Mental Health & Psychiatric Nursing NCLEX
Practice Exam (Quiz #5: 25 Questions)
1. 1. Question
Nurse Greta is aware that the following is classified as an Axis I disorder by
the Diagnosis and Statistical Manual of Mental Disorders, Text Revision
(DSM-IV-TR) is:
o A. Obesity
o B. Borderline personality disorder
o C. Major depression
o D. Hypertension
Correct
Correct Answer: C. Major depression
The DSM-IV-TR classifies major depression as an Axis I disorder. Axis I
disorders tend to be the most commonly found in the public. They include
anxiety disorders, such as panic disorder, social anxiety disorder, and post-
traumatic stress disorder. Other examples of Axis I disorders are as follows:
Dissociative disorders. Eating disorders (anorexia nervosa, bulimia nervosa,
etc.) Mood disorders (major depression, bipolar disorder, etc.) Published by
the American Psychiatric Association, the DSM is the mental health bible of
sorts. The DSM-IV organized all psychiatric disorders and other problems
into five different categories or axes.
• Option A: Obesity was in Axis III. DSM-IV approached
psychiatric assessment and organization of biopsychosocial
information using a multi-axial formulation (American
Psychiatric Association, 2013b). There were five different axes.
Axis I consisted of mental health and substance use disorders
(SUDs); Axis II was reserved for personality disorders and
mental retardation; Axis III was used for coding general
medical conditions; Axis IV was to note psychosocial and
environmental problems (e.g., housing, employment); and Axis
V was an assessment of overall functioning known as the GAF.
, • Option B: Mental disorders are diagnosed according to a
manual published by the American Psychiatric Association
called the Diagnostic and Statistical Manual of Mental
Disorders. A diagnosis under the fourth edition of this manual,
which was often referred to as simply the DSM-IV, had five
parts, called axes. Each axis of this multi-axial system gave a
different type of information about the diagnosis. Borderline
personality disorder as an Axis II. Axis II provided information
about personality disorders and mental retardation.
• Option D: Hypertension was in Axis III. Axis III provided
information about any medical conditions that were present
which might impact the patient’s mental disorder or its
management. General Medical Condition (GMC) Axis III is for
reporting current general medical conditions that are
potentially relevant to the understanding or management of
the individual’s mental disorder. The purpose of recording
General Medical Conditions on Axis III is to encourage
thoroughness in evaluation/assessment and to enhance
communication among healthcare providers. Axis III also
ensures that medical or physical conditions that can directly or
indirectly influence management and treatment are not
forgotten.
2. 2. Question
Katrina, a newly admitted is extremely hostile toward a staff member she
has just met, without apparent reason. According to Freudian theory, the
nurse should suspect that the client is experiencing which of the following
phenomena?
o A. Intellectualization
o B. Transference
o C. Triangulation
o D. Splitting
Answer
Correct Answer: B. Transference
, Transference is the unconscious assignment of negative or positive feelings
evoked by a significant person in the client’s past to another person.
Transference occurs when a person redirects some of their feelings or
desires for another person to an entirely different person. Transference can
also happen in a healthcare setting. For example, transference in therapy
happens when a patient attaches anger, hostility, love, adoration, or a host
of other possible feelings onto their therapist or doctor. Therapists know
this can happen. They actively try to monitor it.
• Option A: Intellectualization is a defense mechanism in which
the client avoids dealing with emotions by focusing on facts.
The development of patterns of excessive thinking or over-
analyzing, which may increase the distance from one’s
emotions. For example, someone who is diagnosed with a
terminal illness does not show emotion after the diagnosis is
given but instead starts to research every source they can find
about the illness.
• Option C: Triangulation refers to conflicts involving three
family members. Triangulation or triangling is defined in the
AAMFT Family Therapy Glossary as the “process that occurs
when a third person is introduced into a dyadic relationship to
balance either excessive intimacy, conflict, or distance and
provide stability in the system” (Evert et al. 1984 p. 32).
• Option D: Splitting is a defense mechanism commonly seen in
clients with personality disorder in which the world is
perceived as all good or all bad. Failing to reconcile both
positive and negative attributes into a whole understanding of
a person or situation, resulting in all-or-none thinking.
