Question 1

What is an unpleasurable reaction to a real or threatened situation termed as?

Accepted Answer

Answer reason: Fear is an unpleasant emotional response to an identifiable real or perceived threat. Anxiety is a vague, diffuse apprehension without a specific source; apathy is lack of interest; ambivalence is having mixed feelings.

Question 2

A person's need of belongingness is called as-?

Accepted Answer

Answer reason: Belongingness reflects the desire for social connection and acceptance, termed the affiliation motive in motivation theory, not achievement or power.

Question 3

Which of the following is NOT a basic component of attitude?

Accepted Answer

Answer reason: Attitude consists of three basic components: affective (emotional), behavioral, and cognitive (informational). A spiritual component is not part of this tri-component model.

Question 4

Which part of the mind distinguishes right from wrong and acts as a censor of behavior?

Accepted Answer

Answer reason: The superego represents internalized morals and ideals, judging right from wrong and censoring behavior. The ego mediates reality; the id seeks pleasure; libido is psychic energy, not a mind part.

Question 5

The client with a myocardial infarction comes to the nurse's station stating that he is ready to go home because there is nothing wrong with him. Which defense mechanism is the client using?

Accepted Answer

Answer reason: Refusing to accept the reality of illness by insisting nothing is wrong is denial. Rationalization makes excuses, projection attributes feelings to others, and conversion manifests psychological stress as physical symptoms.

Question 6

A 16 year-old client is admitted to a psychiatric unit with a diagnosis of attempted suicide. The nurse is aware that the most frequent cause for suicide in adolescents is?

Accepted Answer

Answer reason: Adolescent suicide most commonly stems from loneliness and social isolation, where feelings of alienation lead to withdrawal and loss of meaningful connections. Other options are less frequent precipitants.

Question 7

A PRIORITY goal of involuntary hospitalization of the severely mentally ill client is?

Accepted Answer

Answer reason: Involuntary hospitalization is primarily for safety—when a person is a danger to self or others or gravely disabled. Protection from harm is the immediate priority; symptom elimination and return to independent functioning are longer-term goals.

Question 8

An HIV+ gay client confides in the nurse that his physician avoids touching him. The nurse recognizes the physician's behavior suggests?

Accepted Answer

Answer reason: Avoiding physical contact is a differential action toward a client based on minority status (HIV+ and gay), which constitutes discrimination. Prejudice is an attitude, stereotyping is a generalized belief, and ethnocentrism is judging others by one’s own cultural standards.

Question 9

Which of the following statements made by a client indicates a need for ADDITIONAL assessment of the impact of body-image alteration following mastectomy?

Accepted Answer

Answer reason: This statement shows significant anxiety and disturbed body image requiring further assessment, unlike the other responses which reflect coping or rationalization.

Question 10

The nurse is teaching a client about the healthy use of ego defense mechanisms. An appropriate goal for this client would be?

Accepted Answer

Answer reason: Ego defense mechanisms are unconscious strategies that help reduce anxiety and protect self-esteem; they do not eliminate anxiety, avoid responsibility, or primarily foster independence/communication.

Question 11

A 19 year-old client is paralyzed in a car accident. Which of the following statements used by the client would indicate to the nurse that the client was using the mechanism 'suppression'?

Accepted Answer

Answer reason: Suppression is a conscious, voluntary attempt to avoid or postpone dealing with distressing thoughts; saying "I'd rather not talk about it right now" reflects this. Claiming not to remember is more consistent with repression (unconscious).

Question 12

During change-of-shift report the tending nurse notes a Catholic client will soon be admitted for the delivery of her ninth child. The tending nurse comments angrily to a colleague, "Doesn't she know there's such a thing as birth control?" The nurse's attitude is an example of?

Accepted Answer

Answer reason: The remark reflects a negative judgment toward an individual based on membership in a group (Catholic), which is prejudice—an attitude—not a behavior (discrimination) or a generalized belief alone (stereotyping).

Question 13

Hepatic hallucinations are also known as which type of hallucinations?

Accepted Answer

Answer reason: Haptic (often misstated as hepatic) hallucinations refer to sensations of touch; therefore they are tactile hallucinations.

