DIAGNOSTIC EXAMINATIONS (TEST 5)

INSTRUCTIONS: There are 50 Items assigned to each subject. There are 100-items to be answered in this test. Refer to the proctor for the time schedule. Select the BEST ANSWER for the following questions. Mark only ONE answer for each item by shading the box corresponding to the letter of choice. Use Mongol No. 2. STRICTLY no erasures allowed. Do not write anything on this questionnaire. Please write the answer sheet number in the ANSWER SHEET NO. and TEST 5 to the Subject box.

MEDICAL-SURGICAL NURSING (Part 2)

1. An adult client with a history of gastrointestinal bleeding has a platelets count of 300,000 cells/mm3. Which action by the nurse is most appropriate after seeing the laboratory result? a. Report the abnormally low count b. Report the abnormally high count c. Place the client on bleeding precaution d. Place the normal in the clients medical record 2. An adult client with cirrhosis has been following a diet with optimal amount of protein because neither an excess nor a deficiency of protein has been helpful. The nurse evaluates the clients status as being most satisfactory if the total protein level is which of the following values? a. 0.4 g/dL b. 3.7 g/dL c. 6.4 g/dL d. 9.8 g/dL

4. The physician has determine that the client with hepatitis has contracted the infection from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis? a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Hepatitis D 5. Nurse Andrew is assessing for a correct placement of a nasogastric tube. Nurse Andrew aspirates the stomach content and checks the content for ph. Nurse Andrew verifies correct tube placement if which ph value is noted? a. 3.5 b. 7.0 c. 9 d. 10 6. The nurse provides medications instruction to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy? a. antacids will coats my stomach. b. Maalox will change the fluid in my stomach. c. omeprazole will coat the ulcer and help it heal. d. cimetidine will cause me to produce less stomach acid. 7. A nurse caring for a client with a pneumothorax and who has had a chest tube inserted notes continues gentle bubbling in the suction control chamber. What action is appropriate? a. Do nothing because this is an expected finding b. Immediately clamp the chest tube and notify physician c. Check for an air leak because the bubbling should be intermittent

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3. Nurse Adam checks for residual before administering a bolus tube feeding to a client with a nasogastric tube and obtains a residual amount of 150 ml. what is the appropriate action for the nurse to take? a. Hold the feeding b. Reinstill the amount and continue administering the feeding c. Elevate the client;s head at least 45 degrees and administer the feeding d. Discard the residual amount and proceed with administering the feeding

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d.

Increase the suction pressure so that the bubbling becomes vigorous. 8. During auscultation of the heart, the nurse would expect the first hear sound (S1) to be the loudest at the: A. Base of the heart B. Apex of the heart C. Left lateral border D. Right lateral border 9. When auscultating a clients heart, the nurse understands that the first heart sound is produced by the closure of the: A. Mitral and tricuspid valves B. Aortic and tricuspid valves C. Mitral and pulmonic valves D. Aortic and pulmonic valves 10. A client who has been admitted to the cardiac care unit with a myocardial infarction complains of chest pain. The nursing intervention that would be most effective in relieving the clients pain would be to administer the ordered: A. Morphine sulfate 2 mg IV B. Oxygen per nasal cannula C. Nitroglycerin sublingually D. Lidocaine hydrochloride 50 mg IV bolus 11. A client with a history of hypertension and left ventricular failure arrives for a scheduled clinic appointment and tells the nurse, My Feet are killing me. These shoes got so tight. The nurses best initial action would be to: Weigh the client Notify the physician Take the clients pulse rate Listen to the clients breath sounds 12. A 76-year-old client is admitted with the diagnosis of mild chronic heart failure. The sounds indicative of chronic heart failure that the nurse expect to hear when listening to the clients lungs would be: Stridor Crackles Wheezes Friction rubs 13. when assessing a client for sign of right ventricular failure the nurse should expect to note: A slowed pulse rate Neck vein distention A pleural friction rub Increasing hypotension

