychiatric nurse for assistance. Nurse Alvin knows that the client’s behavior most likely represents the use of which
defense mechanism?
A. Projection C. Intellectualization
B. Regression D. Reaction-formation

3. Nurse Lucas is aware that the defense mechanism commonly used by clients who are alcoholics is:
A. Displacement C. Denial
B. Compensation D. Projection

4. A rape victim testifying in court suddenly loses her voice when asked to recount to event is displaying which defense
mechanism:
A. Conversion C. Displacement
B. Repression D. Suppression
.

5. Forcing thoughts to remain unconscious in order to avoid the anxiety that would result if they were conscious is the
definition of which defense mechanism?
A. Denial C. Regression
B. Isolation D. Repression
.

Situation for numbers 6-8.

Trent and Elisa have been dating for two years. Elisa breaks up with Trent because he cheated on her with Anna. Elisa
tells her friend Angela about Trent, but she tells her without showing any emotion. Trent continues to call Elisa and treat
her as he did when they were going out. Anna, who did not know about Elisa, tells Trent that she is glad that he feels
guilty for hurting Elisa. She also tells him that it will take a long time to get over the guilt.

6. Elisa is using as a defense mechanism.

A.Repression C. Projection
B.Denial D. Isolation

7. Trent is using as a defense mechanism.

A. Repression C. Projection
B. Denial D. Isolation

8. Anna is using as a defense mechanism.

A. Repression C. Projection
B. Denial D. Isolation

9. A corrupt politician who constantly attends mass and donates large amounts of money to his parish is exhibiting which
defense mechanism?
A. Undoing C. Denial
B. Repression D. Projection

10. The student who is failing in class and hates the teacher constantly says positive things about the teacher to his friends
is using which defense mechanism
A. Projection
B. Sublimation
C. Displacement
D. Reaction Formation

LESSON WRAP - UP (20 Minutes)

SAS 12

1. While caring for a male client with a mental illness, the nurse notices that the client has suddenly become quiet after
seeing a physician walk by with a syringe, the client then becomes agitated, is not responsive to the nurse and runs to a
corner of his room and hide in fear. Based on the nurse’s assessment, the client is in which level of anxiety?
A. Moderate Anxiety C. Panic Anxiety
B. Severe Anxiety D. Mild Anxiety
Rationale: The client is displaying symptoms indicative of Panic Anxiety such as mutism (suddenly become quiet),
agitation, flight where he runs to a corner and delusions of persecution when he hides in fear inside his room.

2. The nurse observes a client who is becoming increasingly upset. He is rapidly pacing, hyperventilating, clenching his jaw,
wringing his hands, and trembling. His speech is high-pitched and random; he seems preoccupied with his thoughts. He is
pounding his fist into his other hand. The nurse identifies his anxiety level as:
A. Mild Anxiety C. Severe Anxiety
B. Moderate Anxiety D. Panic Anxiety
Rationale: Severe Anxiety is a an anxiety where panic and more primitive survival skills take over, cognitive skills decrease
significantly, the person has trouble thinking and reasoning, manifestations include: vital signs increase, restless, irritable,
angry, cannot complete tasks, feels dread or horror, crying, trembling, chest pain, nausea, vomiting

3. Which of the following would be the best intervention for a client having a panic attack?
A. Involve the client in a physical activity. C. Remain with the client.
B. Offer a distraction such as music. D. Teach the client a relaxation technique
Rationale: A client in a panic attack has no coherent thought. This prevents the client from learning information or performing
effective coping. During the stage, the primary consideration is to ensure the safety of the client by remaining with the client
and preventing injury to the client as a result of the flight response.

4. When assessing a client with anxiety, the nurse’s questions should be:
A. Avoided until the anxiety is gone C. Postponed until the client volunteers information
B. Open-ended D. Specific and direct
Rationale: Clients experiencing anxiety exhibits narrowed or distorted perception and cognitive deficits. The client develops
poor comprehension which prevents the client from answering questions correctly. The nurse’s questions, therefore, must be
clear, concise and direct to allow the client to provide a fast and easy answer without the need for further introspection.

5. A client resorting to fantasizing and delusions during an anxious event is experiencing which type of adaptive behavior:
A. Negative Adaptive Behaviors C. Delusional Adaptive Behaviors
B. Positive Adaptive Behaviors D. Panic Adaptive Behaviors
Rationale: Negative Adaptive Behaviors is coping that results in maladaptive behaviors such as tension headaches, pain
syndromes, and stress-related responses that reduce the efficiency of the immune system, hallucinations and delusions

6. Which of the following is an appropriate intervention for a client experiencing a severe anxiety:
A. Teach relaxation techniques C. Confining the client to the room
B. Walk with client if he/she is restless and agitated D. Offer the client a distraction such as music
Rationale: Clients in severe anxiety become restless, agitated and has trouble thinking. In order to ensure safety, the nurse
must walk with the client if he/she is pacing or walking around.

7. This type of anxiety allows the person to build health coping skills and engage in goal – oriented activities:
A. Panic Anxiety C. Moderate Anxiety
B. Severe Anxiety D. Mild Anxiety
Rationale: Mild Anxiety is a sensation that something is different or needs special attention, this type motivates people to
make changes or engage in goal - directed activity.

8. During this stage of the response stress, the client begins to exhibit agitation, clenching of the fist andanger:
A. Exhaustion Stage C. Resistance Stage
B. Alarm Stage D. General Anxious Stage
Rationale: The Resistance Stage is where the client begins to show the fight, flight or freese response as the muscles begin
to receive more blood supply.