Question 14

The geriatric residents of a long-term care facility are engaged in a reminiscing group. The nurse knows that the primary goal of this type of group activity is to?

Accepted Answer

Answer reason: Reminiscence groups primarily promote socialization and companionship by sharing past experiences. Psychoeducation, exercise, and reality orientation are different goals of other interventions.

Question 15

The nurse asks a client with a history of alcoholism about the client's drinking behavior. The client states "I didn't hurt anyone. I just like to have a good time, and drinking helps me to relax." The client is using which defense mechanism?

Accepted Answer

Answer reason: The client provides justifying explanations to make risky drinking seem acceptable, which is rationalization. It is not denial (rejecting the problem), projection (attributing to others), or intellectualization (overly factual detachment).

Question 16

A Chinese woman, is admitted with generalized anxietydisorder and inability to care for herself. According to Chinese folk medicine, her health is regulated by the opposing forces of yin and yang. Based on this cultural belief, the nurse would expect her family to attribute her illness to?

Accepted Answer

Answer reason: In traditional Chinese folk medicine, illness such as nervousness/anxiety is attributed to an excess of yin, the negative force associated with darkness, cold, and emptiness.

Question 17

At the day treatment center a client diagnosed with Schizophrenia - Paranoid Type sits alone alertly watching the activities of clients and staff. The client is hostile when approached and asserts that the doctor gives her medication to control her mind. The client's behavior most likely indicates?

Accepted Answer

Answer reason: Sitting alone, hostility when approached, and paranoid belief that medication is for mind control indicate withdrawal from others and altered thought content, consistent with social isolation related to altered thought processes.

Question 18

The school nurse suspects that a third grade child might have Attention Deficit Hyperactivity Disorder. Prior to referring the child for further evaluation, the nurse should?

Accepted Answer

Answer reason: Before referral for suspected ADHD, the nurse should gather a comprehensive behavioral and developmental history to inform evaluation and rule out other causes. Observation or comparison alone is insufficient.

Question 19

The nurse is assessing the mental status of a recently admitted psychiatric client. Which of the following questions will BEST assess the memory function for recall of events?

Accepted Answer

Answer reason: Three-item immediate recall tests recent memory. A assesses orientation, B tests attention/calculation, and D assesses object recognition/naming.

Question 20

A client has been admitted with complaints of lower abdominal pain, difficulty swallowing, nausea, dizziness, headache and fatigue. The client is agitated, fearful, tachycardic and complains of being "too sick to return to work." The client is diagnosed as having somatoform disorder. In formulating a plan of care, the nurse must consider that the client's behavior?

Accepted Answer

Answer reason: Somatoform (somatic symptom) disorders involve physical symptoms that are unconsciously produced; they are not under voluntary control. This distinguishes them from malingering or factitious disorder.

Question 21

Which of the following is the BEST definition of insight?

Accepted Answer

Answer reason: Insight refers to a sudden awareness or understanding, particularly of oneself or the solution to a problem. Option A describes trial-and-error, C describes a defense mechanism, and D is a therapy technique.

Question 22

A spouse is concerned because the client frequently daydreams about moving to Arizona to get away from the pollution and crowding in southern California. The nurse explains that?

Accepted Answer

Answer reason: Daydreaming is the defense mechanism of fantasy, used to gratify unconscious wishes or imagine future possibilities. The other options describe different mechanisms: dissociation, conversion, and isolation, which do not fit the behavior described.

Question 23

A client was admitted to the eating disorder unit with bulimia nervosa. When the nurse assesses for a history of complications of this disorder, the following are expected?

Accepted Answer

Answer reason: Recurrent self-induced vomiting in bulimia exposes teeth to gastric acid causing enamel erosion and can lead to parotid gland enlargement (sialadenosis). Other options do not reflect typical bulimia complications; vomiting causes metabolic alkalosis, not acidosis.

Question 24

A potential concern when caring for an older adult who has diminished hearing and vision would be the client’s?

Accepted Answer

Answer reason: Hearing and vision loss limit communication and participation in social activities, leading to withdrawal and loneliness. This sensory deprivation increases risk for depression and reduced quality of life. Cognitive impairment is not a direct consequence, and sensory overload is unlikely with decreased input. Disorientation can occur but social isolation is the most consistent and primary concern.

