Which of the following BEST describes how the nurse should deal with manic patients?
    A．Enthusiasm                                    B．Encouraging support
    C．A reassuring manner that reduces anxiety       D．Quiet calmness

What should the nurse's reaction be to a manic patient's loud jokes and crude pranks? She should
    A．React with studied prudishness                B．Chastise the patient
    C．Put restraints on the patient                    D．React with silence, ignoring it

How should the psychiatric nurse handle direct questions from the patient? The nurse should answer
    A．All questions to substantiate her professional credentials
    B．Questions about the patient's illness
    C．Questions about her behavior that the patient has observed
    D．All questions honestly

A manic episode consists of a group of characteristic symptoms accompanying an abnormal mood that is predominantly euphoric, expansive, or irritable. DSM-Ⅲ-R diagnostic criteria for manic episodes include all of the following EXCEPT
    A．Rapid shifts to anger or even short-lived spells of depression
    B．Increased psychomotor activity and restlessness with flight of ideas and racing thoughts
    C．Most of the symptoms present most of the time for at least six weeks
    D．Mood disturbances sufficiently severe to cause marked impairment in occupational functioning or in usual social activities

While managing a manic episode, a nurse would NOT
    A．Provide a quiet environment and decrease stimuli
    B．Argue with patient about his disruptive behavior
    C．While administering medication as advised, observe for side effects, monitor lithium blood levels, and maintain fluid and salt intake
    D．Assist dressing and bathing

When assessing a client with a diagnosis of mood disorder-manic episode, the nurse is aware that the manic episode is in reality an
    A．Exaggerated response to an elating situation
    B．Uncontrolled acting out of uncensored id drives
    C．Incorrect interpretation of environmental stimuli
    D．Attempt to block unconscious feelings of depression

When caring for clients demonstrating manic behavior, the nurse must he aware of these clients' physical needs. This is particularly important because
    A．Left alone, these clients will withdraw to their rooms
    B．These clients have difficulty making their needs known
    C．These clients may gain too much weight from overeating
    D．The danger of exhaustion is always present for these clients

When selecting a room for a client with the diagnosis of bipolar disorder, manic phase, who is hyperactive and talking nonstop in a loud demanding voice, the nurse recognizes that a most important factor would be that the
    A．Room have a pleasant view                     B．Atmosphere be quiet and restful
    C．Location be close to the nurses'station         D．Roommates have similar behavioral responses

When developing an initial nursing care plan for a female client with a bipolar disorder, manic phase, the nurse should plan to
    A．Increase her gym time                       B．Isolate her from her peers
    C．Provide food, fluids, and rest                D．Encourage her active participation in unit programs

A nursing care plan for a client with a bipolar disorder should include..
    A．Providing a structured environment
    B．Touching the client to provide reassurance
    C．Engaging the client in conversation about current attain
    D．Designing activities that will require the client to maintain contact with reality.

The nurse realizes that the environment is very important when caring for a client with a diagnosis of mood disorder manic episode. The nurse should
     A．Put bright drapes in the client's room to cheer up the client
     B．Place the client in a private room to provide a quiet atmosphere
     C．Assign the client to a room with other clients to provide company
     D．Assign the client to a room near the dayroom to be accessed to activities

A client demonstrating manic behavior is elated and sarcastic. The client is constantly cursing and using foul language and has the other clients on the unit terrified. The nurse should
     A．Firmly tell the client that the behavior is unacceptable
     B．Demand that the client stop the behavior immediately
     C．Ask the client to identify, what is precipitating the behavior
     D．Increase the client's medication or get additional medication ordered

Encouragement and praise should be given to hyperactive clients to help them increase their feelings of self-esteem. When they have behaved welt, the best way to let them know the staffis aware of their improvement is for the nurse to say
     A．"You behaved well today. "
     B．"We knew you could behave. "
     C．"Everyone likes you better when you behave like this. "
     D．"Your behavior today was much better than yesterday. \

The major difference between bipolar Ⅰ and bipolar Ⅱ disorder is that
     A．Clients with bipolar Ⅰ have no symptoms of mania, but only depression
     B．The prognosis for bipolar Ⅰ is much better than for bipolar Ⅱ
     C．Both disorders are the same, except that clients with bipolar Ⅰ disorders have a much higher incidence of suicide
     D．Clients with bipolar Ⅱ disorder do not have symptoms of mania that interfere enough to cause marked functional disturbances

James T. is admitted to the unit in an acute manic episode. He has had three major depressive episodes in the past 10 years and two other hospitalizations for mania. Which of the following disorders would reflect James'symptom profile?
     A．Bipolar Ⅰ            B．Bipolar Ⅱ          C．Cyclothymic disorder   D．Dysthymic disorder

Ms. T. has been admitted to your unit for obsessive-compulsive personality disorder. He constantly washes his hands. In planning his nursing care which of the following is an important short-term goal. The client will
    A．Refrain from washing his hands                B．Discuss conflicts underlying his behavior
    C．Be protected from skin integrity breakdown    D．Verbalize understanding of his disorder

