NLE Sample Questions 4

DEC ’08 B-Exam
Nursing Practice 5

Situation 1 - The following questions refer to nurse's efforts to do collaboration and teamwork. Select the best answer.

1. The most important role of the nurse as a member of the team is to:
A. carry out medical orders
B. meet the needs for the physical well being of patients
C. coordinate the psychological care and management of clients
D. keep a 24 hour watch for the patients

2. A biologic/medical approach to patient care utilizes which of the following?
A. Million therapy C. Behavioral therapy
D. Somatic therapy D. Psychotherapy

3. Which of these nursing actions belong to the secondary level of preventive intervention?
A. Providing mental health consultation to health care providers
B. Providing emergency psychiatric services
C. Being politically active in relation to mental health issues
D. Providing mental health education to members of the community

4. When the nurse identifies a client who has attempt to commit suicide the nurse should;

A. call a priest
B. counsel the client
C. refer the client to the psychiatrist
D. refer the matter to the police

5. The community health nurse was invited by the principal of an elementary school and was asked to give a talk to parents. An appropriate topic would be:

A. the legal aspects of drug abuse
B. disciplining children at home and school
C. marital crises
D. the problems of out of school youth

Situation 2 - The nurse visited the Reyes family to check on their two growing children, aged 7 and 4 years. Upon her visit she observed that common areas of arguments between Mr. and Mrs. Reyes are about conflicting ways of bringing up their children. Mrs. Reyes is lax and tolerant while Mr. Reyes often insists strict ways to a point of over protectiveness from what he perceives as unsafe i.e. community and neighbors that cannot be trusted.
6. Mr. Reyes remarked "I am wary about people visiting- with all the media news about child kidnapping and robberies” - The nurse's BEST response would be:
A. "Would you rather wish that I don't come and visit you may regard me as a stranger?"
B. "I get that.” The nurse diverts the attention to talk about non-threatening topics.
C. "It must be distressing to think and feel the way you do."
D."I acknowledge what you are saying. My concern is the health care of your family and information are strictly confidential."

7. Mrs. Reyes expressed that her socializing with neighbors is limited because her husband thinks she is getting overly friendly with a guy next door. Which of the following would the nurse emphasize as basic?
A. Keeping trust in the relationship
R. Avoid relating with neighbors to minimize conflict
C. De assertive to express her individuality
D. Ignore the husband and just be supportive

8. For the nurse to be effective in developing rapport with the family it is essential that she keeps her appointment on time and stick to a care plan. She is applying the principle of:

A. responsibility and accountability
B. consistency and predictability
C. honesty and integrity
D. empathy and compassion

9. Which of these symptoms if demonstrated by Mr. Reyes would necessitate referral to a doctor?

A. Hypervigilance C. Hypersensitive
3. Suspicious affect D. Loss of reality contact

10. The paranoid client utilizes which of the following defense mechanisms?

A. Sublimation C. Rationalization
B. Projection D. Reaction formation

Situation 3 - Mr. Sison has been diagnosed as having early chronic glaucoma. He has been' admitted to the hospital for treatment.

11. The nurse identified a nursing problem of disturbed sensory perception: visual impairment characterized by:

A. Sudden loss of eyesight
B. Loss of night vision
C. Loss of peripheral vision
D. Loss of central vision

12. In order to understand the rationale for drug therapy, it is important for the nurse to know that glaucoma is usually caused by:

A. opacity in the lens
B. gradual diminution of the- retina
C. damage to the proteins in the lens
D. increase production of aqueous fluid

13. Diamox is a drug used in the treatment of glaucoma. Which of these is the effect of this drug?

A. Constricts the pupil
B. Acts as osmotic diuretic
C. Reduces the production of aqueous humor
D. Facilitates outflow of aqueous humor

14. Public health nurses should Identify which of these patients as a risk group for development of glaucoma, hence the need for annual eye examinations:
A. Patient with Parkinson's disease
B. Cancer patients
C. Diabetic and hypertensive patients
D. Patient with COPD

15. The appropriate method of instilling eye drops is: Instilling into an opened eye with the head held back and with the eye looking:
A. to the left C. to the right
B. downward D. upward

Situation 4 - SEXUAL DISORDER

16. A hospitalized male adolescent flirts with and is sexually provocative toward a female nurse. The nurse can respond MOST therapeutically by doing which of the following?