9. Refocusing the client who is experiencing a moderate anxiety can be achieved through:
A. Guided imagery C. Restraining the client
B. Physical activity D. Confining the client to his room
Rationale: One of the best methods to refocus clients is through guided, calm imagery. This allows the client to reflect and
visualize healthier coping alternatives with the help of guidance from the nurse.

10. An anxious client who is able to use deep breathing and relaxation techniques has:
A. Negative Adaptive Behaviors C. Acceptable Adaptive Behaviors
B. Positive Adaptive Behaviors D. Positive Coping
Rationale: Deep breathing and relaxation techniques are examples of positive coping which a client with positive adaptive

SAS 13

1. The nurse working with a client during a flashback says, “I know you’re scared, but you’re in a safe place. Do you see
the bed in your room? Do you feel the chair you’re sitting on?” The nurse is using which of the following techniques?
A. Distraction C. Relaxation
B. Reality orientation D. Grounding

2. A client in the emergency department is suspected of having been raped. The patient is withdrawn, confused and at
times physically withdrawn. As the nurse on duty, you realize that these behaviors are:
A. Signs of the patients increased risk of suicide
B. An indication for the client’s need for admission
C. Signs of depression
D. Normal reactions to rape or sexual assault

3. A child was abducted and raped. Which personal reaction by the nurse could interfere with the child’s care?
A. Anger C. Compassion
B. Concern D. Empathy

4. A person was abducted and raped at gunpoint by an unknown assailant. Which among the following best indicates that
the person is in the immediate and initial stage of rape trauma?
A. Decreased motor activity
B. Confusion and disbelief
C. Fears and phobias
D. Flashbacks and dreams

5. A woman abducted and raped at gunpoint is displaying confusion, talks rapidly in disconnected phrases and is unable to
concentrate and make simple decisions. As the nurse, you know that a rape victim’s anxiety will be in which level?
A. Weak C. Moderate
B. Mild D. Severe

6. Initial intervention for a rape victim should focus on:

A. Oxygenation C. Safety and Security
B. Hydration D. STD Prophylaxis

7. During the initial care of a rape victim, the following are to be considered EXCEPT:
A. Assure privacy
B. Touch the client to show acceptance and empathy
C. Accompany the victim to the examination room
D. Maintain a non – judgmental approach

8. A client is brought to an emergency department after being violently raped. Which nursing action isappropriate?
A. Discourage the client from discussing the event as this may lead to further emotional trauma.
B. Remain non-judgmental and actively listen to the client's description of the event.
C. Meet the client's self-care needs by assisting with showering and perineal care.
D. Provide cues, based on police information, to encourage further description of the event.

9. A college student was raped when out on a date. After several weeks of crisis intervention therapy, which client
statement should indicate to a nurse that the student is handling this situation in a healthy manner?
A. "I know that it was not my fault."
B. "My boyfriend has trouble controlling his sexual urges."
C. "If I don't put myself in a dating situation, I won't be at risk."
D. "Next time I will think twice about wearing a sexy dress."

10. A man who rapes his neighbour for the sheer thrill of the act and to meet a sexual urge is which type of rapist?
A. Sexual Sadist C. Inadequate men
B. Exploitive predators D. Displacement of anger and rage

11. A kindergarten student is frequently violent toward other children. A school nurse notices bruises and burns on the
child's face and arms. What other symptom should indicate to the nurse that the child might have been physically
abused?
A. The child shrinks at the approach of adults.
B. The child begs or steals food or money.
C. The child is frequently absent from school.
D. The child is delayed in physical and emotional development.

12. Billy, a 12-year-old child, complains to the school nurse about nausea and dizziness. While assessing the child, the
nurse notices a black eye that looks like an injury. This is the third time in 1 month that the child has visited the nurse.
Each time, the child provides vague explanations for various injuries. Which of the following is the school nurse’s priority
intervention?
A. Contact the child’s parents and ask about the child’s injury.
B. Encourage the child to be truthful with her.
C. Question the teacher about the parent’s behavior.
D. Report suspicion of abuse to the proper authorities.

13. Nurse Jasmin is observing 8-year-old Andrea during a community visit. Which of the following findings wouldlead the
nurse to suspect that Andrea is a victim of sexual abuse?
A. The child is fearful of the caregiver and other adults.
B. The child has a lack of peer relationships.
C. The child has self-injurious behavior.
D. The child has an interest in things of a sexual nature.

14. Nathaniel is studying about abuse for the upcoming exam. For her to fully instill the topic, she should know that the
priority nursing intervention for a child or elder victim of abuse is:
A. Assess the scope of the abuse problem.
B. Analyze family dynamics.
C. Implement measures to ensure the victim’s safety.
D. Teach appropriate coping skills.

15. Nurse Rica is assessing a parent who abused her child. Which of the following risk factors would the nurse expect to
find in this case?
A. Flexible role functioning between parents
B. History of the parent having been abused as a child
C. Single-parent home situation
D. Presence of parental mental illness

16. In a home visit to a family of three: a mother, father, and their child, the mother tells the community nurse that the
father (who is not present) had hit the child on several occasions when he was drinking. The mother further explains that
she has talked her husband into going to alcoholics support group. She asks the nurse not to interfere, so her husband
won’t get angry and refuse treatment. Which of the following is the best response of the nurse?
A. The nurse agrees not to interfere if the husband attends an alcoholics support group meeting that evening.
B. The nurse commends the mother’s efforts and agrees to let her handle things.
C. The nurse commends the mother’s efforts and also contacts protective services.
D. The nurse confronts the mother’s failure to protect the child.