A. B. C. D.

A. B. C. D. A. B. C. D.

14. The nurse should assess for the development of pernicious anemia when a client has history of: A. Hemorrhage B. Diabetes mellitus C. Poor dietary habits D. Having had a gastrectomy 15. After a client has a total gastrectomy, the nurse should plan to include in the discharge teaching the need for: A. Monthly injection of vitamin B12 B. Regular daily use of a stool softener C. Weekly injections of iron dextran(imferon) D. Daily replacement therapy of pancreatic enzymes 16. When teaching a client how to avoid the dumping syndrome following a gastrectomy, the nurse should emphasize: A. Increasing activity after eating B. Avoiding excess fluid with meals C. Eating heavy meals to delay emptying D. Providing carbohydrates with each meal

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17. On the third postoperative day after a subtotal gastrectomy, a client complains of severe abdominal pain. The nurse palpates the clients abdomen and notes rigidity. The nurse should first: A. Assist the client to ambulate B. Assess the clients vital signs C. Administer the prescribed analgesic D. Encourage the use of the spirometer 18. The physician orders contact precautions for a client with hepatitis A. In addition to standard precautions, the isolation procedure that must be followed are: A. A private room is required, and the door must kept closed B. Persons entering the room must wear a gown, a mask, and gloves C. Gowns and gloves must be worn only when handling the clients soiled linen, dishes, or utensils D. A gown and gloves must be worn when handling articles possibly contaminated by urine of feces 19. A 64-year-old client is suspected of having carcinoma of the live and a liver biopsy is scheduled. The nurse understands that a liver biopsy may be contraindicated in certain situations. Therefore, it is important for the nurse to assess the client for: A. Confusion and disorientation B. The presence of any infectious disease C. A prothrombin time of less than 40% of normal D. An inclusion of foods high in vitamin K in the clients diet. 20. When discussing a scheduled liver biopsy with a client, the nurse should explain that for several hours after the biopsy the client will have to remain in: A. The left side-lying position with the head of the bed elevated B. A high Fowlers position with both arms supported on pillows C. The right side-lying position with pillows placed under the costal margin D. Any comfortable recumbent position as long as the client remains immobile 21. The equipment that will be used by the nurse during central venous catheter site care for a client receiving total parenteral nutrition is: A. Double sterile gloves B. Mask and sterile gloves C. helmet and sterile gloves D. Mask, helmet, and sterile gloves 22. An extremely obese client must self-administer insulin with an insulin syringe. The nurse should teach the client to: A. Pinch the tissue and inject at a 45-degree angle B. Pinch the tissue and inject at a 60- degree angle C. Spread the tissue and inject at a 45- degree angle D. Spread the tissue and inject at a 90-degree angle 23. The nurse is aware that the teaching about myasthenic and cholinergic crises is understood when a client who has been diagnosed with myasthenia gravis state that a symptom common to both is : A. Diarrhea B. Salivation C. Difficulty breathing D. Abdominal cramping 24. The physician orders 0.2 mg of cyanocobalamin ( vitamin B12) IM for a client with pernicious anemia. A vial of the drug labeled 1 mL = 100 mcg is available the nurse should administer: A. 0.5 mL B. 1.0 mL C. 1.5 mL D. 2.0 mL 25. A client with emphysema is short of breath and using accessory muscle of respiration. The nurse recognizes that the clients dyspnea is caused by: A. Spasm of the bronchi that traps the air B. An increase in the vital capacity of the lungs C. A too rapid expulsion of the air from the alveoli D. Difficulty in expelling the air trapped in the alveoli 26. The nurse is instructs a client with diabetes mellitus about blood glucose monitoring and monitoring for a signs of hypoglycemia. The nurse informs the client that hypoglycemia is a blood glucose level is lower than: a. 120 mg/dl b. 110mg/dl KEEP THIS 3 QUESTIONNAIRE CLEAN 2009 SHIELD REVIEW CENTER FOR NURSES

c. d.