Question 25

A man was sentenced to 6 months imprisonment after he was caught observing a tenant bathing through a key hole. This behavior is called......?

Accepted Answer

Answer reason: Observing an unsuspecting person who is nude or undressing for sexual arousal is characteristic of voyeurism (a paraphilic disorder). Frotteurism involves rubbing against a nonconsenting person. Sadism is sexual arousal from inflicting pain or humiliation. Fetishism involves sexual focus on nonliving objects or specific body parts.

Question 26

A nurse in an emergency department completes an assessment on an adolescent client that has conduct disorder. The client threatened suicide to teacher at school. Which of the following statements should the nurse include in the assessment?

Accepted Answer

Answer reason: In an adolescent who has threatened suicide, the nurse must assess risk factors that increase lethality, including substance use. Alcohol lowers inhibitions and heightens impulsivity, which can precipitate suicidal behavior, particularly in conduct disorder. The other options are not directly related to suicide risk assessment and do not inform immediate safety planning.

Question 27

Esteem needs include?

Accepted Answer

Answer reason: In Maslow’s hierarchy, esteem needs involve self-esteem and esteem from others, including confidence, achievement, recognition, and respect. Sleep and rest, food and shelter, and oxygen and water are physiologic/basic needs at lower levels of the hierarchy. Therefore, the option that reflects esteem needs is confidence and respect.

Question 28

Respecting patient’s values meets which need?

Accepted Answer

Answer reason: In Maslow’s hierarchy, esteem needs include respect, recognition, and feeling valued. When nurses respect a patient’s values and beliefs, they affirm the patient’s dignity and autonomy, supporting self-worth. Safety needs relate to protection from harm, social needs involve love and belonging, and physiological needs are basic survival needs. Therefore, respecting values primarily addresses esteem needs.

Question 29

A clean environment fulfills which need?

Accepted Answer

Answer reason: In Maslow's hierarchy, a clean environment reduces exposure to pathogens and hazards, providing protection, security, and freedom from harm. These are components of the safety and security level. Physiological needs involve basic survival (air, water, food), while esteem and social needs concern self-worth and belonging. Therefore, cleanliness primarily fulfills the Safety need.

Question 30

Feeling safe from harm is a?

Accepted Answer

Answer reason: In Maslow's hierarchy, safety and security needs are the second level and include protection from harm, stability, and freedom from fear. The feeling of being safe from harm directly reflects this level. Love/belonging and esteem needs are higher-level psychosocial needs, while physiological needs involve basic survival functions such as oxygen, fluids, and nutrition.

Question 31

The highest level in Maslow’s hierarchy is?

Accepted Answer

Answer reason: In Maslow’s hierarchy, needs ascend from physiologic and safety to love/belonging and esteem, with self-actualization at the top. Self-actualization reflects achieving one’s fullest potential, personal growth, and fulfillment. In nursing prioritization, lower-level needs are addressed first, but the highest level represents ultimate psychological development.

Question 32

The first level of Maslow’s hierarchy includes?

Accepted Answer

Answer reason: In Maslow’s hierarchy, the first (most basic) level is physiological needs, which include essentials for survival such as oxygen, food, water, sleep, and elimination. These must be met before higher-level needs like safety, love/belonging, and esteem can be effectively addressed. In nursing prioritization, unmet physiological needs typically take immediate precedence over psychosocial concerns.

Question 33

The nurse is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is most to?

Accepted Answer

Answer reason: In bulimia nervosa, binge–purge behaviors are often triggered by anxiety, stress, or other negative affect; early nursing goals focus on improving insight into triggers and building coping alternatives. Helping the client identify anxiety-provoking situations is an appropriate initial, achievable goal that supports later interventions such as coping skills training and relapse prevention. Options about controlling impulses or restricting shopping/meal patterns are more outcome-focused and may be unrealistic or overly behavioral without first addressing underlying triggers.

Question 34

Sexual stimulation obtained through some inanimate object is known as?

Accepted Answer

Answer reason: Fetishism is defined as sexual arousal derived from nonliving objects, distinguishing it from other paraphilias involving behaviors, observation, or animals.

Question 35

The most common sign associated with substance abuse in an adolescent is?