17. Mrs. Smith, 70 years old, was admitted to the emergency department of Valley River Medical Center with a fractured
arm. She explains to the nurse that her injury resulted when she provoked her drunken son, who then pushed her. Which
of the following best describes the nurse’s understanding of the mother’s explanation?
A. Mrs. Smith’s explanation is appropriate acceptance of her responsibility.
B. Mrs. Smith’s explanation is an atypical reaction of an abused woman.
C. Mrs. Smith’s explanation is evidence that the woman may be an abuser as well as a victim.
D. Mrs. Smith’s explanation is a typical response of a victim accepting blame for the abuser.

18. Which situation would Nurse Sally identify as placing a client at high risk for caregiver abuse?
A. Cristina, an elderly adult’s child, quits her job to move in and care for a parent with severe dementia.
B. Mr. So, an elderly man with severe heart disease, resides in a personal care home and is frequently visited by his adult
child.
C. Mrs. Rosales, an elderly parent with limited mobility, lives alone and receives help from several adult children.
D. Yolly cares for her husband who is in early stages of Alzheimer’s disease and has a network of available support
persons.
19. The interventions common to treatment plans for abuse survivors include which of the following? Select all that apply.
A. Establish trust and rapport.
B. Identify areas of control.
C. Remove the client from home.
D. Support the client in the decisions he/she makes.
E. Encourage the client to pursue legal action.

20. Nurse Trent, a community nurse, is conducting a home visit on Mrs. Bucog, a 75 year old, who lives with an adult
male child. Upon entering the house, Nurse Trent notes the house is filthy with disarranged furniture, unwashed laundry
with rodents present. As a community nurse, Nurse Trent knows that this form of elderly is:
A. Neglect Abuse
B. Psychosocial Abuse
C. Physical Abuse
D. Material Abuse

SAS 14

1. The best goal for a client learning a relaxation technique is that the client will
A. Confront the source of anxiety directly C. Report no episodes of anxiety
B. Experience anxiety without feeling overwhelmed D. Suppress anxious feelings

2. Which of the following would be the initial intervention for a client having a panic attack?
A. Involve the client in a physical activity. C. Remain with the client.
B. Offer a distraction such as music. D. Teach the client a relaxation technique.

3. A child being constantly bullied in school has developed an aversion to going to school exhibited by excessive
drowsiness while preparing for school, crying and temper tantrums in the morning and not wanting to go to school. This
behaviour is an example of:
A. Primary Gain C. Panic Attack
B. Secondary Gain D. School Phobia

4. While assessing an out – patient client with a panic disorder, the nurse completes a thorough health history and
physical examination. Which of the following is most significant for this client?
A. Compulsive behaviour C. Fear of flying
B. Sense of impending doom D. Predictable episodes

5. A client experiencing a panic attack would display which physical symptom?

A. Fear of dying C. Palpitations and abdominal distress
B. Depersonalization D. Restlessness and pacing

6. You are caring for a man who has a fear of the outside world. He only comes outside when accompanied by his wife.
Based on this situation, the man is likely experiencing:
A. Social Phobia C. Claustrophobia
B. Agoraphobia D. Hypochondriasis

7. Jordan is a client with a fear of air travel. He is being treated for phobic disorder. The treatment method involves
systematic desensitization. The nurse would consider the treatment successful if:
A. Jordan plans a trip requiring air travel.
B. Jordan takes a short trip in an airplane.
C. Jordan recognizes the unrealistic nature of the fear of riding on airplanes.
D. Jordan verbalizes a decreased fear about air travel.

8. Social anxiety disorder is:

A. Excessive worry bouts triggered by object or situation
B. Anxiety and discomfort from being embarassed
C. Intense anxiety from separation with significant others
D. A persistent fear of heights
9. One important issue in therapy for specific phobias is to address:
A. Ensure the individual never comes in contact with the phobic event or situation
B. The phobic beliefs that sufferers hold about their phobic event or situation
C. The individual has ample opportunity to talk about the phobic event
D. That any dreams about the phobic event or situation are analyzed

10. A nurse who is planning a quick remedy to her male client’s phobia plans to introduce him to the fear – inducing
stimuli during the first session of therapy. This treatment is known as:
A. Desensitization C. Behavior Desensitization
B. Systematic Desensitization D. Flooding Desensitization

SAS 15

1. Fred has a diagnosis of schizophrenia with negative symptoms. In planning care for the client, Nurse Mae would
anticipate a problem with:
A. Auditory hallucinations.
B. Bizarre behaviors.
C. Ideas of reference.
D. Motivation for activities.

2. Nurse Elwood assesses for evidence of positive symptoms of schizophrenia in a newly admitted client. Which ofthe
following symptoms are considered positive evidence? Select all that apply.
A. Anhedonia
B. Delusions
C. Flat affect
D. Hallucinations
E. Loose associations
F. Social withdrawal

3. A client tells the nurse that psychotropic medicines are dangerous and refuses to take them. Which intervention should
the nurse use first?
A. Ask the client about any previous problems with psychotropic medications.
B. Ask the client if an injection is preferable.
C. Insist that the client takes medication as prescribed.
D. Withhold the medication until the client is less suspicious.