90mg/dl 60 mg/dl

27. A nurse is caring for a postoperative parathyroidectomy client. Which client complaint would indicate that a serious, life threatening complication may be developing, requiring immediate notification of physician a. Larygeal stridor b. Abdominal cramps c. Difficulty in voiding d. Mild to moderate incisional pain 28. A nursing instructor asks a nursing student to identify the risk factors associated with the development of thyrotoxicosis. The student demonstrate understanding of the risk factors by identifying increased risk for thyrotoxicosis in which of the following clients? a. A client with hypothyroidism b. A client with Graves disease who is having surgery c. A client with diabetes mellitus scheduled for debridement of a foot ulcer d. A client with diabetes insipidus scheduled for a diagnostic test 29. A client with diabetes mellitus is at risk for serious metabolic disorder from breakdown of fats for conversion to glucose. The nurse caring for the client determines that pathological fat metabolism is occurring if the client has elevated levels of which of the following substance? a. Glucose b. Ketones c. Glucagon d. Lactate dehydrogenase 30 A 21-year-old college student with diabetes mellitus requests additional information about the advantages of using pen-like insulin delivery devices. The nurse explains that the advantages of these devise over syringes includes: A. shorter injection time B. accurate dose delivery C. use of a smaller gauge needle D. lower cost with reusable insulin cartridges 31. A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden sharp pain in the midepigastric region along with rigid, boardlike abdomen. These clinical manifestation most likely indicate which of the following ? a. An intestinal obstruction has developed b. Additional ulcers have developed c. The esophagus has become inflamed d. The ulcer has perforated 32. A client who has been diagnosed with gastroesophageal reflux disease (GERD) complains of heartburns. To decrease the heartburns. The nurse should instruct the client to eliminate which of the following items form the diet? a. Lean beef b. Air-popped popcorn c. Hot chocolate d. Raw vegetables 33.A 64-year-old client is suspected of having carcinoma of the live and a liver biopsy is scheduled. The nurse understands that a liver biopsy may be contraindicated in certain situations. Therefore, it is important for the nurse to assess the client for: a . Confusion and disorientation b. The presence of any infectious disease c. A prothrombin time of less than 40% of normal d. An inclusion of foods high in vitamin K in the clients diet. 34. The group of characteristics that would alert the nurse that a client is at increased risk of developing gallbladder disease would be a female: A. over the age 40, obese b. under the age of 40, history of high fat intake c. over the age of 40, low serum cholesterol level d. under the age 40, family history of gall-stone 35. An adaptation after a gastroscopy that indicates a major complication would be: a. Increased GI motility 2009 SHIELD REVIEW CENTER FOR NURSES 4 QUESTIONNAIRE CLEAN

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b. Difficulty swallowing c. Nausea and vomiting d. Abdominal distention 36.A client with pneumonia is experiencing pleuritic pain. Which of the following measure would most likely be successful in reducing his chest pain? a. Encourage the client to breathe shallowly b. Have the client practice abdominal breathing c. Offer the client incentive spiromentry d. Teach the client to splint the ribs cage when coughing 37.Which of the following physical assessment findings would the nurse expect to find in a client with advanced COPD? a. Barrel- chest b. Collapsed neck veins c. Increased chest excursions with respiration d. Nonproductive hacking cough 38. The nurse is teaching the client how to manage a nosebleed. Which of the following instructions would be appropriate to give to the client? a. Sit down lean back tilt your head backward and pinch your nose b. Sit down , lean forward and pinch the soft position of your nose c. lie down flat and place an ice compress over the bridge of your nose d.lie down Blow your nose gently with your neck flexed 39. Which of the following is the primary reason to teach pursed-lips breathing to client with emphysema? a. To promote oxygen intake b. To strengthen the diaphragm c. To strengthen intercostals muscles d. To promote carbon dioxide elimination 40.When monitoring pt who has respiratory acidosis,nurse would expect w/c of the ff ABG level A. pH 7.36 paCO2 37 HCO3 24 B. pH 7.35 paCO2 35 HCO3 24 C. pH 7.34 paCO2 46 HCO3 24 D. pH 7.37 paCO2 37 HCO3 24 41. When monitoring pt who has respiratory alkalosis ,nurse would expect w/c of the ff ABG level A. pH 7.45 paCO2 37 HCO3 24 B. pH 7.44 paCO2 35 HCO3 24 C. pH 7.43 paCO2 46 HCO3 24 D. pH 7.46 paCO2 22 HCO3 24 42. When monitoring pt who has metabolic alkalosis ,nurse would expect w/c of the ff ABG level A. pH 7.36 paCO2 20 HCO3 24 B. pH 7.46 paCO2 40 HCO3 35 C. pH 7.46 paCO2 22 HCO3 26 D. pH 7.36 paCO2 40 HCO3 24 43. When monitoring pt who has ph 7.47, hco3 40, paC02 35 ,nurse would expect A. Metabolic alkalosis uncompensated B. Metabolic alkalosis compensated C. Respiratory alkalosis compensated d. Respiratory alkalosis uncompensated 44. When monitoring pt who has ph 7.46, hco3 24, paC02 22 ,nurse would expect A. Metabolic alkalosis uncompensated B. Metabolic alkalosis compensated C. Respiratory alkalosis compensated d. Respiratory alkalosis uncompensated