A. Telling him she is married and too old for him
B. Introducing him to female clients his own age
C. Encouraging him to watch TV in his room
D. Ignoring his flirtatious and provocative behaviors

17. The premorbid personality of a person with a non psychotic maladaptive response to anxiety may most accurately be described as:

A. unpredictable, irnpulsive and aggressive
B. rigid, insecure and conforming
C. dependent, pessismistic and moody
D. anxious, insensitive and self-absorbed

18. An oral-dependent personality is characterized by "which of the following?

A. Helplessness C. Aggressiveness
B. Hopelessness D. Suspiciousness

19. The pedophile's choice of a sex object is primary based on:
A. Difficulty relating with adults
B. Feelings of tenderness toward children-
C. Feats of incestuous impulses
D. Preferred for a passive sexual rote

20. A young adult maid unable to stay put in one job and has commitment in his relationship is having difficulty achieving a sense of:
A. autonomy
B. trust
C. industry
D. intimacy

Situation 5 - Anita is experiencing rape-trauma syndrome in an acute phase. She had been invited to a fraternity party. She had too much drink and she was raped by her date. The day after, she was brought to the hospital. She has feelings of anger, humiliation, helplessness, nausea, vomiting, nightmare and muscle tension.

21. When the nurse approached Anita, initially she was just crying, felt she was in a nightmare and she was at a loss. The appropriate nursing diagnosis is:

A. Situational low self-esteem
B. Sexual violence
C. Ineffective coping
D. Sexual dysfunction

22. Anita expressed to the nurse that he douched, showered for half an hour and still did not feel clean. Anita is experiencing:

A. guilt C. denial
B. anger D. frustration

23. Which of these communicate unconditional acceptance of Anita and her situation?

A. "You are safe hero and I am ready to listen."
B. "Why did you date a guy you hardly knew?" ,
C. "Tell me when you are ready and I'll corne back to you'
D. "I would be best of help if you slop crying."

34. Anita is experiencing:
A. maturational crisis C. anticipated crisis
B. developmental crisis D. situational crisis

25. Which of these behaviors of Anita signal her readiness to proceed to the working phase of the nurse-patient relationship?

A. She states she trusted the nurse
B. She wants to talk to a lawyer
C. She inquired about personal information about the nurse
D. She wants to be told what her rights are

Situation 6 - The psychiatric mental health nurse adheres to standards that ensure quality improvement. The following situations and behaviors are means to achieve this goal.

26. This is the process wherein the clients chart is reviewed to compare criteria for quality care with actual practice.

A. Psychiatric Audit
B. Nursing Care Process
C. Interaction Process Analysis
D. Algorithms

17, In order to assess "Reliability" as a behavioral characteristic, the nurse would ask herself which of the following questions regarding her recording:

A. Did the history of the present problem correlate with the review of growth and development?
B. How long did it take to complete the nursing data base?
C. Is the nursing data base complete?
D. Are the nursing history and psychosocial assessment accurate?

28. All of these are the advantages of peer review EXCEPT:

A. Demands accountability for nursing actions
B. Has the possibility of enhancing intra professional respect
C. It requires the development of standards for quality care
D. Provide an evaluation of the nurse's abilities

29. The nursing team leader wants to involve all the nurses in participating in their own personal and professional growth through a brainstorming session. One of the most important ground rules is;

A. follow the problem solving approach
B. do not pass judgment on the ideas presented
C. ideas must be feasible
D. suggestions must be cost effective

30. "Did the nurse perform in the best possible manner without waste?" aims 10 describe the nurse's:
A. thoroughness C. efficiency
B. reliability D. analytic sense

Situation 7 – A nurse was interested to study the research question: “What are the differences and similarities between aggressive and non-aggressive cognitively impaired, elderly, institutionalized people?”