Splitting is commonly associated with a borderline personality
disorder.
3. 3. Question
An 83-year-old male client is in extended care facility is anxious most of
the time and frequently complains of a number of vague symptoms that
interfere with his ability to eat. These symptoms indicate which of the
following disorders?
o A. Conversion disorder
, o B. Hypochondriasis
o C. Severe anxiety
o D. Sublimation
Answer
Correct Answer: B. Hypochondriasis
Complaints of vague physical symptoms that have no apparent medical
causes are characteristic of clients with hypochondriasis. In many cases, the
GI system is affected. Hypochondriasis, which is now known as illness
anxiety disorder, and the other somatic symptom disorders (e.g., factitious
disorder, conversion disorder) are among the most difficult and most
complex psychiatric disorders to treat in the general medical setting. On
the basis of many new developments in this field, the DMS-5 has revised
diagnostic criteria to facilitate clinical care and research. While illness
anxiety disorder is included in the category of “somatic symptom and
related disorders” it continues to have much overlap with obsessive-
compulsive disorder and related illness.
• Option A: Conversion disorders are characterized by one or
more neurologic symptoms. Conversion disorder is a mental
condition in which a person has blindness, paralysis, or other
nervous system (neurologic) symptoms that cannot be
explained by medical evaluation. People who have conversion
disorder are not making up their symptoms in order to obtain
shelter, for example (malingering). They are also not
intentionally injuring themselves or lying about their
symptoms just to become a patient (factitious disorder). Some
health care providers falsely believe that conversion disorder is
not a real condition and may tell people that the problem is all
in their head. But this condition is real. It causes distress and
cannot be turned on and off at will.
• Option C: The client’s symptoms don’t suggest severe anxiety.
People with anxiety disorders frequently have intense,
excessive and persistent worry and fear about everyday
situations. Often, anxiety disorders involve repeated episodes
of sudden feelings of intense anxiety and fear or terror that
reach a peak within minutes (panic attacks).
Practice Exam (Quiz #5: 25 Questions)
1. 1. Question
Nurse Greta is aware that the following is classified as an Axis I disorder by
the Diagnosis and Statistical Manual of Mental Disorders, Text Revision
(DSM-IV-TR) is:
o A. Obesity
o B. Borderline personality disorder
o C. Major depression
o D. Hypertension
Correct
Correct Answer: C. Major depression
The DSM-IV-TR classifies major depression as an Axis I disorder. Axis I
disorders tend to be the most commonly found in the public. They include
anxiety disorders, such as panic disorder, social anxiety disorder, and post-
traumatic stress disorder. Other examples of Axis I disorders are as follows:
Dissociative disorders. Eating disorders (anorexia nervosa, bulimia nervosa,
etc.) Mood disorders (major depression, bipolar disorder, etc.) Published by
the American Psychiatric Association, the DSM is the mental health bible of
sorts. The DSM-IV organized all psychiatric disorders and other problems
into five different categories or axes.
• Option A: Obesity was in Axis III. DSM-IV approached
psychiatric assessment and organization of biopsychosocial
information using a multi-axial formulation (American
Psychiatric Association, 2013b). There were five different axes.
Axis I consisted of mental health and substance use disorders
(SUDs); Axis II was reserved for personality disorders and
mental retardation; Axis III was used for coding general
medical conditions; Axis IV was to note psychosocial and
environmental problems (e.g., housing, employment); and Axis
V was an assessment of overall functioning known as the GAF.
, • Option B: Mental disorders are diagnosed according to a
manual published by the American Psychiatric Association
called the Diagnostic and Statistical Manual of Mental
Disorders. A diagnosis under the fourth edition of this manual,
which was often referred to as simply the DSM-IV, had five
parts, called axes. Each axis of this multi-axial system gave a
different type of information about the diagnosis. Borderline
personality disorder as an Axis II. Axis II provided information
about personality disorders and mental retardation.
