1 Benha University Faculty of Nursing Fourth year final exam Course title: Psychiatric and Mental Health Nursing 2 nd semester Date: 27 / 5 / 2012 Time allowed: 3 hours Parts Questions Marks Parts( 1) Multiple-choice questions 20 Parts(2) True and false 15 Parts(3) Matching 10 Parts(4) Definitions 5 Parts(5) Fill in the blanks 30 total 80 د مواهب محمود ذكىب السيد محمد احمد د/رحا
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1
Benha University
Faculty of Nursing
Fourth year final exam
Course title: Psychiatric and Mental Health Nursing 2nd
semester
Date: 27 / 5 / 2012
Time allowed: 3 hours
Parts Questions Marks
Parts( 1) Multiple-choice questions 20
Parts(2) True and false 15
Parts(3) Matching 10
Parts(4) Definitions 5
Parts(5) Fill in the blanks 30
total 80
د مواهب محمود ذكى
د/رحاب السيد محمد احمد
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Please answer all of the following questions:-
Part (1): Multiple Choice Questions (M C Q)
For each of the following (M C Q), select the one most appropriate answer,
there is only one best answer.
1- The nurse interprets a patient's fear of being in situations or places
that may be difficult or embarrassing to leave as evidence of:
a) Social phobia
b) Panic disorder
c) Agoraphobia
d) Generalized anxiety disorder.
2- The diagnosis of cyclothymic disorder requires which one of the
following criteria?
a) Repeated episodes of hypomania and mild depression
b) A minimum duration of 6 months
c) At least one prior manic episode
d) At least one prior major depressive episode
3- The nurse has just assessed a patient with anorexia in the outpatient
clinic, which finding would prompt the nurse to anticipate the need for
hospitalization for this patient?
a) Persistent tachycardia
b) Hyperthermia
c) Blood pressure of 85/50 mmHg
d) Amenorrhea
4- The nurse observes a patient washing his hands every 5 minutes
throughout the course of an interview, identifying this behavior as a
characteristic of someone with:
a) Compulsions
b) Obsessions
c) Ideas of reference
d) Delusions
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5- Which intervention would the nurse include with developing a care
plan for a patient with Alzheimer's disease or vascular dementia?
a) Speak to the patient in a loud voice
b) Keep the television on throughout the day's activities
c) Frequently tell the patient what's going to happen
d) Place the patient in a group activity room with about 10 people
6- A patient with schizophrenia says, "We can, pan, scan, ran, plan."
The nurse identifies this as which speech abnormality?
a) Clang association
b) Echolalia
c) Word salad
d) Neologism
7- A patient is to receive conventional antipsychotic drug therapy
which drug would the nurse except to administer?
a) Prolixin
b) Olanzapine
c) Seroquel
d) Risperidone
8- A schizophrenic patient who began taking Haldol 1 week ago is
exhibiting jerking movements of the neck and mouth. The nurse
interprets theses findings as suggesting:
a) Dystonia
b) Tradive dyskinesia
c) Akathisia
d) Parkinsonism
9- When caring for a patient with schizophrenia, which nursing
intervention would be least effective?
a) Exploring the content of his hallucinations
b) Asking the patient to clarify his neologisms
c) Rewarding the patient for positive behavior
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d) Performing all activities for the client so his needs are met
10- During his assessment interview, a schizophrenic patient tells the
nurse, people are reading my mind. They are out to get me. The nurse
documents that the patient is experiencing:
a) Delusions
b) Hallucinations
c) Illusions
d) Magical thinking
11- Which of the following conditions is known to have the best
response to ECT?
a) Depression with suicidal tendancy
b) Simple schizophrenia
c) Paranoid schizophrenia
d) Obsessive compulsive disorder
12- Which of the following condition is associated with long-term use of
lithium in mood disorders?
a. Hypothyroidism
b. Hyperprolactinemia
c. Hypoglycemia
d. Hypertension
13- Combining MAOIs with SSRIs may cause
a) Serotonin Syndrome
b) Extrapyramidal Symptoms (EPS)
c) Neroleptic Malignant Syndrome (NMS)
d) Agranulocytosis
14- Depression is characterized by all, Except:
a) Psychomotor retardation
b) Loosening of association
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c) Retardation of thinking process
d) Pervasive mood of sadness
15- Which of the following disturbances is the basic defect in mania?
a) Ideas of reference
b) coining of new words
c) Delusion of grandiosity
d) Elation
16- Older adults have reached Erikson's developmental stage of ego
integrity when they:
a) Acknowledge that one cannot get everything one wants in life.
b) Assess their lives and identify actions that had value and purpose.
c) Express a wish that life could be relieved differently.
d) Feel that they are being punished for things they did not do.
17- A Psychiatric and mental health nurse manager of a milieu
treatment team receives a report that a nurse was threatened and
frightened by a patient. No assault occurred; another staff member
intervened to calm the patient. The threatened nurse is visibly shaken.