31. Investigation of cognitively impaired individual presented some ethical dilemmas. Which of the following protocol would be considered unethical?
A. Recording interaction with the elderly with their permission
B. B. Verbal permission from the subject is unnecessary
C. Data coded and recorded solely by the investigation
D. A written consent from the institution and a significant other
32. A semi-structured interview was conducted. This means that:

A. interview is conducted precisely in the same manner
B. interviewer is not held to any specific question
C. subject is allowed to express without any suggestion from interviewer
D. interviewer is free to prove beyond a number of specific major questions

33. The type of study conducted is :

A. descriptive C. experimental
B. quasi-experimental D. case study

34. The review of literature included reference to retrospective studies. Such studies have the following advantages EXCEPT:

A. data are inexpensive to obtain
B. possibility of memory bias and distortion of fact
C. there is much material available
D. it is easy to gel data

35. The average age of the respondents was 86. This represents:

A. the sum ages divided by total number of participants
B. the youngest participant is 86 years old
C. the eldest participant is 86 years old
D. most of the number of participants is 85 years old
Situation E - Mr. David is brought to the hospital due to pain radiating to the hip and leg. He is diagnosed with a herniated lumbar disk. He is scheduled for myelogram.

36. After the procedure, the nurse must include which of the following nursing action in his caie.

A. Assess for movement and sensation of the lower extremity
B. Place the client in most comfortable position
C. Lying supine with heels flexed
D. Bed test with bed elevated at 45 degrees

37. Mr. David is scheduled for lumbar laminectomy, Post operatively the nurse should:

A. logroll the client with the help of another nurse
B. inform the client that he should be in supine position
C. assess for sensory loss in the legs
D. instruct the patient to move from side to side

38. Trirnethobenzamide Hydrochloride (Tigan) was administered postoperatively. The action of this drug is effective when it:

A. controls nausea
B. controls pain
C. controls muscle spasm
D. controls edema

39. Mr. David is to ambulate for the first time following surgery. What nursing action should be Best when the client begins to faint?

A. Get another nurse for help
B. Manuever the client to a sitting position
C. Get back to his bed and place in side lying position
D. Assist the client to form a wide base of support and lean against the nurse

40. Mr. David has to wear back brace. Which position is recommended when the brace is applied?

A. Sitting position C. Lying on his side in bed
B. Standing position D. Supine position in bed

Situation 9 - Through the nurse-patient relationship, the nurse intervenes utilizing effective communication techniques. The following are varied situations in a psychiatry ward.

41. The patient verbalizes. "Masama ang pakiramdarn ko. Hindi ako nakatulog kagabi." A therapeutic response of the nurse would be:
A. “Baka ini-istorbo ka na naman ng mga boses.”
B. “Sinabi mo sana sa nars para nabigyan ka ng sedative drug mo.”
C. “Relax lang! Huwag ka masyadong mag-isip ng mga problema mo."
D. “Maaari mo bang sabihin sa akin ang mga naiisip at nararamdaman mo?”

42. Soledad is terminally ill of cancer. Looking sad she expresses, "Wala na yata akong pag-asang mabuthay pa” A response which fosters hope is:

A. Mukhang napakabigat ng dinaramdam ninyo. Andito po ako at puwede tayong mag-usap
B. "Huwag po ninyong isipin sakit ninyo. Bale wala yon. Andito naman ako para makausap ninyo."
C. “Lakasan ang loob ninyo. Lahat naman po tayo ay doon ang patutunguhan."
D. "Gagaling din po kayo. Huwag po kayong mag-atala."

43. Camilia verbalizes. “Pinag-uusapan nila ako. Ayaw nila ako. "A therapeutic response is:

A. "Nalulungkot ba ang pakiramdam mo”
B. 'Hayaan mo sila. Arng mahalaga ay ang palagay mo sa sarili mo."
C. “Sino ang ‘nila’' ang tinutukoy mo?”
D. Huwag rnong isipan yan. Hindi tama yan”

44. During socialization, Nicanor was provoked, became furious and started shouting "Walang hiya kayo! Ako ang bida dito\" The nurse's action is:

A. take him away from the group until he manages to have control of himserf.
B. Immediately restrain him and put him en isolation to protect other patients.
C. Prevent him from becoming more furious by giving an extra PRN dose of sedative
D. Respond with, "Nicanor, paro-pareho tang kayo ng mga ibang pasyente dito"

45. “Nicanor becomes verbally assaultive to the nurse. He says, "Ikaw, nurse, wala kang alam! Marunong pa'ako sa iyo, e. Ano ba ang pinagmamalaki mo? The nurse responds therapeutically by:

A. admonishing him with, "Ako ang nurse dito. Dapat sumunod ka sa akin."
B. acknowledging his behavior, however, put him in his right senses; respond with. "Oo nga, galit ka sa nurse pero hindi tama na naninigaw ka."
C. acknowledging his behavior and respond. "Nagagalit ka sa nurse at nawawala ka ng kontrol sa sarili mo.”
D. ignoring the behavior of the patient

Situation 10 - Nicanor was discharged from the hospital and recovered from a manic episode of Bipolar Disorder. Nicanor was readmitted with an entirely different behavior. He was very depressed:

46.. The defense mechanism utilized by manic patients to cover up depression is:

A. reaction formation C. displacement
B. compensation D. denial

47. The psychodymics of depression is:

A. lax super-ego
B. weak super-ego
C. internalized hostility feelings
D. narcissistic personality

48. Which of these drugs is likely to be indicated for Nicanor?

A. Serenace (Haloperidol)
B. Valium (Diazepam)
C. Tofranil (Imipramine HCi)
D. Trilafon (Perphenazine)

49. Therapeutic use of self is essential in relating with psychiatric patients. This is BEST demonstrated in:

A. sympathizing with the miserable feelings of Nicanor
B. engaging Nicanor in productive activity
C. engaging Nicanor in introspective thinking
D. suppressing her own feelings toward Nicanor

50. After three days of antidepressant medication, Nicanor still manifests depression. The nurse evaluates this as:
A. unusual because action of antidepressant drug is immediate
B. expected because it takes about two weeks for the medication to be effective
C. unexpected because it takes within one week for the medication to be effective
D. ineffective because perhaps the drug's dosage is inadequate

Situation 11 - Ninety year old Purita is confined at the medical unit for respiratory ailment for which a breathing apparatus is prescribed for her to use while she sleeps. She refuses to wear it continuously though she fully understands the medical indication for it.

51. Which of these, ethical principles can guide the nurse in her action?

A. Beneficence C. Autonomy
B. Fidelity D. Nonmaleficence

52. Purita has six children who are already adults. They differ in their opinion. Whether or not to allow their mother to decide for herself. The nurse would encourage family conference for:

A. the eldest child's opinion to be given priority
B: majority of the children to decide
C. allowing the medical staff to decide in their behalf
D. consensus building

53. Breathing treatments are to be given to Purita. In anticipation that Purita might refuse, Dinio, one of the children requests that he be the one to sign consent in behalf of their mother. The nurse explains that Purita is rational in her thinking and which of these client's right must be regarded?

A. Right to refuse treatment
B. Right to privacy
C. Right to Informed consent
D. Right of habeas consent

54. Which of these would be the nurse's priority following the treatment principle of least restrictive alternative?

A. Ono to one staffing C. Physical restraint
D. Use of on site guard/watcher D. Seclusion

55. Purita talks about her joy in having responsible and accomplished children and recalls challenging career as a lawyer. She is demonstrating a sense of:

A. ego integrity C. generativity
B. industry D. autonomy

Situation 12 -Marina. 26 years old is aloof in relating with other patients and members of the staff. She claims that the medications being given her are meant to poison her. She is also suspicious about the food being served to her.
56. Basically, Marina is suspicious because of her inability to develop a sense of:
A. Intimacy C. Trust
B. Generativity D. Intiative

57. Marina utilizes projection by being suspicious. This means that she:

A. unconsciously refuses to accept a feeling, thought or impulse and attributes it to someone else
B. justifies behavior, attitudes and feelings with excuses.
C. involuntarily refuses to acknowledge reality
D. involuntarily excludes wishes, impulses, memories and feelings from awareness