45. An unresponsive 78-year-old patient is admitted to the emergency department in a coma during a summer heat wave. The patients core temperature is 106.2 F (41.2 C), blood pressure (BP) 86/52, and pulse 102. The nurse will plan to a.apply wet sheets and a fan to the patient. b.administer an acetaminophen (Tylenol) suppository. c.start O2 at 6 L/min with a nasal cannula. 5

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d.infuse lactated Ringers solution at 1000 ml/hr. 46. After the removal of the fluid, you will observe the client for: A. Decrease pulse rate B. Increased BP C. Increase pulse rate D. Decrease respiratory rate 47. patient was rushed to the Emergency Room complaining of slurred speech, headache, blurring of vision, and weakness of the lower extremities. Upon admission to the ER, Nurse Alex taked the patients vital signs and the results are the ff: BP 190/120 mmHg, PR 57 bpm, RR 11 cpm, T 38.9 c. Dr. Michael Mark ordered the patient to have CT Scan as soon as possible. Now, the patient was diagnosed with Cerebrovascular Accident. The physican orders the nurse to assess the 11th cranial nerve. The nurse must assess knowing that the 11th cranial nerve will elicit in which of the following? A. Cotton wisp B. Shoulder Shrugging C. Using of six cardinal gaze D. Tongue protruding

48. The nurse is caring for the client with increased intracranial pressure. The nurse would note which of the following trends in vital signs if the ICP is rising? a. Increasing temperature, increasing pulse, increasing respirations, decreasing blood pressure b. Increasing temperature, decreasing pulse, decreasing respirations, increasing blood pressure. c. Decreasing temperature, decreasing pulse, increasing respirations decreasing blood pressure d. Decreasing temperature, increasing pulse, decreasing respirations, increasing blood pressure. 49.After an automobile accident a client complains of seeing frequent flashes of light. The nurse should suspect: a. Scleroderma b. Acute glaucoma c. A detached retina d. A cerebral concussion 2009 SHIELD REVIEW CENTER FOR NURSES 6 QUESTIONNAIRE CLEAN 50. The ascites of Freddie is related to: A. Decrease oncotic pressure B. Decrease blood pressure C. Portal hypotension D. Decrease blood hydrostatic pressure

PSYCHIATRIC NURSING
51. The nurse is working with a client who has sought counseling after trying to rescue a neighbor involved in a house fire. In spite of the client's efforts, the neighbor died. Which action does the nurse engage in with the client during the working phase of the nurse-client relationship? a) Exploring the client's ability to function b) Exploring the client's potential for self-harm c) Inquiring about the client's perception or appraisal of the neighbor's death d) Inquiring about and examining the client's feelings that may block adaptive coping 52. A client who has just been sexually assaulted is quiet and calm. The nurse analyzes this behavior as indicating which defense mechanism? a) Denial b) Projection c) Rationalization d) Intellectualization 53. Laboratory work is prescribed for a client who has been experiencing delusions. When the nurse approaches the client to obtain a specimen of the client's blood, the client begins to shout You're all vampires. Let me out of here! The appropriate nursing response is which of the following? a) What makes you think that I am a vampire? b) I'll leave and come back later for your blood. c) I am not going to hurt you; I am going to help you.

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d)

It must be frightening to think that others want to hurt you.