Accepted Answer

Answer reason: Behavioral changes are the most common and broad early indicator of adolescent substance use, often presenting as irritability, mood swings, secrecy, new peer groups, and declining responsibility. These changes frequently precede or accompany more specific problems such as sleep disturbance or school difficulties. Poor school performance and sleep changes are common but are less specific and can occur with many other adolescent stressors or mental health conditions. Increased blood pressure is not a typical common presenting sign of substance abuse across adolescents.

Question 36

At which stage of Kohlberg's theory does an individual want to fulfill the expectations of one's immediate group?

Accepted Answer

Answer reason: In Kohlberg’s conventional level, Stage 3 (good boy–nice girl orientation) centers on meeting the expectations of close others and gaining approval by being seen as “good.” The focus is on interpersonal relationships and conformity to the immediate group’s norms. Stage 4 (society-maintaining) emphasizes law-and-order and maintaining social systems, not just the immediate group. Stages 2 and 6 reflect self-interest exchange and universal principles, respectively, which do not match the stem.

Question 37

A male hospital employee is pushed out of the way by a female employee because of an oncoming gurney. The pushed employee becomes very angry and swings at the female employee. Both employees are referred for counseling with the staff psychiatric RN. Which factor in the pushed employee's history is most related to the reaction that occurred?

Accepted Answer

Answer reason: The male employee’s explosive anger and aggressive swinging after being pushed can reflect a trauma-triggered fight response, especially when physical contact resembles past abuse. A history of being physically abused (including by a caregiver) is strongly associated with heightened threat perception, hyperarousal, and impulsive reactive aggression when startled or touched. The other options are less directly linked to an immediate touch-triggered aggression in this scenario: worry about job loss is cognitive, animal torture relates more to conduct/antisocial traits, and “hates to be touched” describes avoidance but does not explain the intensity and learned fight response as clearly as prior physical abuse.

Question 38

The nurse observes a patient talking to someone who is not present. This is called?

Accepted Answer

Answer reason: Talking to someone who is not present indicates a perception without an external stimulus, which is a hallucination (commonly auditory). A delusion is a fixed false belief rather than a sensory experience. A phobia is an irrational fear, and an obsession is an intrusive recurrent thought. Therefore, the best answer is hallucination.

Question 39

Which of the following is being used when the mother of a hospitalized child calls the student nurse and states, “You idiot, you have no idea how to care for my sick child”?

Accepted Answer

Answer reason: The mother is experiencing anxiety and fear about her child’s illness and redirects (shifts) those emotions onto a safer target—the student nurse—by verbally attacking them. This is characteristic of displacement: transferring feelings from the true source of distress to another person. Projection would involve attributing her own unacceptable feelings to the nurse (e.g., claiming the nurse is angry or incompetent because she feels guilty/inadequate). Repression is an unconscious blocking of distressing thoughts, and psychosis involves loss of reality testing, neither of which is suggested here.

Question 40

A mental illness also known as stereotype movement?

Accepted Answer

Answer reason: Stereotyped movements are repetitive, purposeless, patterned motor behaviors commonly seen in severe mental illness (e.g., schizophrenia/catatonia) and are classified among motor behavior abnormalities. “Mannerism” refers to odd, exaggerated, repetitive, and goal-directed-appearing movements that are not appropriate to the situation and overlaps with the concept of stereotypy. Illusions and hallucinations are perceptual disturbances, not movement abnormalities. Verbigeration is a speech disturbance (meaningless repetition of words/phrases), not stereotyped movement.

Question 41

Which is not a symptom of depression?

Accepted Answer

Answer reason: Core depressive symptoms commonly include persistent low mood, anhedonia (loss of interest/pleasure), and neurovegetative changes such as insomnia or hypersomnia. Therefore, persistent sadness, loss of interest in activities, and changes in sleep pattern are consistent with depression. “Excessive happiness” is not a typical symptom of depression and is more suggestive of elevated mood states (e.g., mania/hypomania) rather than depressive episodes.

Question 42

The branch of nursing that deals with the care of patients with mental illness is called?

