Exam 1 - Psychiatric/Mental Health Nursing Practice Questions and
Answers 100% Correct
A 12-year-old has engaged in bullying for several years. The parents say, "We can't believe anything our
child says." Recently this child shot a dog with a pellet gun and set fire to a neighbor's trash bin. The
child's behaviors support the diagnosis of:
a. attention deficit hyperactivity disorder.
b. intermittent explosive disorder.
c. defiance of authority.
d. conduct disorder. correct answer D
The behaviors mentioned are most consistent with criteria for conduct disorder, for example, aggression
against people and animals; destruction of property; deceitfulness; rule violations; and impairment in
social, academic, or occupational functioning. Intermittent explosive disorder is a pattern of behavioral
outbursts characterized by an inability to control aggressive impulses in adults 18 years and older. The
behaviors are not consistent with attention deficit and are more pervasive than defiance of authority.
A 15-year-old ran away from home six times and was arrested for shoplifting. The parents told the court,
"We can't manage our teenager." The adolescent is physically abusive to the mother and defiant with the
father. Which diagnosis is supported by this adolescent's behavior?
a. Attention deficit hyperactivity disorder (ADHD)
b. Posttraumatic stress disorder (PTSD)
c. Intermittent explosive disorder
d. Conduct disorder correct answer D
Conduct disorders are manifested by a persistent pattern of behavior in which the rights of others and
age-appropriate societal norms are violated. Intermittent explosive disorder is a pattern of behavioral
outbursts characterized by an inability to control aggressive impulses in adults 18 years and older.
Criteria for ADHD and PTSD are not met in the scenario.
A 15-year-old was placed in a residential program after truancy, running away, and an arrest for theft. At
the program, the adolescent refused to join in planned activities and pushed a staff member, causing a
fall. Which approach by nursing staff will be most therapeutic?
a. Planned ignoring c. Neutrally permit refusals
b. Establish firm limits d. Coaxing to gain compliance correct answer B
,Firm limits are necessary to ensure physical safety and emotional security. Limit setting will also protect
other patients from the teen's thoughtless or aggressive behavior. Permitting refusals to participate in
the treatment plan, ignoring, coaxing, and bargaining are strategies that do not help the patient learn to
abide by rules or structure.
A 16-year-old diagnosed with a conduct disorder has been in a residential program for 3 months. Which
outcome should occur before discharge?
a. The adolescent and parents create and agree to a behavioral contract with rules, rewards, and
consequences.
b. The adolescent identifies friends in the home community who are a positive influence.
c. Temporary placement is arranged with a foster family until the parents complete a parenting skills
class.
d. The adolescent experiences no anger and frustration for 1 week. correct answer A
The adolescent and the parents must agree on a behavioral contract that clearly outlines rules, expected
behaviors, and consequences for misbehavior. It must also include rewards for following the rules. The
adolescent will continue to experience anger and frustration. The adolescent and parents must continue
with family therapy to work on boundary and communication issues. It is not necessary to separate the
adolescent from the family to work on these issues. Separation is detrimental to the healing process.
While it is helpful for the adolescent to identify peers who are a positive influence, it's more important
for behavior to be managed for an adolescent diagnosed with a conduct disorder.
A 26-month-old displays negative behavior, refuses toilet training, and often says, "No!" Which
psychosocial crisis is evident?
a. Trust versus mistrust
b. Initiative versus guilt
c. Industry versus inferiority
d. Autonomy versus shame and doubt correct answer ANS: D
The crisis of autonomy versus shame and doubt relates to the developmental task of gaining control of
self and environment, as exemplified by toilet training. This psychosocial crisis occurs during the period
of early childhood. Trust versus mistrust is the crisis of the infant. Initiative versus guilt is the crisis of the
preschool and early-school-aged child. Industry versus inferiority is the crisis of the 6- to 12-year-old
child.
A 26-month-old displays negative behavior, refuses toilet training, and often says, "No!" Which stage of
psychosexual development is evident?
,a. Oral
b. Anal
c. Phallic
d. Genital correct answer ANS: B
The anal stage occurs from age 1 to 3 years and has as its focus toilet training and learning to delay
immediate gratification. The oral stage occurs between birth and 1 year. The phallic stage occurs
between 3 and 5 years, and the genital stage occurs between age 13 and 20 years.
A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the
nurse, "What should we do?" Select the nurse's best response.
a. "Ask the teacher to let the child call you at play time."
b. "Withdraw the child from preschool until maturity increases."
c. "Remain with your child for the first hour of preschool time."
d. "Give your child a kiss before you leave the preschool program." correct answer D
The child demonstrates age-appropriate behavior for a 4-year-old. The nurse should reassure the
parents. The distracters are over-reactions.
