1. A client who abuses alcohol and cocaine tells a nurse that he only
uses substances because of his stressful marriage and difficult job.
Which defense mechanism is this client using?
A. Displacement
B. Projection
C. Rationalization
D. Sublimation
2. Nurse Rita enters the room of a client with a cognitive impairment
disorder and asks what day of the week it is: what the date,
month, and year are; and where the client is: The nurse is
attempting to assess:
A. Confabulation
B. Delirium
C. Orientation
D. Perseveration
3. Schizophrenia is a/an:
A. Anxiety disorder
B. Neurosis
C. Psychosis
D. Personality disorder
4. For more than a month now, Osei is persistently feeling restless,
worried and feeling as if something dreadful is going to happen.
He fears being alone in places and situations where he thinks that
no one might come to rescue him. Osei is demonstrating:
A. Acrophobia
B. Claustrophobia
C. Agoraphobia
D. Xenophobia
5. being in contact with reality and the environment is a function of
the:
A. conscience
B. ego
C. id
D. Super ego
6. The mentally ill person responds positively to the nurse who is
warm and caring. This demonstration of the nurse’s role serves as:
A. Counselor
B. Mother surrogate
C. Therapist
D. Socializing agent
7. Regina, 25 years old, was reported to be gradually withdrawing
and isolating herself from friends and family members. She
became neglected of personal hygiene. She was observed to be
talking irrelevantly and incoherently. She was diagnosed as
schizophrenia. The past history of Regina would not probably
reveal that her premorbid personality is:
A. Schizoid
B. Extrovert
C. Ambient
D. Cycloid
8. Owusuaa is an 18 year old beginning her university education. Her
mother observed that she is having problems relating with her
friends. She is undecided about her future. She has lost insight,
lost interest in anything and complained of constant tiredness.
Owusuaa is out on anti-depressant drugs. These drugs act on the
brain chemistry, therefore they would be useful in which type of
depression?
A. Exogenous depression
B. Neurotic depression
C. Endogenous depression
D. Psychotic depression
9. The nurse recognizes that the most specific signs and symptoms
for diagnosing anorexia nervosa are:
A. Excessive weight loss, amenorrhea, and abdominal
distention
B. Excessive activity, memory lapses and an increase pulse
C. Compulsive behaviors, excessive fears, and nausea
D. Slow pulse, mild weight loss, and alopecia
10. A patient admitted to a mental health unit for treatment of
psychotic behavior. She spends hours at the unit exit gate
shouting “let me out. There is nothing wrong with me. I don’t
belong here.” What defense mechanism is the patient
implementing?
A. Denial
B. Projection
C. Regression
D. Rationalization
11. Eighteen hours after undergoing an emergency major surgery, a
client with a reported history of social drinking exhibits gross hand
tremors and is screaming for some to kill the bugs in the bed.
Nurse Ophelia should suspect:
A. A post-operative infection
B. Alcohol withdrawal
C. Acute sepsis
D. Pneumonia
12. Dorothy says: “give me 10 minutes to recall the name of our
secondary school teacher who failed many students in our science
class.” She is operating on her
A. Subconscious
B. Conscious
C. Unconscious
D. Ego
13. According to Piaget, a five year old is in what stage of
development:
A. Sensorimotor stage
B. Concrete operations
C. Pre-operational
D. Formal operation
14. The nurse correctly teaches a client taking benzodiazepine
oxazepam (Serax) to avoid excessive in-take of:
A. Cheese
B. Coffee
C. Sugar
D. Shellfish
15. The nurse must see to it that the written consent of mentally ill
patients are taken from:
A. Doctor
B. Social worker
C. Parents or legal guardian
D. Law enforcement authorities
16. When screening families for post-traumatic stress disorder
following a major natural disaster, psychiatric and mental health
nurses are practicing which type of disease prevention?