Accepted Answer

Answer reason: Psychiatric nursing (mental health nursing) is the specialty focused on assessing, treating, and supporting patients with mental illnesses and behavioral disorders. It includes therapeutic communication, safety management, medication monitoring, and psychosocial interventions. Pediatric, surgical, and geriatric nursing are defined primarily by patient age group or care setting rather than mental health focus.

Question 43

The RN is caring for a client with major depression. Which of the following statements by the client is most concerning?

Accepted Answer

Answer reason: Anhedonia ("I just don't enjoy doing anything anymore") is a core symptom of major depressive disorder and signals significant functional impairment and higher risk for worsening depression and suicidality, making it the most concerning to the nurse. Hypersomnia and weight loss are also depressive symptoms but are less immediately indicative of severe loss of interest/pleasure that often correlates with poorer prognosis. Hair loss is not a classic key symptom of major depression and suggests other causes (e.g., thyroid disorder, nutritional deficiency, medication effects), but it is not typically the priority safety concern compared with profound anhedonia.

Question 44

The main goal of psychiatric nursing is?

Accepted Answer

Answer reason: Psychiatric nursing focuses on promoting mental health, preventing mental illness when possible, and helping individuals develop effective coping skills. Care is holistic and includes therapeutic communication, milieu management, psychoeducation, and support for adaptive functioning. It is not limited to curing physical illness, preparing for surgery, or only administering medications.

Question 45

Which therapeutic approach focuses on coping skills in addiction recovery?

Accepted Answer

Answer reason: Cognitive Behavioral Therapy (CBT) is specifically designed to help clients identify triggers, challenge maladaptive thoughts, and practice healthier coping strategies to prevent relapse. In addiction recovery, CBT emphasizes skill-building such as craving management, problem-solving, and behavioral planning. Psychoanalysis is insight-focused and typically long-term rather than coping-skills oriented. Family therapy can support recovery but is not primarily centered on individual coping-skill training, and ECT is used for severe mood disorders, not addiction coping skills.

Question 46

When a patient is not aware of his mental disorder it is called?

Accepted Answer

Answer reason: A patient who is not aware of having a mental illness is described as having poor or absent insight. Insight refers to the ability to recognize one’s symptoms as part of an illness and understand the need for treatment. Disorientation is confusion about person/place/time, and unconsciousness is a decreased level of arousal, neither of which specifically addresses awareness of mental illness.

Question 47

Circumstantiality is the disorder of-?

Accepted Answer

Answer reason: Circumstantiality is a disturbance in the form of thought/process in which the person includes excessive, unnecessary detail but eventually returns to the point. It is categorized under thought (thought process) rather than perception, consciousness, or memory. Perception disturbances include hallucinations/illusions, while memory disorders involve amnesia and related deficits. Therefore, the best answer is thought.

Question 48

What is the treatment for depression?

Accepted Answer

Answer reason: Depression is commonly treated with evidence-based psychotherapy and/or antidepressant medications; among the options, antidepressants represent a core, widely accepted medical treatment. Vitamin supplements are not a primary treatment unless a specific deficiency is identified. Antibiotics treat bacterial infections and have no role in treating depressive disorders.

Question 49

An attorney who throws books and furniture around the office after losing a case is referred to the psychiatric nurse in the law firm’s employee assistance program. The nurse knows that the client’s behavior most likely represents the use of which defense mechanism?

Accepted Answer

Answer reason: Throwing books and furniture after losing a case is an immature, childlike outburst that reflects a temporary return to earlier patterns of behavior under stress, which best fits regression. Projection would involve attributing one’s unacceptable feelings to others (e.g., blaming coworkers for the anger). Reaction formation would show behaving in the opposite way of the true feeling (e.g., excessive politeness while feeling enraged). Intellectualization would involve focusing on facts/logic to avoid emotions, not acting out physically.

Question 50

What are the immediate side effects of Electroconvulsive therapy?

Accepted Answer

Answer reason: The most common immediate adverse effects after ECT are transient confusion on awakening from anesthesia and short-term memory impairment (anterograde and retrograde), which typically improve over hours to days. Fractures/dislocations were historical risks before modern anesthesia and muscle relaxants and are now rare. Myocardial infarction/cardiac arrest are uncommon serious complications rather than expected immediate side effects. Permanent memory loss and brain damage are not expected effects of properly administered ECT.

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