54. Unresolved feelings related to loss most likely may be recognized during which phase of the therapeutic nurse-client relationship? a. Working b. Trusting c. Orientation d. Termination 55. A client with a diagnosis of major depression who has attempted suicide says to the nurse, I should have died. I've always been a failure. Nothing ever goes right for me. The therapeutic response to the client is: a) I don't see you as a failure. b) You have everything to live for. c) Feeling like this is all part of being ill. d) You've been feeling like a failure for a while? 56. The community health nurse visits a client at home. The client states, I haven't slept at all the last couple of nights. Which response by the nurse illustrates a therapeutic communication technique for this client? a. Go on. b. Sleeping? c. You're having difficulty sleeping? d. Sometimes, I have trouble sleeping too. 57. A client admitted to the mental health unit is experiencing disturbed thought processes and believes that the food is being poisoned. Which communication technique does the nurse plan to use to encourage the client to eat? a. Using open-ended questions and silence b. Focusing on self-disclosure regarding food preferences c. Identifying the reasons that the client may not want to eat d. Offering opinions about the necessity of adequate nutrition 58. A client is admitted to a mental health unit for treatment of psychotic behavior. The client is at the locked exit door and is shouting, Let me out. There's nothing wrong with me. I don't belong here. The nurse analyzes this behavior as: a. Denial b. Projection c. Regression d. Rationalization 59. The supervisor reprimands the nurse in charge of the nursing unit because the charge nurse has not adhered to the unit budget. Later that afternoon, the charge nurse accuses the nursing staff of wasting supplies. This behavior is an example of: a. Denial b. Repression c. Suppression d. Displacement 60. The client says to the nurse, I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying. The therapeutic response by the nurse is: a. Have you shared your feelings with your family? b. I think we should talk more about your anger with your family. c. You're feeling angry that your family continues to hope for you to be cured? d. Well, it sounds like you're being pretty pessimistic. After all, years ago, people died of pneumonia. 61. The nurse employed in a mental health unit is assigned to care for a client admitted to the unit 2 days ago. On review of the client's record, the nurse notes that the admission was a voluntary admission. Based on this type of admission, the nurse anticipates which of the following? a. The client will resist treatment measures. b. The client will be angry and will refuse care. c. The client's family will resist treatment measures. d. The client will participate in the planning of the care and treatment plan. 62. A nurse enters a client's room, and the client is demanding release from the hospital. The nurse reviews the client's record and notes that the client was admitted 2 days ago for treatment of an anxiety disorder and that the admission was a voluntary admission. Which of the following actions will the nurse take? a. Contact the physician. b. Call the client's family.

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c. d.

Persuade the client to stay a few more days. Tell the client that discharge is not possible at this time.

63. Nurse Monet is caring for a female client who has suicidal tendency. When accompanying the client to the

restroom, Nurse Monet should a. Give her privacy b. Allow her to urinate c. Open the window and allow her to get some fresh air d. Observe her 64. A neuromuscular blocking agent is administered to a client before ECT therapy. The Nurse should carefully observe the client for? a. Respiratory difficulties b. Nausea and vomiting c. Dizziness d. Seizures 65. A 39 year old mother with obsessive-compulsive disorder has become immobilized by her elaborate hand washing and walking rituals. Nurse Trish recognizes that the basis of O.C. disorder is often: a. Problems with being too conscientious b. Problems with anger and remorse c. Feelings of guilt and inadequacy d. Feeling of unworthiness and hopelessness 66. When working with a male client suffering phobia about black cats, Nurse Trish should anticipate that a problem for this client would be? a. Anxiety when discussing phobia b. Anger toward the feared object c. Denying that the phobia exist d. Distortion of reality when completing daily routines 67. Nurse Penny is aware that the symptoms that distinguish post traumatic stress disorder from other anxiety disorder would be: a. Avoidance of situation & certain activities that resemble the stress b. Depression and a blunted affect when discussing the traumatic situation c. Lack of interest in family & others d. Re-experiencing the trauma in dreams or flashback 68. Malou is diagnosed with major depression spends majority of the day lying in bed with the sheet pulled over his head. Which of the following approaches by the nurse would be the most therapeutic? a. Question the client until he responds b. Initiate contact with the client frequently c. Sit outside the clients room d. Wait for the client to begin the conversation 2009 SHIELD REVIEW CENTER FOR NURSES 8 69.Joe who is very depressed exhibits psychomotor retardation, a flat affect and apathy. The nurse in charge observes Joe to be in need of grooming and hygiene. Which of the following nursing actions would be most appropriate? a. Waiting until the clients family can participate in the clients care b. Asking the client if he is ready to take shower c. Explaining the importance of hygiene to the client d. Stating to the client that its time for him to take a shower 70. Joy has entered the chemical dependency unit for treatment of alcohol dependency. Which of the following clients possession will the nurse most likely place in a locked area? a. Toothpaste b. Shampoo c. Antiseptic mouthwash d. Moisturizer 71. After administering naloxone (Narcan), an opioid antagonist, Nurse Ronald should monitor the female client carefully for which of the following? a. Respiratory depression b. Epilepsy c. Kidney failure d. Cerebral edema