After ensuring the safety of the milieu, the nurse manager
a) has the threatened nurse attend Managing Assault Behavior classes
b) Identifies ways that the threatened nurse could have prevented the
confrontation.
c) Spends time with the threatened nurse and the team to process
attitudes and feelings.
d) tells the threatened nurse that this situation is a normal risk of
psychiatric and mental health nursing
18- The most important assessment data for the nurse to gather from
the client in crisis would be:
a. The client's work habits
b. Any significant physical health data
c. A past history of any emotional problems in the family
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d. The specific circumstances surrounding the perceived crisis situation
19- A female client is admitted for surgery. Although not physically
distressed, the client appears apprehensive and alienated. A nursing
action that may help the client to feel more at ease includes:
a. Telling her that everything is all right
b. Giving her a copy of hospital regulations
c. Orienting her to the environment and unit personnel
d. Reassuring her that staff will be available if she becomes upset
20- Parents are at the clinic with a child diagnosed with attention
deficit hyperactivity disorder. Which group characteristics would the
nurse most likely observe in the waiting room of the clinic? The child
a. plays with 2 children in the waiting room
b. runs over and turns on the video player without listening to parent's
directions
c. constantly wiggles( يتذبذذ) a leg when waiting to take a turn at the
board game
d. Puts the toy truck back into the playbox only after visiting with three
other children and their parents
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Part (2)
II -Read each statement carefully and circle (T) if the statement is true
and (F) if statement false
No T F statement
1 T F When the nurse talks with the delirious patient, she must avoid face-
to-face contact to increase the patient orientation with persons.
2 T F You can say to psychotic patient, you will get well
3 T F Child develops psychologically and grows normally by passing
through more positive experiences than negative ones.
4 T F Mental health is defined as the ability to distinguish what is real
from what is not
5 T F Depersonalization is the false perception by a person that the
environment has changed.
6 T F One of the main nursing roles regarding chronically schizophrenic
client is to assist him to enjoy dependence on staff
7 T F In caring for a patient receiving antidepressant drugs the nurse
should be alert for sudden cheerfulness of the patient
8 T F Crisis intervention emphasizes the healthy aspect of the personality
9 T F In a therapeutic relationship the nurse must argue with the patient
about his delusion
10 T F Patient can take mono-amino-oxidase inhibitors and eating milk
product
11 T F Anxiety has been defined as diffuse apprehension that is vague in
nature and is associated with feeling of uncertainty
12 T F Suppression is the refusal to acknowledge the existence of a real
situation or the feeling of association
13 T F Sitting silently with depressed patient saying nothing conveys
acceptance to him
14 T F Coexistence of tow opposing impulses toward the same thing in the
same person at the same time is called ambivalence.
15 T F The principles of acceptance shouldn't be applied with all patient's
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Part (3) Matching
In the space provided in front of each statement in column (A)place the
corresponding number from column (B)
No Column (A) Column (B)
D 1- Disorientation A. Retreating to level of behavior that reduces
anxiety, allows one to feel more comfortable
and permits dependency.
C 2- Delusion of
influence
B. The continuous repetition of the same word or
theme in response to different questions.
F 3- Phobia C. False belief that one is being controlled by other
or agencies.
E 4- Insight D. Inability to locate oneself in relation to time or
persons.
B 5- Echolalia E. Patient' awareness of his condition and the need
of treatment.
A 6- Regression F. Abnormal symbolic fear
G 7- situational
crisis
G. Dysthymic disorder
J 8- Distractability H. Feeling that one's environment is strange, unreal
or unfamiliar
I 9- Chronically
depressed mood
I. Occurs in response to a sudden unexpected
event in a person's life from an external source.
H 10-Derealization J. Disorder in attention
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Part (4)
Define the following
(1) Distractibility
Is the disorder of attention in which the patient gives attention to every passing stimulus (e.g. someone coughing, a door opened or a bird flying) it is prominent in manic states.
(2) Mental health - mental illness continuum
Experts agree that mental health and mental illness are not polar opposites.
This approach is useful in communicating that neither state exists in isolation from the other.
Mental health Mental illnes (3) Denial
Failure to acknowledge an intolerable thought, feeling, experience or reality
E.g. A middle-aged man after being admitted to the CCU because of an AMI insists that he is in the Hospital for just a diagnostic work-up.
(4) Derealization
The false perception by a person that his or her environment has changed
For example: - everything seems bigger or smaller or familiar objects have become stranger and unfamiliar.
N.B depersonalization and derealisation are usually not delusional and the patient recognizes their abnormality and complains of the distress which they cause.
(5) Crisis
It is biopsychosocial response to conditions of stress and change that overwhelm the individual, families and communities that are involved or as a threat to homeostasis.
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Part V: - Fill in the blanks
1- When working with a patient with paranoid schizophrenia the nurse