• Option D: Hypertension was in Axis III. Axis III provided
information about any medical conditions that were present
which might impact the patient’s mental disorder or its
management. General Medical Condition (GMC) Axis III is for
reporting current general medical conditions that are
potentially relevant to the understanding or management of
the individual’s mental disorder. The purpose of recording
General Medical Conditions on Axis III is to encourage
thoroughness in evaluation/assessment and to enhance
communication among healthcare providers. Axis III also
ensures that medical or physical conditions that can directly or
indirectly influence management and treatment are not
forgotten.
2. 2. Question
Katrina, a newly admitted is extremely hostile toward a staff member she
has just met, without apparent reason. According to Freudian theory, the
nurse should suspect that the client is experiencing which of the following
phenomena?
o A. Intellectualization
o B. Transference
o C. Triangulation
o D. Splitting
Answer
Correct Answer: B. Transference
, Transference is the unconscious assignment of negative or positive feelings
evoked by a significant person in the client’s past to another person.
Transference occurs when a person redirects some of their feelings or
desires for another person to an entirely different person. Transference can
also happen in a healthcare setting. For example, transference in therapy
happens when a patient attaches anger, hostility, love, adoration, or a host
of other possible feelings onto their therapist or doctor. Therapists know
this can happen. They actively try to monitor it.
• Option A: Intellectualization is a defense mechanism in which
the client avoids dealing with emotions by focusing on facts.
The development of patterns of excessive thinking or over-
analyzing, which may increase the distance from one’s
emotions. For example, someone who is diagnosed with a
terminal illness does not show emotion after the diagnosis is
given but instead starts to research every source they can find
about the illness.
• Option C: Triangulation refers to conflicts involving three
family members. Triangulation or triangling is defined in the
AAMFT Family Therapy Glossary as the “process that occurs
when a third person is introduced into a dyadic relationship to
balance either excessive intimacy, conflict, or distance and
provide stability in the system” (Evert et al. 1984 p. 32).
• Option D: Splitting is a defense mechanism commonly seen in
clients with personality disorder in which the world is
perceived as all good or all bad. Failing to reconcile both
positive and negative attributes into a whole understanding of
a person or situation, resulting in all-or-none thinking.
Splitting is commonly associated with a borderline personality
disorder.
3. 3. Question
An 83-year-old male client is in extended care facility is anxious most of
the time and frequently complains of a number of vague symptoms that
interfere with his ability to eat. These symptoms indicate which of the
following disorders?
o A. Conversion disorder
, o B. Hypochondriasis
o C. Severe anxiety
o D. Sublimation
Answer
Correct Answer: B. Hypochondriasis
Complaints of vague physical symptoms that have no apparent medical
causes are characteristic of clients with hypochondriasis. In many cases, the
GI system is affected. Hypochondriasis, which is now known as illness
anxiety disorder, and the other somatic symptom disorders (e.g., factitious
disorder, conversion disorder) are among the most difficult and most
complex psychiatric disorders to treat in the general medical setting. On
the basis of many new developments in this field, the DMS-5 has revised
diagnostic criteria to facilitate clinical care and research. While illness
anxiety disorder is included in the category of “somatic symptom and
related disorders” it continues to have much overlap with obsessive-
compulsive disorder and related illness.
• Option A: Conversion disorders are characterized by one or
more neurologic symptoms. Conversion disorder is a mental
condition in which a person has blindness, paralysis, or other
nervous system (neurologic) symptoms that cannot be
explained by medical evaluation. People who have conversion
disorder are not making up their symptoms in order to obtain
shelter, for example (malingering). They are also not
intentionally injuring themselves or lying about their
symptoms just to become a patient (factitious disorder). Some
health care providers falsely believe that conversion disorder is
not a real condition and may tell people that the problem is all
in their head. But this condition is real. It causes distress and
cannot be turned on and off at will.
• Option C: The client’s symptoms don’t suggest severe anxiety.
People with anxiety disorders frequently have intense,
excessive and persistent worry and fear about everyday
situations. Often, anxiety disorders involve repeated episodes
of sudden feelings of intense anxiety and fear or terror that
reach a peak within minutes (panic attacks).