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72. The Geriatric residents of a long term care facility are engaged in a reminiscing group. The primary goal of this type of group of activity is: a. Provide psycoeducation opportunities for stress and coping. b. Provide an avenue for physical exercise c. provide an environment for social interaction and companionship d.reorient and provide a reality test of confused clients 73. Which of these Nursing interventions is most important when caring for a client who has just been placed in physical restraints? a. Prepare PRN dose of psychotropic medication b. Check that the restraints have been applied correctly c. Review hospital policy regarding duration of restraints d. monitor clients need for hydration and nutrition while restrained 74. A young woman is transffered to a psychiatric crisis unit with a diagnosis of Dissociative disorder. Which of the following comments by the client is most indicative of this disorder? a. Palage akong nananaginip ng masama sa gabi (I keep having reoccuring nightmares) b. Ouch! 1 week ng masakit ung ulo ang tummy ko.. hindi nako makawork (I have a headache and my stomache has bothered me for a week) c. Palage ko chinecheck ung lock ng pinto 3x bago ako umalis ng bahay (I always check the door locks three times before I leave home) d. e0w p0whZ.. zinn0w ak0hw? nHazan ak0hw nakahtir@? (I dont know who I am and I dont know where I live) 75. A young adult client describes her fears about taking the elavator to the 28th floor of her office building. She states feeling anxious, dizzy, heart races and short of breath. This information gained during the nursing assessment reveals that the client is probably experiencing: a.Somatization disorder b. Obsessive-Compulsive disorder c. Phobic disorder d.Dissociative disorders 76. A client who has been frequently hospitalized for noncompliance with the medication therapy for severe thought disturbances is to be placed on haloperidol decanoate (HALDOL) in preparation for discharge. The nurse understands the rationale for the selection of this medication is: A. This medication has the least amount of unpleasant side effects B. The client has done well on this medication in the past C. This medication is less expensive than most other antipsychotic medications D. This medication can be given as a long-acting injection by the community mental health center nurse 77. The nurse is developing a comprehensive care plan for a young woman with an eating disorder. The nurse refers this client to assertiveness skills classes. This is an appropriate intervention for clients with eating disorders because they often have problems with 2009 SHIELD REVIEW CENTER FOR NURSES 9 A. Aggressive behavior and angry feeling B. Self identity and self esteem C. Focusing on reality D. Family boundary intrusions 78. The evening nurse is caring for a psychotic client who repeatedly tells people that he is Jesus Christ. Before giving the client medication, which of the following actions by the nurse is necessary? A. ask several nursing assistants to be available for safety. B. Ask the priest to come and speak with the client C. Check the clients name band to make sure of the clients identity D. Make sure the client has eaten a full meal 79. All but one of the following patient is at risk for suicide? a. patient diagnosed with autism spectrum disorder who is exhibiting head banging b. patient with an eating disorder manifesting depression and low self esteem c. patient with depression giving her precious possessions d. patient with a personality disorder manifesting anxiety and avoidance 80. Kris a farmer from Baguio is diagnosed having Bipolar disorder. Which of the following therapy is best for Kris? A. Group therapy B. Milieu therapy KEEP THIS QUESTIONNAIRE CLEAN