58. Which of those nursing approaches is MOST appropriate for the nurse to begin with?

A. Engage Marina for at least one hour in a one-to-one interaction dairy
B. Invite her to socialize with other patients
C. Make self available while maintaining distance until pa tient shows readiness to interact
D. Refer her for activity therapy

59. When she resists to take her medication, it is best to:

A. let her read the drug literature to convince her that it is therapeutic
D. force her to take the drug to maintain therapeutic effectiveness of the drug
C. have the same nurse, who she interacts with regularly, administer the drug
D. request the doctor to give her medication

60. Another reason why she refuses to take Thorazine is because she complains of robot like movement and slurred speech. The nurse's action is :

A. decrease the dosage of thorazine
B. explain the extrapyramidal side effects and administer Benadryl
C. avoid giving foods that are rich in tyramine
D. withhold medication until referral is made to the doctor

Situation 13 - The supervising nurse received report that a staff nurse is displaying frequent irritation, anger, and even indifference toward clients and co-workers.

61. The initial action of the supervisor would be to:

A. post guidelines on proper decorurn of nurses in the bulletin board
B. write a memo of warning to the nurse
C. request anecdotal report from nurse's co-workers
D. call the nurse for a one on one conference

62. The nurse expressed increasing feelings of dissatisfaction. The supervising nurse intervenes therapeutically by taking on the role of:

A. administrator by relieving her of responsibilities
B. therapist by delving into the nurse's internal conflicts
C. counselor by actively listening
D. educator by reorienting her of her role as a nurse

63. Coupled with poor work performance, mental and physical fatigue and actual withdrawal from client contact and nursing duties, the nurse can be said to be suffering from:

A- psychotic anxiety
B. staff burnout
C. personality maladjustment
D. neurotic depression

64. A priority in the nurse's personal development program would be to :

A. address her physical well being
B. boost her self-confidence
C. provide social support
D. help her find value and meaning in her work

65. The most relevant professional program for hpr would be.:

A. assertiveness training
B. stress management
C. group dynamics and team building
D. behavior modification

Situation 14 - The purpose of the nursing care plan is to identify the care for an individual
patient based on his problems. The nurse writes a nursing care plan for a patient based on nursing care standards.

66. Given this example of a problem; "Anxiety due to a job interview". The "due to" or the reason for the problem should be included if it is known. The initial step in identifying problems is:

A. gather the data about the patient
B. determine if the problems are usual or unusual
C. analyze the data
D. analyze the problems as concisely as possible

67. Given this example of an expected outcome: "Openly verbalize anxiety about job interview. Identify how he can prepare for the job interview." Which of these is not a criterion of expected outcomes?

A. An expected outcome is stated in terms of what the patient will do
B. An expected outcome is stated in terms of what the nurse will do
C. Every outcome must be measurable
D. Every outcome answers the question How will you know when the problem is resolved?

68. The following are reasons for setting deadlines within which to achieve outcomes of care EXCEPT:

A. Indicate specific times to review progress or lack of progress
B. Does not allow plans to be changed
C. Allow plans the need to be changed
D. Set the time by which the expected outcome should be reached

69. Which of these is not a relevant nursing order?

A. Ask patient any untoward side effects of medications he is taking
B. Have patient role play interview situation
C. Discuss with a patient with specific means he might prepare for the job interview
D. Ask the patient what he is feeling about the job interview

70. Which of these practices on evaluation support nursing care? Review of care plan is:

A. a nursing team responsibility
B. the sole responsibility of the primary nurse
C. the responsibility of peers
D. the sole responsibility of the supervisor

Situation 15 - A nurse assigned in the neurologic unit is taking care of clients with varying degrees of degenerative disorders.

71. Mr. A with myasthenia gravis is having difficulty speaking. What communication strategies should the nurse avoid when interacting with Mr. A?

A. Repeating what the client says for better understanding
B. Using paper and pencil in communicating with the client
C. Encouraging the client to speak slowly
D. Encouraging the client to speak quickly

72. When planning for nursing care for Mr. B, who has Parkinson's disease, which of the following goals would be MOST appropriate?