Borderline personality disorder involves continuous dysfunctional behaviors in which patient may injury himself. Predisposing factors of this disorder include all of the following except
    A．Diagnosed with attention deficit hyperactivity disorder(ADHD) ever
    B．Abuse by his parents or others in childhood
    C．His efforts to be autonomous were often punished by his grandmother who fosters him
    D．None of the above

John has been on the telephone for ten minutes. He has become increasingly loud and terminates the conversation by slamming the phone. He walks into the lounge and kicks a chair. The BEST nursing intervention for John would be to
    A．Respect John personal space and offer him one-to-one in a quiet area
    B．Let J. know that continued agitation will result in restraints
    C．Remove other patients and let John "blow off steam" in the lounge by himself
    D．Immediately gather several staff to physically take J. to seclusion

The typical character of narcissistic personality disorder is
    A．Extreme social anxiety                       B．Intolerance of aloneness
    C．Apathy                                      D．Low self-esteem

A nurse taking care of a patient with antisocial personality disorder should
    A．Help him to control impulsivity
     B．Promote him taking responsibility for himself and others
     C．Discern what and who will become his trigger
     D．All of the above

When interviewing a patient with BPD, an attending nursing should assess whether the patient has a risk to suicide. The risk factors she should collect including the followings except
     A．Physiologic and self-care considerations        B．Emotional antecedents
     C．Abuse history                                D．Working performance

The most important feeling for the nurse to convey to the client in order for the client with personality disorder to accept the nurse is one of
     A．Let client feel warm and being care            B．Willingness to help
     C．Remorse for client                            D．No-nonsense demands with client

A patient being treated for an antisocial personality disorder insists that other nursing staff gave him lithium everyday in this time, which helped him, and he demands the current nurse get some immediately. The nurse's BEST reply to this patent would be
     A．I will go and get some for you if you calm down
     B．There isn't any doctor's advice for you about lithium
     C．I won't believe in what you said
     D．Ok, be patient please, and I'll talk to your attending doctor about whether lithium would be appropriate for you

Which one of the following is useful for treatment with BPD?
     A．DBT               B．Gestalt therapy      C．REBT              D．All of the above

Which one of the following type of PD has a high incidence of suicide?
     A．Antisocial personality disorder                B．Bordline personality disorder
     C．Paranoid personality disorder                  D．Schizotypal personality disorder

One morning the nurse overhears Elma, who is admitted with BPD, having an argument with her mother, When suppertime, Elma is very angry with the nurse and complains nurse must say something bad to her mother about her performance in ward. What the defense mechanism Elma is using?
     A．Dissociation         B．Denial               C．Projection           D．Splitting

A nurse in a psychiatric setting has promoted a therapeutic relationship with an APD patient. One day the nurse is off duty and is prepare for leaving, the clients says in a pity tone, "Don't let me alone, please, other staff don't like me and often punish me. " What the nurse say is suitable and can assist the patient?
    A．"Don't worry, I will be back soon. "
    B．"I will ask the staff not to punish you. "
    C．"You are lying, none of staff will punish you. "
    D．"You know I leave at this time everyday. We'll talk about this in my next duty time. \

A patient with BPD cries bitterly, pounds the bed in frustration, and said: "this therapist also dislike me, I am going to die rather than stay here. " If you were his attending nurse, what would be the most helpful for you to assist the patient?
     A．Leave him alone until he calm down
     B．Tell him that the therapist is very kind and experienced
     C．Sit down and listen attentively if he wishes to talk about something
     D．Pat the patient reassuringly on the back and say, "I can understand it's difficult to bear. \

Which one is not right about personality disorder?
     A．Multiple personality disorder is distinct and separate personalities within the same person
     B．People with personality disorder often experience child abuse or traumatic
     C．Only the symptoms of personality disorder represent the person's stable characteristics and social functioning, he can be diagnosed personality disorder
     D．Paranoid and antisocial personality disorders are more commonly diagnosed in women than men

One afternoon, many patients are discussing a topic about substance abuse in an activity room of psychiatric unit. A patient with APD won't join them and he turn on the TV in same activity roorm. The most appropriate response by nurse would be
     A．Turn down the TV and say, "now is the decided discussing time for all patients, this topic is also helpful for you. If you really aren't interested in it, you can keep silence, but you can't interfere other patients. "
     B．Turn up volume of TV and say, "if you think the discussing isn't helpful for you, you can watch TV, but the volume need be turn down little. "
     C．Arrange other patients changing to another room for discussing and leave him alone.
     D．Turn down the TV and say, "this isn't your home, it's public activity room, you need apply public norm.\