4. Lance told his nurse that the CIA is monitoring and recording his every movement and that microphones have been
placed in his room walls. Which action would be the most therapeutic response?
A. Confront the delusional material directly by telling Gio that this simply is not so.
B. Tell Gio that this must seem frightening to him but that you believe he is safe here.
C. Tell Gio to wait and talk about these beliefs in his one-on-one counseling sessions.
D. Isolate Gio when he begins to talk about these beliefs.

5. Upon John’s admission for schizophrenia, Nurse Divine documents the following: Client refuses to bathe or dress,
remains in room most of the day, speaks infrequently to peers or staff. Which nursing diagnosis would be the priority at
this time?
A. Anxiety
B. Decisional conflict
C. Self-care deficit
D. Social isolation

6. Which statement is correct about a 25-year-old client with newly diagnosed schizophrenia?
A. Age of onset is typical for schizophrenia.
B. Age of onset is later than usual for schizophrenia.
C. Age of onset is earlier than usual for schizophrenia.
D. Age of onset follows no predictable pattern in schizophrenia.

7. The family of a schizophrenic client asks the nurse if there is a genetic cause of this disorder. To answer thefamily,
which fact would the nurse cite?
A. Conclusive evidence indicates a specific gene transmits the disorder.
B. Incidence of this disorder is variable in all families.
C. There is a little evidence that genes play a role in transmission.
D. Genetic factors can increase the vulnerability for this disorder.

8. Client M arrived in the ER poorly kempt and speaking to an “alien” she calls “Broot”. After 2 months of hospitalization,
client M was discharged. She is now able to take care of herself and her hallucinations disappeared. Client M’s psychotic
disorder is:
A. Schizophrenia
B. Schizophreniform
C. Schizoaffective
D. Shared Psychosis

9. Folie a deux is synonymous to what type of psychotic disorder?

A. Brief Psychotic Disorder
B. Schizophreniform
C. Schizoaffective
D. Shared Psychosis

10. A schizophrenic client is manifesting a bizarre delusion. Which of the following is an example of bizarre delusion?
i. Jealous delusion
ii. Dorian Gray
iii. Religious delusion
iv. Somatic delusion

A. i, ii
B. i, ii, iii
C. i, iv
D. ii,iii, iv

SAS 16

1. A young, handsome man with a diagnosis of antisocial personality disorder is being discharged fromthe hospital next
week. He asks the nurse for her phone number so that he can call her for a date. The nurse’s best response would be:
A. “We are not permitted to date clients.”
B. “No, you are a client and I am a nurse.”
C. “I like you, but our relationship is professional.”
D. “It’s against my professional ethics to date clients.”

2. A client with avoidant personality disorder says occupational therapy is boring and doesn’t want to go. Which action
would be best?
A. State firmly that you’ll escort him to OT.
B. Arrange with OT for the client to do a project on the unit.
C. Ask the client to talk about why OT is boring
D. Arrange for the client not to attend OT until he is feeling better

3. A nurse notices other clients on the unit avoiding a client diagnosed with antisocial personality disorder. When
discussing appropriate behavior in group therapy, which of the following comments is expected about this client by his
peers?
A. Lack of honesty
B. Belief in superstitions
C. Show of temper tantrums
D. Constant need for attention

4. Which of the following information must be included for the family of a client diagnosed with dependent personality
disorder?
A. Address coping skills
B. Explore panic attacks
C. Promote exercise programs
D. Decrease aggressive outbursts

5. Which of the following characteristics is expected for a client with paranoid personality disorder who receivesbad
news?
A. The client is overly dramatic after hearing the facts
B. The client focuses on self to not become over-anxious
C. The client responds from a rational, objective point of view
D. The client doesn’t spend time thinking about the information.

6. A hospitalized client, diagnosed with a borderline personality disorder, consistently breaks the unit’s rules. This
behavior should be confronted because it will help the client:
A. Control anger
B. Reduce anxiety
C. Set realistic goals
D. Become more self-aware

7. Which of the following types of behavior is expected from a client diagnosed with a paranoid personality disorder?
A. Eccentric
B. Exploitative
C. Hypersensitive
D. Seductive

8. An adult client with a borderline personality disorder become nauseated and vomits immediately after drinkingafter
drinking 2 ounces of shampoo as a suicide gesture. The most appropriate initial response by the nurse would be to:
A. Promptly notify the attending physician
B. Immediately initiate suicide precautions
C. Sit quietly with the client until nausea and vomiting subsides
D. Assess the client’s vital signs and administer syrup of ipecac

9. A client with schizotypal personality disorder is sitting in a puddle of urine. She’s playing in it, smiling, and softly singing
a child’s song. Which action would be best?
A. Admonish the client for not using the bathroom
B. Firmly tell the client that her behavior is unacceptable
C. Ask the client if she’s ready to get cleaned up now
D. Help the client to the shower, and change the bedclothes.