A. To improve muscle tone
B. To start rehabilitation as much as possible
C. To treat the disease
D. To maintain optimal body function

73. For the past 10 years. Alma, 42 years old, has had multiple sclerosis. Clients with multiple sclerosis experience many different symptoms. As part of the rehabilitation planned for Alma, the nurse suggested therapy and hobbies to help her:

A. strengthen muscle coordination
B. establish routine
C. develop perseverance and motivation
D. establish good health habits

74. On his second day of hospitalization. Mr. Santos was unable to stand and is having difficulty swallowing and talking. Which of the following is the priority of the nurse in assisting Mr. Santos?

A. To prevent bladder distention
B. To prevent decubitus ulcer
C. To prevent contracture
D. To prevent aspiration pneumonia

75. The wife of a seventy two (72) year old male with a diagnosis of Alzheimer's disease begins to cry and tells the nurse, "I could not understand my husband anymore. He has changed drastically." Which of the following responses of the nurse is MOS T appropriate?

A. The physician and the staff will make sure that your husband will be comfortable and safe here".
B. This has been a difficult time for you. Let us walk and find a quiet place where we can talk".
C. "He will soon recover in his condition.
D. "You need not worry, we are doing the best we could".

Situation 16 - Annie has a morbid fear of heights. She asks the nurse what desensitization
therapy is:

76. The accurate information of the nurse of the goal of desensitization is:

A. to help the clients relax and progressively work up a list of anxiety provoking situations through imagery.
B. to provide corrective emotional experiences through a one-to-one intensive relationship.
C. to help clients in a group therapy setting to take on specific roles and reenact in front of an audience, situations in which interpersonal conflict is involved.
D. to help clients cope with their problems by learning behaviors that are more functional and be better equipped to face reality and make decisions.

77. It is essential in desensitization for the patient to:

A. have rapport with the therapist
B. use deep breathing or another relaxation technique
C. assess one's self for the need of an anxiolytic drug
D. work through unresolved unconscious conflicts

78. In this level of anxiety, cognitive capacity diminishes. Focus becomes limited and client experiences tunnel vision. Physical signs of anxiety become more pronounced.

A. Severe anxiety C. Mild anxiety
B. Panic D. Moderate anxiety

79. Antianxiety medications should be used with extreme caution because long term use can lead to:

A. Parkinsonian like syndrome
B. hypertensive crisis
C. hepatic failure
D. risk of addiction

80. The nursing management of anxiety related with post traumatic stress disorder includes all of the following EXCEPT:
A. encourage participation in recreation or sports activities
B. reassure client's safety while touching client
C. speak in a calm soothing voice
D. remain with the client while fear level is high

Situation 17 - For personal and professional development, the nursing staff decided to hold a staff development program, "Self-enhancement through Assertiveness".

81. An appropriate assessment tool to maximize gathering of needs of nurses is through :

A. interview of nurses C. observation
D. survey D. brainstorming sessions

82. A priority objective of the program is :
A. develop the art public speaking
B. project a positive image of the nursing profession
C. develop art and skills of therapeutic use of self
D. earn continuing education units

82. The most effective way to practice assertiveness skills is through :

A. written evaluation form C. descriptive report
B. process recording D. role play

83. The least satisfactory method to evaluate the effectiveness of the program is through :

A. group discussion and report
B. return demonstration
C. attendance
D. individual interviews

84. Which of those feedback from individual participants indicate maximum gain from the staff development program?

A. "I will write a plan for personal development program."
B. “I feel very good. The program inspired me a lot.”
C. "I learned a lot I hope to have more seminars of its kind."
D."I have a 'Do it Now’ project for myself, i.e to approach my clinical supervisor regular to discuss nursing care of our clients."

Situation 18 - A Vehicle hit some pedestrians while waiting for a bus ride. Some of the victims suffered Injuries in the different parts of their bodies. The victims were brought to the nearby hospital. One of the victims, Josephine was confirmed to have a fractured left arm. While waiting for the plaster cast to be applied, Josephine appears to be anxious.