A. Primary
B. Secondary
C. Tertiary
D. Universal
17. Mr. Addai is admitted to the psychiatric unit because of a major
depressive disorder. He is exhibiting increasingly withdrawn
behaviors. The nurse understands that eventually the client will
experience feelings of:
A. Ambivalence
B. Isolation
C. Paranoia
D. Anger
18. In caring for a depressed client, the nurse should initially:
A. Keep the client’s surroundings bright and cheery
B. Try to keep the client from talking too much
C. Attempt to keep the client occupied
D. Accept what the client says
19. Eben is remanded by the courts for psychiatric treatment. His
police record, which dates to his early teenage years, includes
delinquency, running away, and vandalism. He dropped out of
school at age 16 and has been living on his own since then. His
history suggests maladaptive coping, which is associated with:
A. Anti-social personality disorder
B. Borderline personality disorder
C. Obsessive personality disorder
D. Narcissistic personality disorder
20. A female client who’s high risk for suicide needs close supervision.
To best ensure the client’s safety, nurse Collins should:
A. Check the client frequently at irregular intervals
throughout the night
B. Assure the client that the nurse will hold in confidence
anything the client says
C. Repeatedly discuss previous suicide attempts with the client
D. Disregard decreased communication by the client because
this is common in suicidal clients
21. Freud explains anxiety as:
A. Strives to gratify the needs for satisfaction and security
B. Conflict between id and super-ego
C. A hypothalamic pituitary adrenal reaction to stress
D. A conditioned response to stressors
22. Madam Serwaa, an old woman was brought for evaluation due to
increasing forgetfulness and limitations in daily function. The
daughter revealed that the client used her toothbrush to comb
her hair. She is manifesting:
A. Apraxia
B. Aphasia
C. Agnosia
D. Amnesia
23. A supervisor observes inconsistency in the psychiatric and mental
health nurse’s behavior toward a patient; the nurse is
unreasonably concerned, overly kind, or irrationally hostile. The
most appropriate explanation is that the nurse is displaying:
A. Countertransference
B. Empathic resonance
C. Negative transference
D. Splitting behavior
24. Aside from feeling sad and having difficulty concentrating and
sleeping, what are other common signs of depression?
A. Diminished pleasure in activities and alteration in appetite
B. Excessive socialization and interest in activities of daily living
C. Alternating episodes of fatigue and high energy
D. Rigidity and a narrowing of perception
25. A male client is admitted to a psychiatric facility by court order for
evaluation for anti-social personality disorder. This client has a
long history of initiating fights and abusing animals and recently
was arrested for burying a neighbor’s dog alive. When evaluating
this client for the potential for violent, nurse Yeguo should assess
for which behavioral clues?
A. A rigid posture, restlessness and glaring
B. Depression and physical withdrawal
C. Silence and non-compliance
D. Hyper-vigilance and talk of past violent acts
26. Older adults have reached Erickson’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 relived differently
D. Feel that they are being punished for thing they did not do
27. On review of Mr. James record, the nurse notes the admission
was voluntary. Based on this information, the nurse anticipates
which patient behavior?
A. Fearfulness regarding treatment measures
B. Anger and aggressiveness directed towards others
C. An understanding of pathology and symptoms of the
diagnosis
D. A willingness to participate in the planning of the care and
treatment plan.
28. Mr. Owusu who reportedly consumes 1.5 litres of Akpeteshie is
admitted for alcohol detoxification. To try to prevent alcohol
withdrawal syndrome, Dr. Frimpong is most likely to prescribe
which drug?
A. Clozapine (clozaril)
B. Thiothixene (navane)
C. Iorazepam (ativan)
D. Lithium carbonate (eskalith)
29. Sarpong is admitted to the psychiatric unit with a diagnosis of
obsessive-compulsive disorder spends a significant amount of
time during the day and night washing his hands. On the third
hospital day, Sarpong reports feeling better and more
comfortable with the staff and other patients. The psychiatric and
mental health nurse knows that the most appropriate nursing
intervention is to:
A. Acknowledge the ritualistic behavior each time and point
out that it is inappropriate
B. Allow Sarpong to carry out the ritualistic behavior, since it is
helping him
C. Collaborate with Sarpong to reduce the amount of time he
engages in ritualistic behavior
D. Ignore the ritualistic behaviors, and the behaviors will be
eliminated due to lack of re-inforcement
30. Nurse Bempomaa is aware that the drug of choice for treating
Tourette syndrome?
A. Fluoxetine (Prozac)
B. Fluvoxamine (Luvox)
C. Haloperidol (Haldol)
D. Paroxetine (Paxil)
31. A patient being seen in the emergency department immediately
after being sexually assaulted calm and controlled. The nurse
analyzes this behavior as indicating which defense mechanism?