10. Which of the following behaviors by a client with dependent personality disorder shows the client has made progress
toward the goal of increasing problem solving skills?
A. The client is courteous
B. The client asks questions
C. The client stops acting out
D. The client controls emotions

SAS 17

1. Using cognitive-behavioral therapy, which treatment would be appropriate for a client with depression?
A. Challenging negative thinking
B. Encouraging analysis of dreams
C. Prescribing antidepressant medications
D. Using ultraviolet light therapy

2. Nurse Alvin teaches the family of a client with major depressive disorder. Which of the following information shouldbe
included in the teaching? Select all that apply.
A. Depression is characterized by sadness, feelings of hopelessness, and decreased self-worth
B. It is common for a pressed individual to have thoughts of suicide.
C. Attempts to cheer up a person with depression are often helpful.
D. Talk therapy, along with antidepressant medications, is usually the treatment.
E. Someone with depression may be preoccupied with spending money and too busy to sleep.
F. Encourage a person with depression to keep a regular routine of activity and rest.

3. Which of the following would best indicate to the nurse that a depressed client is improving?
A. Reduced levels of anxiety.
B. Changes in vegetative signs such as insomnia, anorexia
C. Compliance with medications.
D. Requests to talk to the nurse.

4. A client is diagnosed with major depressive disorder is withdrawn and rarely communicates with others. Which nursing
diagnosis should a nurse assign to this client to address a behavioral symptom of this disorder?
A. Altered communication R/T feelings of worthlessness AEB anhedonia
B. Social isolation R/T poor self-esteem AEB secluding self in room
C. Altered thought processes R/T hopelessness AEB persecutory delusions
D. Altered nutrition: less than body requirements R/T high anxiety AEB anorexia

5. A nurse assesses a client suspected of having major depressive disorder. Which client symptom does not support this
diagnosis?
A. The client is disheveled and malodorous.
B. The client refuses to interact with others.
C. The client is unable to feel any pleasure.
D. The client has maxed-out charge cards and exhibits promiscuous behaviors.

6. Kathleen, age 68, is a widow of 6 months. Since her husband died, her sister reports that Kathleen has become socially
withdrawn, has lost weight, and does little more each day than visit the cemetery where her husband was buried. She told
her sister today that she "didn't have anything more to live for." She has been hospitalized with major depressive disorder.
The PRIORITY nursing diagnosis for Kathleen would be:
A. Altered Thought Process
B. Complicated Grieving
C. Risk for Suicide
D Social Isolation

7. A patient diagnosed with bipolar disorder is dressed in a red leotard & brightly colored scarves. The patient says, "I'll
punch you, munch you, crunch you" while twirling & shadowboxing. Then the patient says gaily, do you like my scarves?
Here, they are my gift to you. How should the nurse document the patient’s mood?
A. Labile and euphoric
B. Irritable and belligerent
C. Highly suspicious and arrogant
D. Excessively happy and confident

8. A client diagnosed with bipolar disorder, who has taken lithium carbonate (Lithane) for 1 year, presents in an
emergency department with severe diarrhea, blurred vision, and tinnitus. How should the nurse interpret these
symptoms?
A. Symptoms indicate consumption of foods high in tyramine.
B. Symptoms indicate lithium carbonate discontinuation syndrome.
C. Symptoms indicate the development of lithium carbonate tolerance.
D. Symptoms indicate lithium carbonate toxicity.

9. A client is diagnosed with bipolar disorder: manic phase. Which nursing intervention would be implemented to achieve
the outcome of "Client will gain 2 lbs by the end of the week?"
A. Provide client with high-calorie finger foods throughout the day.
B. Accompany client to cafeteria to encourage adequate dietary consumption.
C. Initiate total parenteral nutrition to meet dietary needs.
D. Teach the importance of a varied diet to meet nutritional needs.

10. A client is diagnosed with bipolar disorder and admitted to an inpatient psychiatric unit. Which is the priority outcome
for this client?
A. The client will accomplish activities of daily living independently by discharge.
B. The client will verbalize feelings during group sessions by discharge.
C. The client will remain safe throughout hospitalization.
D. The client will use problem solving to cope adequately after discharge.

SAS 18

LESSON REVIEW / PREVIEW& HOOK ACTIVITY (10 minutes)

KEY IDEAS
1. Write down a word/group of words which you believe best defines the following:
a. Post – Traumatic Stress Disorder
b. Acute Stress Disorder
c. Adjustment Disorder

1. A newly admitted client is diagnosed with post – traumatic stress disorder. Which behavioral symptom would the
nurse expect to assess?
A. Recurrent, distressing flashbacks
B. Intense fear, helplessness and horror
C. Diminished participation in significant activities
D. Detachment or estrangement from others

2. When planning the care of a client experiencing post – traumatic stress disorder, the nurse identifies which of the
following as an appropriate goal? The client will report:
A. A decrease in hearing voices
B. Spending less time on ritualistic behaviour
C. Having more energy
D. A decrease in flashbacks and nightmares

3. A nurse at North Medical Center is developing a care plan for a female client with post-traumatic stress disorder.
Which of the following would she do initially?
A. Instruct the client to use distraction techniques to cope with flashbacks.
B. Encourage the client to put the past in proper perspective.
C. Encourage the client to verbalize thoughts and feelings about the trauma.
D. Avoid discussing the traumatic event with client

4. A group of community nurses sees and plans care for various clients with different types of problems. Which of
the following clients would they consider the most vulnerable to post-traumatic stress disorder?
A. An 8 year-old boy with asthma who has recently failed a grade in school
B. A 20 year-old college student with DM who experienced date rape
C.A 40 year-old widower who has recently lost his wife to cancer
D.A wife of an individual with a severe substance abuse problem