A 4-year-old grabs toys from siblings and says, "I want that now!" The siblings cry, and the child's parent
becomes upset with the behavior. According to Freudian theory, this behavior is a product of impulses
originating in which system of the personality?
a. Id
b. Ego
c. Superego
d. Preconscious correct answer ANS: A
The id operates on the pleasure principle, seeking immediate gratification of impulses. The ego acts as a
mediator of behavior and weighs the consequences of the action, perhaps determining that taking the
toy is not worth the mother's wrath. The superego would oppose the impulsive behavior as "not nice."
The preconscious is a level of awareness. This item relates to an audience response question.
A 5-year-old child was diagnosed with encopresis. Which assessment finding would the nurse expect
associated with this diagnosis? The child:
a. frequently smears feces on clothing and toys.
, b. experiences frequent nocturnal episodes of bedwetting.
c. has accidents of defecation at kindergarten three times a week.
d. has occasional episodes of voiding accidents at the day care center. correct answer ANS: C
Encopresis refers to unsuccessful bowel control. Bowel control is expected by age 5, so frequent
involuntary defecation is associated with this diagnosis. Smearing feces is behavioral. Enuresis refers to
the voiding of urine during the day (diurnal) or at night (nocturnal).
A black patient says to a white nurse, "There's no sense talking. You wouldn't understand because you
live in a white world." The nurse's best action would be to:
a. explain, "Yes, I do understand. Everyone goes through the same experiences."
b. say, "Please give an example of something you think I wouldn't understand."
c. reassure the patient that nurses interact with people from all cultures.
d. change the subject to one that is less emotionally disturbing. correct answer ANS: B
Having the patient speak in specifics rather than globally will help the nurse understand the patient's
perspective. This approach will help the nurse engage the patient. Reassurance and changing the subject
are not therapeutic techniques.
A category 5 tornado occurred in a community of 400 people resulting in destruction of many homes
and businesses. In the 2 years after this disaster, 140 individuals were diagnosed with posttraumatic
stress disorder (PTSD). Which term best applies to these newly diagnosed cases?
a. Prevalence
b. Co-morbidity
c. Incidence
d. Parity correct answer ANS: C
Incidence refers to the number of new cases of mental disorders in a healthy population within a given
period of time. Prevalence describes the total number of cases, new and existing, in a given population
during a specific period of time, regardless of when they became ill. Parity refers to equivalence, and
legislation required insurers that provide mental health coverage to offer annual and lifetime benefits at
the same level provided for medical/surgical coverage. Co-morbidity refers to having more than one
mental disorder at a time.
A Category V tornado hits a community, destroying many homes and businesses. Which nursing
intervention would best demonstrate compassion and caring?
Answers 100% Correct
A 12-year-old has engaged in bullying for several years. The parents say, "We can't believe anything our
child says." Recently this child shot a dog with a pellet gun and set fire to a neighbor's trash bin. The
child's behaviors support the diagnosis of:
a. attention deficit hyperactivity disorder.
b. intermittent explosive disorder.
c. defiance of authority.
d. conduct disorder. correct answer D
The behaviors mentioned are most consistent with criteria for conduct disorder, for example, aggression
against people and animals; destruction of property; deceitfulness; rule violations; and impairment in
social, academic, or occupational functioning. Intermittent explosive disorder is a pattern of behavioral
outbursts characterized by an inability to control aggressive impulses in adults 18 years and older. The
behaviors are not consistent with attention deficit and are more pervasive than defiance of authority.
A 15-year-old ran away from home six times and was arrested for shoplifting. The parents told the court,
"We can't manage our teenager." The adolescent is physically abusive to the mother and defiant with the
father. Which diagnosis is supported by this adolescent's behavior?
a. Attention deficit hyperactivity disorder (ADHD)
b. Posttraumatic stress disorder (PTSD)
c. Intermittent explosive disorder
d. Conduct disorder correct answer D
Conduct disorders are manifested by a persistent pattern of behavior in which the rights of others and
age-appropriate societal norms are violated. Intermittent explosive disorder is a pattern of behavioral
outbursts characterized by an inability to control aggressive impulses in adults 18 years and older.
Criteria for ADHD and PTSD are not met in the scenario.
A 15-year-old was placed in a residential program after truancy, running away, and an arrest for theft. At
the program, the adolescent refused to join in planned activities and pushed a staff member, causing a
fall. Which approach by nursing staff will be most therapeutic?
a. Planned ignoring c. Neutrally permit refusals
b. Establish firm limits d. Coaxing to gain compliance correct answer B
,Firm limits are necessary to ensure physical safety and emotional security. Limit setting will also protect
other patients from the teen's thoughtless or aggressive behavior. Permitting refusals to participate in
the treatment plan, ignoring, coaxing, and bargaining are strategies that do not help the patient learn to
abide by rules or structure.