A. Denial
B. Projection
C. Rationalization
D. Intellectualization
32. Tutuwaa is assigned to care for a suicidal client. Initially, which is
the nurse’s highest care priority?
A. Assessing the client’s home environment and relationships
outside the hospital
B. Exploring the nurse’s own feelings about suicide
C. Discussing the future with the client
D. Referring the client to a clergy-person to discuss the moral
implications of suicide
33. Nurse Awuni is developing a plan of care for a client with anorexia
nervosa. Which action should the nurse include in the plan?
A. Restrict visits with the family until the client begins to eat
B. Provide privacy during meals
C. Set up a strict eating plan for the client
D. Encourage the client to exercise, which will reduce her
anxiety
34. The primary nursing intervention for a victim of child abuse is:
A. Assess the scope of the problem
B. Analyze the family dynamics
C. Ensure the safety of the victim
D. Teach the victim coping skills
35. Which factors are associated with development of post-traumatic
stress disorder?
A. Anxiety and low self-esteem
B. Distorted and negative cognitive functioning
C. Excess serotonin and norepinephrine levels
D. Severity of the stressor and availability of support systems
36. In the emergency department, a client with facial lacerations
states that her husband beat with a stick. After the healthcare
team repairs her lacerations, she waits to be seen by the
psychiatrist, who will evaluate the continued threat of violence.
Suddenly the client’s husband arrives, shouting that he wants to
‘finish the job.’ What is the first priority of the healthcare worker
who witnessed this scene?
A. Remaining with the client and staying calm
B. Calling a security guard and another staff member for
assistance
C. Telling the client’s husband that he must leave at once
D. Determining why the husband feels so angry
37. The nurse is preparing a patient for the termination phase of the
nurse-patient relationship. The nurse prepares to implement
which nursing task that is MOST APPROPRIATE for the phase?
A. Planning short-term goals
B. Making appropriate referrals
C. Developing realistic solutions
D. Identifying expected out-comes
38. A male adult client voluntarily admits himself to the substance
abuse unit. He confesses that he drinks 1 liter of Akpeteshie each
day and use cocaine occasionally. Later that afternoon, he begins
to show signs of alcohol withdrawal. What are some early signs
this condition?
A. Vomiting, diarrhea, and bradycardia
B. Dehydration, temperature above 38.3°C, and pruritus
C. Hypertension, diaphoresis, and seizures
D. Diaphoresis, tremors, and nervousness
39. Nurse Comfort is caring for a client diagnosed with Bulimia. The
most appropriate initial goal for a client diagnosed with Bulimia is
A. Avoid shopping for large amounts of food
B. Control eating impulses
C. Identify anxiety causing situations
D. Eat only three meals per day
40. Mr. Mensah and Mrs. Mensah are a couple and seek emergency
crisis intervention because Mr. Mensah slapped his wife
repeatedly the night before. The husband indicates that his
childhood was marred by an abusive relationship with his father.
When intervening with this couple, nurse Salomey knows they are
at risk for repeated violence because the husband
A. Husband moderate impulse control
B. Denies feelings of jealousy or possessiveness
C. Has learned violence as an acceptable behavior
D. Feels secure in his relationship with his wife
41. A 30 year old male employee frequently complains of low back
pain that leads to frequent absences from work. Consultation and
tests revealed negative results. The client has which somatoform
disorder?
A. Somatization disorder
B. Hypochondriasis
C. Conversion disorder
D. Somatoform pain disorder
42. Naomi is brought to the emergency room by friends who state
that she took something an hour ago. She is actively hallucinating,
agitated, with irritated nasal septum. Which of the following
drugs are more likely to be:
A. Heroin
B. Cocaine
C. LSD
D. Marijuana
43. A 35 year old male has intense fear of riding an elevator. He
claims “As if I will die inside.” This has affected his studies. The
client is suffering from:
A. Agoraphobia
B. Social phobia
C. Claustrophobia
D. Xenophobia
44. Which of the following should be included in the health teachings
among clients receiving Valium?