5. The nurse is talking with a PTSD client who just had a beautiful bouquet of roses delivered. Suddenly the client
becomes tearful and stares out the window. The client has a history of sexual abuse. Which of the following should
the nurse include in the plan of care for this client?
A. Tell the client that the sexual abuse was in the past
B. Tell the client to relax and enjoy the roses
C. Assess if the client is having a flashback
D. Give the client some alone time and return later

6. Nurse Vicky is assessing a newly admitted client for symptoms of post-traumatic stress disorder (PTSD).
Which symptoms are typically is NOT typically seen in clients with this diagnosis?
A. Frequent thoughts of contamination
B. Excessively surprised and startled
C. Anger with numbing of other emotions
D. Frequent nightmares

7. The nurse caring for a PTSD client knows that this diagnosis is what type of disorder?
A. Anger C. Depressive
B. Anxiety D. Phobia

8. Children experiencing PTSD may exhibit which of the following signs and symptoms
A. Delayed growth spurt C. Bedwetting
B. Hives D. Hearing Loss

9. All of the following are re-experiencing symptoms in PTSD EXCEPT:

A. Nightmares C. Frightening Thoughts
B. Difficulty Sleeping D. Flashbacks

10. Boy, a fruit vendor who lost his wife in a vehicular accident while they were on their way home in a vehicular
accident two weeks appears so fearful and severely anxious is likely to be diagnosed with:
A. Acute Stress Disorder C. Adjustment disorder
B. Post-Traumatic Stress Disorder D. None of the above

SAS 19

1. A woman is 5'7", 160 lbs, and wears a size 8 shoe. She says, "My feet are huge. I've asked three orthopedists to
surgically reduce my feet." This person tries to buy shoes to make her feet look smaller and, in social settings, conceals
both feet under a table or chair. Which problem is likely?
A. Social anxiety disorder
B. Body dysmorphic disorder
C. Separation anxiety disorder
D. Obsessive-compulsive disorder due to a medical condition

2. A client with obsessive-compulsive disorder is hospitalized on an inpatient unit. Which nursing response is most
therapeutic?
A. Accepting the client’s obsessive-compulsive behaviors
B. Challenging the client’s obsessive-compulsive behaviors
C. Preventing the client’s obsessive-compulsive behaviors
D. Rejecting the client’s obsessive-compulsive behaviors

3. What intervention does the nurse implement to enable the client with repetitive behavior to complete daily activities?
A. Involve the family in the therapy
B. Increase stimulus to distract client
C. Give the client as much time he wants in a therapy
D. Direct and guide the client in a therapy

4. Akara, a 20-year-old female client believes that doorknobs are contaminated and refuses to touch them, except with a
paper tissue. Akara has symptoms of a client with:
A. Obsessive-Compulsive Disorder
B. Hoarding Disorder
C. Body Dysmorphic Disorder
D. Excoriation Disorder

5. Miss K, a celebrity socialite spends 4 hours every day to check on her body. She claims that she has “small butt” and
that part of her lacks curves that must be enhanced so she can flaunt her body. Miss K is manifesting whatdisorder?
A. Obsessive-Compulsive Disorder
B. Hoarding Disorder
C. Body Dysmorphic Disorder
D. Excoriation Disorder

6. Habit reversal as a therapy is used in clients with:

A. Obsessive-Compulsive Disorder
B. Hoarding Disorder
C. Body Dysmorphic Disorder
D. Excoriation Disorder

7. A client in the psychiatric ER admitted a client with baldness. The clients appears socially impaired and admits to pull
her hair to relieve her tension that started 2 years ago when she her boyfriend died. Which of the following best describes
her condition?
A. Obsessive-Compulsive Personality Disorder
B. Hoarding Disorder
C. Trichotillomania
D. Body Dysmorphic Disorder

8. A nurse in the Psych unit is assigned to a client with OCD. The nurse identifies all of the following manifestations of
OCD clients except:
A. Arranging & Re-arranging
B. Hearing voices in a silence place
C. Waking up in at night several times to check if doors are locked
D. Making sure clothes are inside the closet are color coded

9. Which of the following is a behavioral symptom of as client with OCD?

A. Doubting one’s memory
B. Intense Fear
C. Checking rituals
D. Scrupulosity

10. Marky loves to go to the mall with his friends. But often, he has the tendency to avoid the lines on the floor tiles which
makes him odd among his friends. Avoiding the lines as Marky steps on the floor is a:
A. Obsession
B. Compulsion
C. Illusion
D. Gratification
SAS 20
1. The nurse is working with a client with a somatic symptom disorder. Which client outcome goal would the nurse most
likely establish in this situation?
A. The client will recognize signs and symptoms of physical illness.
B. The client will cope with physical illness.
C. The client will take prescribed medications.
D. The client will express emotional conflicts verbally rather than covert it through physical symptoms.

2. Which outcome is most appropriate for Angelo who has a dissociative disorder?
A. Angelo will deal with uncomfortable emotions on a conscious level.
B. Angelo will modify stress with the use of relaxation techniques.
C. Angelo will identify his anxiety responses.
D. Angelo will use problem-solving strategies when feeling stressed.

3. The nurse evaluates the treatment of Mrs. Reyes with somatic symptom disorder as successful if:
A. Mrs. Reyes practices self-medication rather than changing health care providers.
B. Mrs. Reyes recognizes that physical symptoms increase anxiety level.
C. Mrs. Reyes researches treatment protocols for various illnesses.
D. Mrs. Reyes verbalizes anxiety directly rather than displacing it.