A 16-year-old diagnosed with a conduct disorder has been in a residential program for 3 months. Which
outcome should occur before discharge?
a. The adolescent and parents create and agree to a behavioral contract with rules, rewards, and
consequences.
b. The adolescent identifies friends in the home community who are a positive influence.
c. Temporary placement is arranged with a foster family until the parents complete a parenting skills
class.
d. The adolescent experiences no anger and frustration for 1 week. correct answer A
The adolescent and the parents must agree on a behavioral contract that clearly outlines rules, expected
behaviors, and consequences for misbehavior. It must also include rewards for following the rules. The
adolescent will continue to experience anger and frustration. The adolescent and parents must continue
with family therapy to work on boundary and communication issues. It is not necessary to separate the
adolescent from the family to work on these issues. Separation is detrimental to the healing process.
While it is helpful for the adolescent to identify peers who are a positive influence, it's more important
for behavior to be managed for an adolescent diagnosed with a conduct disorder.
A 26-month-old displays negative behavior, refuses toilet training, and often says, "No!" Which
psychosocial crisis is evident?
a. Trust versus mistrust
b. Initiative versus guilt
c. Industry versus inferiority
d. Autonomy versus shame and doubt correct answer ANS: D
The crisis of autonomy versus shame and doubt relates to the developmental task of gaining control of
self and environment, as exemplified by toilet training. This psychosocial crisis occurs during the period
of early childhood. Trust versus mistrust is the crisis of the infant. Initiative versus guilt is the crisis of the
preschool and early-school-aged child. Industry versus inferiority is the crisis of the 6- to 12-year-old
child.
A 26-month-old displays negative behavior, refuses toilet training, and often says, "No!" Which stage of
psychosexual development is evident?
,a. Oral
b. Anal
c. Phallic
d. Genital correct answer ANS: B
The anal stage occurs from age 1 to 3 years and has as its focus toilet training and learning to delay
immediate gratification. The oral stage occurs between birth and 1 year. The phallic stage occurs
between 3 and 5 years, and the genital stage occurs between age 13 and 20 years.
A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the
nurse, "What should we do?" Select the nurse's best response.
a. "Ask the teacher to let the child call you at play time."
b. "Withdraw the child from preschool until maturity increases."
c. "Remain with your child for the first hour of preschool time."
d. "Give your child a kiss before you leave the preschool program." correct answer D
The child demonstrates age-appropriate behavior for a 4-year-old. The nurse should reassure the
parents. The distracters are over-reactions.
A 4-year-old grabs toys from siblings and says, "I want that now!" The siblings cry, and the child's parent
becomes upset with the behavior. According to Freudian theory, this behavior is a product of impulses
originating in which system of the personality?
a. Id
b. Ego
c. Superego
d. Preconscious correct answer ANS: A
The id operates on the pleasure principle, seeking immediate gratification of impulses. The ego acts as a
mediator of behavior and weighs the consequences of the action, perhaps determining that taking the
toy is not worth the mother's wrath. The superego would oppose the impulsive behavior as "not nice."
The preconscious is a level of awareness. This item relates to an audience response question.
A 5-year-old child was diagnosed with encopresis. Which assessment finding would the nurse expect
associated with this diagnosis? The child:
a. frequently smears feces on clothing and toys.
, b. experiences frequent nocturnal episodes of bedwetting.
c. has accidents of defecation at kindergarten three times a week.
d. has occasional episodes of voiding accidents at the day care center. correct answer ANS: C
Encopresis refers to unsuccessful bowel control. Bowel control is expected by age 5, so frequent
involuntary defecation is associated with this diagnosis. Smearing feces is behavioral. Enuresis refers to
the voiding of urine during the day (diurnal) or at night (nocturnal).
A black patient says to a white nurse, "There's no sense talking. You wouldn't understand because you
live in a white world." The nurse's best action would be to:
a. explain, "Yes, I do understand. Everyone goes through the same experiences."
b. say, "Please give an example of something you think I wouldn't understand."
c. reassure the patient that nurses interact with people from all cultures.
d. change the subject to one that is less emotionally disturbing. correct answer ANS: B
Having the patient speak in specifics rather than globally will help the nurse understand the patient's
perspective. This approach will help the nurse engage the patient. Reassurance and changing the subject
are not therapeutic techniques.
A category 5 tornado occurred in a community of 400 people resulting in destruction of many homes
and businesses. In the 2 years after this disaster, 140 individuals were diagnosed with posttraumatic
stress disorder (PTSD). Which term best applies to these newly diagnosed cases?
a. Prevalence
b. Co-morbidity
c. Incidence
d. Parity correct answer ANS: C
Incidence refers to the number of new cases of mental disorders in a healthy population within a given
period of time. Prevalence describes the total number of cases, new and existing, in a given population
during a specific period of time, regardless of when they became ill. Parity refers to equivalence, and
legislation required insurers that provide mental health coverage to offer annual and lifetime benefits at
the same level provided for medical/surgical coverage. Co-morbidity refers to having more than one
mental disorder at a time.
A Category V tornado hits a community, destroying many homes and businesses. Which nursing
intervention would best demonstrate compassion and caring?