A. Avoid taking CNS depressant like alcohol
B. There are no restriction in activities
C. Limit fluid in-take
D. Any beverage like coffee may be taken
45. Which of the method would a nurse use to determine a client’s
potential risk for suicide?
A. Wait for the client to bring up the subject of suicide
B. Observe the client’s behavior for cues of suicide ideation
C. Question the client directly about suicidal thoughts
D. Question the client about future plans
46. The most appropriate way to decrease a patient’s anxiety is by:
A. Acquiring skills with which to face stressful events
B. Avoiding unpleasant objects and events
C. Introducing an element of pressure into fearful situation
D. Prolonged exposure to fearful situations
47. Which of the following statements determines psychological
abuse?
A. Hitting the patient
B. Humiliating the patient
C. Withholding care from the patient
D. Violation of patient’s right
48. Which of the following factors can lead to functional psychosis?
A. Congenital factors
B. Chromosome abnormality
C. Genetic factors
D. Space occupying lesions
49. Symptoms of mania include:
I. Creativity
II. Persecutory delusion
III. Pressured speech
IV. Irritability
A. I and II
B. II, III and IV
C. III and IV
D. I, II, III and IV
50. The symptom which characterizes paranoid in it’s true form is:
A. Bizarre hallucination
B. Inappropriate affect
C. Severe Depression
D. Systematized delusion
51. In response to a patient’s expression of anxiety that seems to be
associated with no particular happening the nurse can be most
helpful by saying:
A. “Everything will be alright”
B. “You appear very upset”
C. “What is making you so upset”
D. “Why don’t you lie down for a whole”
52. Therapeutic treatment of paranoid schizophrenia includes:
I. Allowing patient much freedom of action
II. Granting patient position of minor responsibility
III. Granting patient the privacy to work alone
IV. Refusing to be drawn into any argument with
patient
A. I and II
B. II and III
C. I, II and III
D. I, II, III and IV
53. Progressive desensitization may be used in the treatment of:
A. Hysterical neurosis
B. Neurotic depression
C. Obsessive compulsive neurosis
D. Phobic neurosis
54. An appropriate approach to the nursing care of an anxious patient
is by:
A. Encouraging the patient to bath twice a day
B. Having social interaction with patient once every week
C. Removing patient from stress producing situation
D. Reducing patient’s meals by half
55. In caring for a manic patient with emotional liability, which of the
following nursing interventions is appropriate?
A. Do not argue with client
B. Engage client in group activities until she is stabilized
C. Give simple truth responses
D. Provide consistent structured environment under close staff
supervision
56. Immaturity in adulthood may be evidenced through
A. Ability to make long range plans
B. Inability to make decisions
C. Mental disorder
D. Self confidence
57. Which of the following patients are likely to benefit from ECT
treatment?
I. Epileptic patients
II. Borderline schizophrenics
III. Manic patient
IV. Severely depressive patients
A. I, II and IV
B. II, III and IV
C. III and IV
D. I, II, III and IV
58. Which of the following responses will indicate to the patient that
you are listening to what he is saying?
A. Ask question from time to time
B. Express your feeling
C. Give negative answers
D. Look away from patient
59. Kojo is admitted with a severe anxiety disorder. He is crying and
wringing the hands. The first nursing intervention should be to:
A. Get the patient involved in a non-threatening activity
B. Gently ask what is bothering him
C. Stay physically close to the patient
D. Tell the patient to sit down and try to relax
60. Fordjour, an epileptic client tells the nurse that he smell roses,
yet there no flowers in the room. This statement should alert the
nurse to the possibility that the patient:
A. Is experiencing and aura
B. Is hallucinating
C. May be imagining he smells roses
D. Wishes to have some roses
61. Which of the following best defines dementia?
A. Loss of intellectual abilities sufficient to hamper activities
of daily living
B. Personal neglect in self care
C. Poor judgment especially in social relationships
D. Memory loss occurring as a natural consequence of aging
62. Vitamin deficiencies are typically associated with:
A. Agrophobia
B. Alcoholism
C. Mongolism (Down’s syndrome)
D. Obesity
63. In the care of a mentally ill patient, restraint should be used:
A. As a usual means to control aggressive behavior
B. Only as a last resort to control aggression
C. To reassure the patient’s relatives
D. To routinely protect other patients and staffs
64. A patient with endogenous depression is most likely to response
to which of the following drugs:
A. Diazepam
B. Chlorpromazine
C. Imipramine
D. Trifluoperazine
65. Miss Fiadzo bought a new dress for her daughter after beating her
for being rude. This defense mechanism is known as:
A. Conversion
B. Fixation
C. Restitution
D. Splitting
66. Disturbance of thinking, emotion and behavior are classical
clinical manifestation of which of the following mental
conditions?