C. Play therapy D. Horticulture therapy 81. Which of the following is a concern for children taking stimulants for ADHD for several years? a. Dependence on the drug b. Insomnia c. Growth suppression d. Weight gain 82. Family members of a client with bipolar tell the nurse that they are concerned that the client is becoming manic. The nurse knows that the manic phase is marked by: a. Flight of ideas and inflated self-esteem b. Increased sleep and greater distractibility c. decreased self-esteem and increased physical restlessness d. obsession with following rules and maintaining order Situation 11: Ramon, a 3 year old patient was diagnosed with Mental Retardation. KEEP THIS QUESTIONNAIRE CLEAN 10 2009 SHIELD REVIEW CENTER FOR NURSES

33. His IQ test score result was 35. The nurse will classify Ramon under: a. Mild b. Moderate c. Severe d. Profound 84. The developmental stage of Ramon is: a. Trust vs Mistrust b. Initiative vs Guilt c. Autonomy vs Shame and Doubt d. Industry vs Inferiority 85. With his IQ level, Ramon will be given remediation skills on: a. self care activities b. making art crafts c. improving handwriting d. simple mathematics and grammar 86. When Ramon tries to imitate Mark from his action styles and acting, Ramon uses which of the following ego defense mechanisms? a. Displacement b. Identification c. Introjection d. Projection 87. What food preparation can be given to Ramon to ensure his adequate nutrition during his hypoactive and depressive state? a. tyramine rich foods b. small frequent feedings c. finger foods d. candies and chocolates Popoy, a 3 year old patient in Hospital Y was diagnosed under Autism Spectrum Disorder. He was rushed in the hospital after suffering from a head injury. 88. Which of the following is the initial priority of the nurse? a. Provision of safety b. Giving small frequent feedings c. Consistent environment should be given d. Monitoring of the clients neurological status 89. Nurse, Gina Cole, who looks like Popoys mother was able to immediately establish rapport with Popoy. This is: a. Countertransference b. Transference c. Boundary violation d. Contract setting

90. Popoy ,age 3, is under which psychosxeual stage? a. Initiative v/s Guilt b. Autonomy v/s Shame and Doubt c. Phallic Stage d. Anal Stage 91. Individuals who are diagnosed with Autism are often fixated to stages of development. A patient who is rigid and ritualistic is fixated in? a. Anal b. Oral c. Phallic d. Latency 92. A girl dresses like her favorite female teacher. a. Identification b. Intellectualization c. Isolation d. Symbolization 93. A physically small teenage male who does poorly in the athletic competition is on the honor roll. a. Conversion b. Rationalization c. Compensation d. Dissociation 94. I would have done better on the test if the teacher had stressed the right information. The defense mechanism used: a. denial b. rationalization c. reaction formation d. intellectualization 95. The client asks the nurse about milieu therapy. The nurse responds, knowing that the primary focus of milieu therapy can best be described as which of the following? a) A form of behavior modification therapy b) A cognitive approach to changing behavior c) A living, learning, or working environment d) A behavioral approach to changing behavior 96. The nurse is caring for a client with a phobia who is being treated for the condition. The client is introduced to short periods of exposure to the phobic object while in a relaxed state. The nurse understands that this form of behavior modification can best be described as: a) Milieu therapy b) Aversion therapy c) Self-control therapy d) Systematic desensitization 97. A client with an eating disorder is planning to attend group meetings with Overeaters Anonymous, and the nurse describes this group to the client. The nurse determines that the client needs additional information if the client states which of the following about this self-help group? a) The leader is a nurse or psychiatrist. b) The members provide support to each other. c) People who have a similar problem are able to help others. d) It is designed to serve people who have a common problem 98. The nurse is conducting a group therapy session, and a client with a manic disorder is monopolizing the group. The appropriate nursing action is which of the following? a) Ask the client to leave. b) Refer the client to another group. c) Tell the client to stop monopolizing d) Thank the client for the contribution and tell him or her to allow others a chance to contribute. 99. Repetition of words or phrases heard from another person a. Clang association b. Echolalia c. Mutism d. Word salad 100. Speaking as if the words are being forced out quickly 2009 SHIELD REVIEW CENTER FOR NURSES 11

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a. b. c. d.

Neologism Pressured speech Verbigeration Word salad

End of exam. Please submit your answer sheet.

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