An adolesent who is extremely underweight talks constantly about being fat, refuse to eat hardly any food, and disppears into the bathroom after meals, angrily says to the nurse, "I don't need to be here. I don't have any problems. Stop watching me. " To reduce the client's feeling of being threatened, the nurse would be most therapeutic by responding
    A．"I hear how frustrated you are to be here. "
    B．"If you do not follow the rules you will lose your privileges. "
    C．"Your feeling are part of your illness. You will feel different. "
    D．"1'11 get you the medication your physician ordered for anxiety. \

Many clients on the eating disorders unit have been admitted for anorexia nervosa. The signs and symptoms that would be most specific for this diagnosis are
    A．Slow pulse, 10% weight loss, and alopecia
    B．Compulsive behaviors, excessive fears, and nausea
    C．Excessive activity, memory lapses, and an increased pulse
    D．Excessive weight loss, amenorrhea, and abdominal distention

A major recognizable difference between clients with anorexia nervosa and clients with bulimia nervosa is that clients with anorexia usually
     A．Tend to be more extroverted than clients with bulimia nervosa
    B．Seek intimate relationships whi]e clients with bulimia avoid them
    C．Deny the problem while clients with bulimia generally recognize that their eating pattern is abnormal
    D．Act at greater risk for physical problems such as fluid and electro

The nurse interviews a young female client with anorexia nervosa to obtain information for the nursing history. The clients history is likely to reveal
     A．A strong desire to improve her self-image
     B．A close, supportive mother-daughter relationship
    C．Low achievement in school, with little concern for grades
    D．satisfaction with and a desire to maintain her present weight

The nursing intervention that should receive the highest priority in the period immediately following an emaciated 13-year-old's admission to the hospital for starvation secondary to anorexia nervosa would be
     A．Providing adequate rest and nutrition
    B．Monitoring client's fluid and electrolyte balance
    C．Completing an assessment of the client's mental status
    D．Obtaining more data about the client's diet and exercise program

The nurse is aware that the major health complication associated with severe anorexia nervosa is
     A．Protein depletion resulting in muscle wasting
    B．Endocrine imbalance resulting in amenorrhea
    C．Glucose intolerance resulting in hypoglycemia
    D．Cardiac dysrhythmias resulting in cardiac arrest

While admitting a young client with severe anorexia nervosa to the unit, the nurse finds a bottle of assorted pills in the client's luggage. The client tells the nurse they are antacids for stomach pains. The best initial response by the nurse would be
     A．"Let's talk about your drug use. "
     B．"These pills don't look like antacids. "
    C．"Tell me more about these stomach pains. "
    D．"Some adolescents take pills to lose weight. \

The parents of an adolescent female are very upset about their daughter's diagnosis of anorexia nervosa and the treatment plan proposed. The best intervention by the nurse when the client's parents ask to bring food in for the client is to state
    A．"Your concern about food contribute to her problem. "
    B．"While in the hospital, she should eat the hospital food. "
    C．"For now, allow the hospital staff to handle her food needs. "
    D．"It is important that you bring in whatever you think she'll eat. \

The multidisciplinary team decides to employ a behavior modification approach to a young female's problem with anorexia nervosa. A planned nursing intervention that would follow this approach would he to
    A．Have client role play interactions with her parents
    B．Provide client with a high-calorie, high-protein diet
    C．Restrict the client to her room until she gains 2 pounds
    D．Force the client to talk about her favorite foods for 1 hour a day

When an adolescent female client with the diagnosis of anorexia nervosa starts to discuss food and eating, the nurse should plan to
    A．Tell her gently but firmly to direct all discussion of food to the dietitian
    B．Use her current interest in food to encourage her to increase her intake
    C．Listen closely to determine her favorite foods and secure these foods for her
    D．Let her talk about food as long as she wants, but limit discussion about her eating

When talking with one of the day nurses, a client with the diagnosis of anorexia nervosa states that the day nurses give better care and nicer than the night nurses. The client also asks a question that the day nurse is aware was answered by one of the night nurse. The nurse should recognize that the client
    A．Needs assistance in exploring and verbalizing feelings about the night nurses
    B．Is trying to develop a bond of trust with a staff member that should he supported
    C．Is attempting to divide the staff, and the behavior should be reported to the other staff members
    D．Has negative feelings about the night nurses, and the nurses should be informed of these feelings

A young male client with anorxia nervosa telephones home just before mealtime. The client uses the phone calls to avoid eating. The nurse could evaluate that the nursing plan to set limits on this avoidance behavior was effective when the client
     A．Organizes an aerobic group for the clients
     B．Arrives on time for meals without being called
     C．Begins reading and clipping recipes from magazines
     D．Contacts his family frequently by telephone between meals

The parents of a male adolescent diagnosed with anorexia nervosa ask the nurse how long their son's treatment will take. The most therapeutic response by the nurse would be
     A．"Treatment of anorexia nervosa takes a long time and setbacks are common. "
     B．"Most anorectic adolescents respond favorably to treatment within a few weeks. "
     C．"Your son's prognosis depends on your willingness to become involved in therapy. "
     D．"Your son's progress depends on determining what triggered his desire to lose weight. \