4. A newly admitted client is diagnosed with Dissociative Identity Disorder. Which nursing intervention is a priority for the
client?
A. Teach new coping skills to replace dissociative behaviors
B. Identify relationships between subpersonalities and work with each equally
C. Establish an atmosphere of safety and security
D. Process events associated with the origins of the disorder

5. Which of the following clinical manifestations would the nurse expect to assess in a clientwith Depersonalization
Disorder?
A. Mechanical, dreamy and detached feelings
B. Ambivalence
C. A loss of reality testing ability
D. Anger

6. The nurse admitting a client with suspected Dissociative Amnesia would report which of the followingmanifestations?
A. The amnesia is a result of prolonged substance abuse
B. The client’s inability to recall personal information
C. The amnesia has its etiology in a medical condition
D. The client exhibits common forgetfulness

7. Clients diagnosed with Dissociative Disorder commonly use which defense mechanism?
A. Suppression
B. Repression
C. Denial
D. Dissociation

8. Mapping is a part of the therapy in what type of dissociative disorder?

A. Dissociative Amnesia
B. Dissociative Fugue
C. Dissociative Identity Disorder
D. Depersonalization Disorder

9. Which of the following is an adjunctive therapy in Dissociative Disorders?

A. Psychotherapy
B. Anxiolytics
C. Antidepressants
D. Music Therapy

10. Seizure may occur in what somatic related disorder?

A. Conversion Disorder
B. Illness Anxiety Disorder
C. Somatic Symptom Disorder
D. Pseudocyesis

SAS 21

1. Nurse Gigi is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with
bulimia is to:
A. Avoid shopping for large amounts of food
B. Control eating impulses
C. Identify anxiety-causing situations
D. Eat only three meals per day

2. During postprandial glucose monitoring, a female client with bulimia nervosa tells the nurse, “You can sit with me, but
you’re just wasting your time. After you sat with me yesterday, I was still able to purge. Today, my goal is to do it twice.”
What is the nurse’s best response?
A. “I trust you not to purge.”
B. “How are you purging and when do you do it?”
C. “Don’t worry. I won’t allow you to purge today.”
D. “I know it’s important for you to feel in control, but I’ll monitor you for 90 minutes after you eat.”

3. For a female client with anorexia nervosa, Nurse Brad is aware that which goal takes the highest priority?
A. The client will establish adequate daily nutritional intake
B. The client will make a contract with the nurse that sets a target weight
C. The client will identify self-perceptions about body size as unrealistic
D. The client will verbalize the possible physiological consequences of self-starvation

4. For a female client with anorexia nervosa, Nurse Irene plans to include the parents in therapy sessions along with the
client. What fact should the nurse remember to be typical of parents of clients with anorexia nervosa?
A. They tend to overprotect their children
B. They usually have a history of substance abuse
C. They maintain emotional distance from their children
D. They alternate between loving and rejecting their children

5. Nurse Jackie is caring for a client with bulimia. Strict management of dietary intake is necessary. Which intervention is
also important?
A. Fill out the client’s menu and make sure she eats at least half of what is on her tray.
B. Let the client eat her meals in private. Then engage her in social activities for at least 2 hours after each meal
C. Let the client choose her own food. If she eats everything she orders, then stay with her for 1 hour after each meal
D. Let the client eat food brought in by the family if she chooses, but she should keep a strict calorie count.

6. A 27-year old client with anorexia nervosa tells the nurse, “When I look in the mirror, I hate what I see. I look so fat and
ugly.” Which strategy should the nurse use to deal with the client’s distorted perceptions and feelings?
A. Avoid discussing the client’s perceptions and feelings
B. Focus discussions on food and weight
C. Avoid discussing unrealistic cultural standards regarding weight
D. Provide objective data and feedback regarding the client’s weight and attractiveness

7. Nurse Angelo is developing a plan of care for a client with anorexia nervosa. Which action should the nurse include in
the plan?
A. Restrict visits with the family until the client begins to eat
B. Provide privacy during meals
C. Set up a strict eating plan for the client
D. Encourage the client to exercise, which will reduce her anxiety

8. A 19-year-old client was brought to the clinic by her mother. Her mother expresses concern about her daughter’s
weight loss and constant dieting. Nurse Kathleen conducts a health history interview. Which of the following comments
indicates that the client may be suffering from anorexia nervosa?
A. “I like the way I look. I just need to keep my weight down because I’m a cheerleader.”
B. “I don’t like the food my mother cooks. I eat plenty of fast food when I’m out with my friends.”
C. “I just can’t seem to get down to the weight I want to be. I’m so fat compared to other girls.”
D. “I do diet around my periods; otherwise, I just get so bloated.”

9. Nurse Helen is assigned to care for a client with anorexia nervosa. Initially, which nursing intervention is most
appropriate for this client?
A. Providing one-on-one supervision during meals and for one (1) hour afterward
B. Letting the client eat with other clients to create a normal mealtime atmosphere
C. Trying to persuade the client to eat and thus restore nutritional balance
D. Giving the client as much time to eat as desired

9. A client diagnosed with binge eating disorder has been attending a mental health clinic for several months. Which
medication should a nurse identify as an appetite suppressing agent?
A. Prozac
B. Haloperidol
C. Vyvanse
D. Chlorpromazine

10. A nurse observes dental deterioration when assessing a client diagnosed with bulimia nervosa. What explains this
assessment finding?
A. The emesis produced during purging is acidic and corrodes the tooth enamel.
B. Purging causes the depletion of dietary calcium.
C. Food is rapidly ingested without proper mastication.
D. Poor dental and oral hygiene leads to dental caries

SAS 22

1. Nurse Alvin has observed a co-worker arriving to work drunk at least three times in the past month. Which action by
Nurse Alvin would best ensure client safety and obtain necessary assistance for the co-worker?
A. Ignore the co- worker’s behavior, and frequently assess the clients assigned to the co-worker.
B. Make general statements about safety issues at the next staff meeting.
C. Report the coworker’s behavior to the appropriate supervisor.
D. Warn the co-worker that this practice is unsafe.