A. Schizophrenia
B. Mania
C. Depression
D. Manic-depressive psychosis
67. Which of the following signs presented by the patient requires the
nurse’s immediate intervention?
A. Grandiose delusions of being a royal descendent
B. Inappropriate dressing and showing grandiose behavior
C. Non-stop physical activity and poor nutritional intake
D. Sexual harassment and teasing of the staff
68. The main duty of the psychiatric nurse is to:
A. Expose the patient to new positive ways of life
B. Give patient time to recover at his own rate
C. Let the patient learn the reason for his illness
D. Protect patient from life’s strains and stresses
69. An altered physiological state brought about by the repeated
ingestion of alcohol leading to the need to have some quantity of
the substance present in the body is referred to as:
A. Dependency
B. Habitation
C. Tolerance
D. Withdrawal
70. Which of the following activities can be taken as a method of
rehabilitation in a hospital?
A. Gate keeping, church attendance, bed making
B. Kitchen chores, bed making, scrubbing
C. Kitchen chores, gate keeping, scrubbing
D. Scrubbing, bed making, habit training
71. When talking to a psychiatric patient for the first time, the nurse
should realize that the:
A. Patient’s case history should be read and discussed with the
doctor
B. Physical appearance provides accurate guide as to whether
he will be receptive.
C. Patient is a stranger to the nurse and vice-versa
D. Hostile behavior indicates that the nurse’s initial approach is
inadequate
72. A patient experiences confusion and wander into another
patient’s room. Which one of the following action would you
take?
A. Escort the patient when wandering is noted and guide him
back to his room
B. Question the patient to know the reason for wandering out
C. Restrict the patient in his room
D. Restrain the patient in a chair so that he remains confined
73. Neurosis can best be regarded as a:
A. Disintegration of the personality
B. Intellectual problem
C. Mal-adaptive process
D. Withdrawal from reality
74. A characteristic feature of dementia is:
A. Auditory hallucination
B. Déjà vu phenomena
C. Delusion of persecution
D. Memory impairment
75. Which of the following symptoms of alcohol intoxication would
you be most concerned about?
A. Vitamin and mineral depletion
B. Diaphoresis
C. Increased heart rate
D. Hallucinations and delusions
76. Personnel changes increase emotional disturbance in patients.
The basic reason for this is that patient often feel:
A. Angry
B. Disappointed
C. Frustrated
D. Insecure
77. Mr. Frimpong, a severe alcoholic patient is suffering from
thiamine deficiency. Which of the following will confirm the
diagnosis?
I. Anorexia
II. Cardiovascular disfunctioning
III. Oedema
IV. Pins and needles
A. I and II
B.I, II and III
C.II, III and IV
D. I, II, III and IV
78. Jaundice, photosensitivity and parkinsonism may occur in
patient’s taking:
A. Amitriptyline
B. Chlorpromazine
C. Diazepam
D. Meprobamate
79. Monica, a 25 year old lady was reported to be gradually
withdrawing and isolating herself from friends and family
members. She became neglected of her personal hygiene. She
was observed to be talking irrelevantly and incoherently. She was
diagnosed as schizophrenia. The past history of Monica would
most probably reveal that her premorbid personality is:
A. Schizoid
B. Extrovert
C. Ambivert
D. Cycloid
80. Schizophrenia is said to be prevalent in:
A. Intelligence classes
B. Lower socio-economic classes
C. Middle affluent classes
D. People with lower intelligence
81. Which of the following factors contributed to a rise in depression
among the elderly:
A. Faltering self-esteem
B. Inability to use appropriate aid in waling
C. Loss of effective support systems
D. Struggle to cope with trauma
82. Persistent confusion in the elderly patient admitted to your health
institution is most likely caused by
A. Continuous deterioration
B. Frustration and anger at the family
C. Unfamiliar environment
D. Rejection
83. The simple schizophrenic reaction are characterized by:
A. Confident, aggressive, extroverted behaviour
B. Mischievous, anti-social behaviour
C. Pompous, loquacious, argumentative behaviour
D. Withdrawn, helpless, submissive behaviour
84. Prolonged hyperactive state of a maniac patient may result in:
A. Death
B. Destruction
C. Exhaustion
D. Malnutrition
85. Which of the statement below is connected with the role of the
community psychiatry nurse:
A. Giving complete treatment in cases of emergencies
B. Giving money to patients at home for their daily activities
C. Providing continuity of hospitalized in-patients or out-
patient treatment
D. Staying at home with convalescent and long stay patients
86. Catatonic schizophrenia is characterized by:
A. Auditory hallucinations
B. Disorganized behavior and incoherence
C. Marked psychomotor disturbances
D. Systematized delusion
87. Mr. Tuffour has been diagnosed with Alzheimer’s disease. He is
likely to have which of the following features?