86. To reduce the anxiety, the nurse teaches the procedure to the client. Which of the following topics should NOT be included in the teaching plan?

A. Leave cast uncovered to promote drying.
B. Bear weight on the plaster cast for one hour. A stockinet will be placed over the left arm to be placed in cast.
C. Handle hardening cast with palms of hands
D. Trim and reshape finish cast with knife or cutter

87. Cast was applied on Josephine's left arm. In assessing the neurovascular status of the client. Which of the following assessment findings should be reported to the physician?
A. Pain on the left arm
B. Swelling of the fingers
C. Skin abrasions on the edges of the plaster cast.
D. Nail bed capillary refill time of 10 seconds

88. One of the victims, a sixty year old woman sustained hip fracture. Prior to surgery a Buck's extension traction is to be applied. The rationale for the application of traction is primarily based on the understanding that Buck's extension traction:

A. reduces muscle spasms and helps to immobilize the fracture
B. allows reduction of the fracture site for bone healing.
C. secures the fracture site to prevent damage to the muscle tissues
D. secures (he fracture she for rigid immobilization

89. Philip was placed in skeletal leg traction with an overbed frame. He is not allowed to move from side to side. Which of the following nursing interventions is useful in maintaining effective traction?

A. Assist the client by holding the trapeze and raising the hips off the bed.
B. Check the apparatus, that weights hang free and knots in the rope are tied securely
C. Suspend a trapeze within easy reach of the client
D. Support the affected extremity while the weights are removed

90. To prevent complications when a child is in Buck's traction, the nurse should :

A. clean the extremity and keep the skin dry
B. assess any skin and circulatory disturbances
C. clean the pin sites as necessary
D. provide high fiber small meals

Situation 19 - It is the nurse's primary responsibility to ensure a safe environment for the patients at the Psychiatry ward:

91. All of the following concepts are true EXCEPT:

A. Hostility is destructive
B. Frustration develops in response to unmet needs, wants and desire
C. Anger is incompatible with love
D. Aggression can be expressed in a constructive as v/ell as a destructive manner

92. Carlo is acting out hostile and aggressive feeling by kicking the chairs in the room. The MOST effective way to deal with Carlo's behavior is initially to:

A. set limits on the behavior by verbal command
B. administer prn tranquilizer
C. remove the chairs from the room
D. restrain the patient and place him in the "Isolation Room"

93. Mrs. Dizon was visiting her son at the Psychiatry Ward. Which of the following items will the nurse not allow to be brought inside the ward?

A. String rosary bracelet C. Bottle of coke
B. Box of cake D. Rubber shoes

94. Which of the following will probably be most therapeutic for a patient on a behavioral modification ward?
A. If the client is agitated, discuss, the feelings especially anger
B. Insist to stop obscene language by verbal reprimand
C. Give client support and positive feedback for controlling - use of obscene language
D. Provide a punching bag as an alternative to express upset emotions

95. Which of the following must be considered while planning activities for the depressed
patient?

A. Activities which require exertion of energy
B. Challenging activities to get him out of his depression -
C. Reading materials to divert his thoughts
D. Variety of unstructured activities
I
Situation 20 - Jim, age 25, recalled that his problem began around age 15 or 16. He would
count pencils in a mug over and over with the thought that stopping could result in something bad happening.

96. There are many things Jim seems he has to do to keep himself from feeling:

A. confused C. excited
B. suspicious D. anxious

97. He has to change clothes 20 times before work, chew each bite he eats 24 times and go up and down the stairs four to five times before it feels right He is demonstrating:

A. ideas of reference
B. denial and projection
C. obsession and compulsion
D. rationalizauon and over reaction

98. The objective of nursing care for Jim is to develop or increase feelings of:

A. self-mastery C. self-actualization
B. self worth D. self-determination

99 All of these are therapeutic interventions EXCEPT:

A. impose limits every time the behavior becomes repetitive
B. establish a routine for him
C. assign task that can be done repetitively
D. facilitate sett-expression

100. Jim is aware of his behavior, yet realizes that it is very disturbing to him. This is a pattern

A. personality disorder
B. psychosis
C. neurosis
D. habitual disorder