2. Nurse Aly is teaching a client about Disulfiram (Antabuse), which the client istaking to deter his use of alcohol. She
explains that using alcohol when taking this medication can result in:
A. Abdominal cramps and diarrhea.
B. Drowsiness and decreased respiration.
C. Flushing, vomiting, and dizziness.
D. Increased pulse and blood pressure.
3. The community nurse practicing primary prevention of alcohol abuse would target whichgroups for educational efforts?
A. Adolescents in their late teens and young adults in their early twenties
B. Elderly men who live in retirement communities
C. Women working in careers outside the home
D. Women working in the home
4. Which medication is commonly used in treatment programs for heroin abusers to produce a non-euphoric state and to
replace heroin use?
A. Diazepam
B. Carbamazepine
C. Clonidine
D. Methadone
5. Nurse Niko recommends that the family of a client with substance-related disorder attend a support group. The purpose
of these groups is to help family members understand the problem and to:
A. Change the problem behaviors of the abuser.
B. Learn how to assist the abuser in getting help.
C. Maintain focus on changing their own behaviors.
D. Prevent substance problems in vulnerable family members.

SAS 23

1. A child diagnosed with intellectual disability (ID) is under the supervision of Nurse Tasha. The nurse is aware that the
signs and symptoms of mild ID include which of the following?
A. Few communication skills
B. Lateness in walking
C. Mental age of a toddler
D. Noticeable developmental delays

2. Ritalin is the drug of choice for children with ADHD. The side effects of the following may be noted:
A. Increased attention span and concentration
B. Increase in appetite
C. Sleepiness and lethargy
D. Bradycardia and diarrhea

3. 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:
A. Profound
B. Mild
C. Moderate
D. Severe

4. The nurse teaches the parents of a mentally retarded child regarding her care. The following guidelines may be taught
except:
A. Overprotection of the child
B. Patience, routine, and repetition
C. Assisting the parents set realistic goals
D. Giving reasonable compliments

5. Intellectual Disability (Mental Retardation) is usually diagnosed before age 18 years and characterized BY?
A. Average IQ and lack of parental involvement
B. Low IQ and problems with daily living
C. Low IQ and lack of parental involvement
D. Average IQ and problems with daily living

6. The parents of Alexa, a child with attention deficit hyperactivity disorder, tell the nurse they have tried everything to
calm their child and nothing has worked. Which action by the nurse is most appropriate initially?
A. Actively listen to the parents’ concern before planning interventions.
B. Encourage the parents to discuss these issues with the mental health team.
C. Provide literature regarding the disorder and its management.
D. Tell the parents they are overacting to the problem.

7. Nurse Daya, a school nurse, is meeting with the school and health treatment team about a child who has been
receiving methylphenidate (Ritalin) for two (2) months. The meeting is to evaluate the results of the child’s medication use.
Which behavior change noted by the teacher will help determine the medication’s effectiveness?
A. Decrease repetitive behaviors
B. Decreased signs of anxiety
C. Increased depressed mood
D. Increased ability to concentrate on tasks

8. The school nurse assesses Brook, a child newly diagnosed with attention deficit hyperactivity disorder (ADHD). Which
of the following symptoms are characteristic of the disorder? Select all that apply.
A. Constant fidgeting and squirming
B. Excessive fatigue and somatic complaints
C. Difficulty paying attention to details
D. Easily distracted
E. Running away
F. Talking constantly, even when inappropriate

9. The community nurse visits the home of George, a child recently diagnosed with autism. The parents express feelings
of shame and guilt about having somehow caused this problem. Which statement by the nurse would best help alleviate
parental guilt?
A. “Autism is a rare disorder. Your other children shouldn’t be affected.”
B. “The specific cause of autism is unknown. However, it is known to be associated with problems in the structure of and
chemicals in the brain.”
C. “Sometimes a lack of prenatal care can be cause of autism.”
D. “Although autism is genetically inherited if you didn’t have testing you could not have known this wouldhappen.”

10. A 5-year-old boy is diagnosed to have autism. Which of the following manifestations may be noted in a client with
autism?
A. Argumentative, disobedience, angry outburst
B. Intolerance to change, disturbed relatedness, stereotypes
C. Distractibility, impulsiveness, and overactivity
D. Aggression, truancy, stealing, lying

LESSON WRAP - UP (20 minutes)

AL Strategy: NURSING CARE PLAN

1. The students will create one nursing care plan each for a client diagnosed with any the following: (1) Mental
Retardation, (2) ADHD or (3) ASD using the format below:
Assessment Nursing Diagnosis Goal/Plan of Care Nursing Interventions
Subjective: Short – Term: Independent:

Objective: Long – Term: Collaborative:

 Give at least 10
interventions

Source:
2. The care plan must be written in a short bondpaper (for each type of abuse) using the required format provided above.
The output will then be attached to the Student Activity Sheets.