A. In-attentive and inability to learn new information
B. Expanded interest in activities of daily living
C. Recall of present event but impairment in past occurrences
D. Slight difficulty in adapting to environment changes
88. A manic patient begins to speak rapidly and jumps from one topic
to another. This behavior is caused by:
A. Bipolar disorder
B. Failure to take his drugs
C. Patient’s psychiatric history
D. Pressure of thought
89. Which of the following will indicate that the patient can make
suicidal attempt?
A. Asking nurses to give him a knife
B. Hiding knives or storing drugs
C. Holding a knife and shouting the “I want kill”
D. Telling the nurses “I want to kill myself”
90. Individuals with paranoid personality disorder are likely to have
which of the following traits?
I. Acute awareness of power
II. Build good relationship
III. Have a sense of humor
IV. Proud about his rank
A. I, II and III
B. I, II and IV
C. I and IV
D. II, III and IV
91. The purpose of occupational therapy for patient in psychiatric
institutions is to:
A. Act a punishment for criminal patients
B. Make psychotic depressive more active
C. Make excited patients produce more materials
D. Prevent the patient from reflecting on his illness
92. For the treatment of chronic alcoholism to be effective, the:
A. Doctor must be firm with the patient
B. Family must agree and give their full support
C. Patient must understand and agree fully to the treatment
D. Patient’s reason for drinking must be explored
93. The primary reason for sharing feelings with a patient is to:
A. Create a controlled opportunity for the patient to deal with
expression of feeling by others
B. Demonstrate that the appropriate expression of feeling is
acceptable
C. Provide a focal point for communication, which enable the
patient to know the nurse better
D. Unburden the nurse of frustrations that may interfere with
effectiveness
94. Nana Ama likes her environment to be as neat and tidy as
possible. According to Freud, she is displaying fixation in which of
the following stages?
A. Anal
B. Genital
C. Oral
D. Phallic
95. Apathy, submissiveness, inertia, loss of interest and individuality
are features of:
A. Chronic schizophrenia
B. Endogenous depression
C. Dementia
D. Institutionalization
96. Which of the following is a potential side effect that may occur
immediately after ECT?
A. Diarrhea
B. Fracture
C. Headache
D. Retrograde amnesia
97. It is the first day of classical experience of nursing, students at the
psychiatry ward. During the orientation, the nurse emphasizes
that the team members including nursing students are legally
responsible to safeguard patient’s records from loss or
destruction or from people not authorized to read it. It is
unethical to tell one’s friends and family members data about
patients, because doing so is violation of patients rights to:
A. Informed consent
B. Confidentiality
C. Least restrictive environment
D. Civil liberty
98. Which of the following activities would you consider most helpful
to the schizophrenic?
A. Attending a social event
B. Going for a walk
C. Needle work
D. Reading a magazine
99. The purpose of screening candidates for group therapy is to
determine:
A. Intelligence
B. Friendliness
C. Motivation
D. Sociability
100. Medical diseases that are known to produce a full depressive
syndrome include:
I. Hypothyroidism
II. Hypertension
III. Pancreatic cancer
IV. Typhoid Fever
A. I, II and III
B. I and III
C. II, III and IV
D. I, II, III and IV
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