I. EATING DISORDERS 6.

Which of the following lab findings would be most

1. A 16-year-old female with anorexia nervosa is admitted concerning for a client with severe anorexia nervosa?
with severe weight loss. Which priority nursing intervention A. Hemoglobin of 12.0 g/dL
should the nurse implement? B. Potassium level of 2.8 mEq/L
A. Encourage the patient to keep a food diary C. Blood glucose of 90 mg/dL
B. Monitor vital signs, especially heart rate and blood pressure D. Sodium level of 135 mEq/L
C. Allow the patient to refuse food to maintain autonomy Answer: B
D. Allow unsupervised meals to promote self-control Rationale: Hypokalemia (low potassium) can cause life-
Answer: B threatening cardiac complications in patients with anorexia
Rationale: Cardiac monitoring is critical in anorexia nervosa nervosa.
due to the risk of bradycardia and hypotension from
malnutrition. 7. A nurse is caring for a patient diagnosed with binge eating
disorder. The patient states, "I feel like I can't control my
2. A nurse is evaluating the effectiveness of therapy for a eating." Which intervention is most appropriate?
patient with bulimia nervosa. Which finding would indicate A. Suggest a low-calorie diet
successful treatment? B. Discuss behavioral strategies for impulse control
A. The patient avoids eating at all during stressful periods. C. Advise the patient to exercise after meals
B. The patient uses healthy coping mechanisms like D. Recommend calorie-counting apps
journaling instead of bingeing. Answer: B
C. The patient continues to purge but in a reduced amount. Rationale: Behavioral strategies address impulse control,
D. The patient engages in excessive exercise rather than binge which is key in managing binge eating disorder.
eating.
Answer: B 8. The nurse is reviewing dietary plans with a patient
Rationale: Using healthy coping mechanisms indicates a shift recovering from bulimia nervosa. Which meal plan should the
from maladaptive behaviors like bingeing and purging. nurse suggest to prevent bingeing?
A. Encourage fasting for 12 hours after meals
3. A client with binge eating disorder reports feelings of guilt B. Recommend small, frequent, balanced meals
and shame after episodes of overeating. What is the best C. Increase protein intake while limiting carbohydrates
nursing response? D. Avoid carbohydrates and focus on fats
A. "You should avoid high-calorie foods to prevent guilt." Answer: B
B. "Everyone feels guilty sometimes, it will pass." Rationale: Balanced, regular meals help prevent the binge-
C. "It’s important to explore these feelings during your purge cycle common in bulimia nervosa.
therapy sessions."
D. "Try to focus on portion control." 9. A patient with anorexia nervosa refuses to eat breakfast.
Answer: C What should the nurse do first?
Rationale: Encouraging exploration of emotions in therapy A. Insist that the patient eat immediately
helps address underlying issues related to the disorder. B. Inform the patient that refusing meals will result in the use
of a feeding tube
4. A patient with anorexia nervosa expresses concern about C. Sit with the patient and explore the reasons for their refusal
gaining weight during treatment. How should the nurse D. Allow the patient to skip the meal to avoid confrontation
respond? Answer: C
A. "Weight gain is not the main focus of your treatment." Rationale: Exploring the reasons for refusal may provide
B. "Your weight will be closely monitored, and the goal is insights into the patient’s emotional state and facilitate better
gradual weight restoration." care.
C. "Weight gain will happen quickly, but you'll get used to it."
D. "You should not worry about weight; it's not your 10. Which medication is most likely to be prescribed for a
responsibility." patient with bulimia nervosa to help reduce binge-purge
Answer: B behaviors?
Rationale: Addressing the patient’s concerns with facts about A. Fluoxetine (Prozac)
gradual weight restoration helps reduce anxiety. B. Clozapine (Clozaril)
C. Lithium (Lithobid)
5. In developing a care plan for a patient with bulimia nervosa, D. Haloperidol (Haldol)
which nursing diagnosis is most appropriate? Answer: A
A. Risk for deficient fluid volume Rationale: Fluoxetine, an SSRI, has been shown to reduce
B. Imbalanced nutrition: Less than body requirements binge-purge behaviors in bulimia nervosa.
C. Disturbed body image
D. Impaired social interaction 11. A patient with anorexia nervosa has a BMI of 16.5. What
Answer: C is the primary goal of treatment?
Rationale: Disturbed body image is a core issue in bulimia A. Immediate weight gain of 2 lbs/week
nervosa, affecting the patient’s relationship with food and B. Correction of electrolyte imbalances
self-perception. C. Development of coping strategies
D. Engagement in psychotherapy
Answer: B
Rationale: Electrolyte imbalances, often present in anorexia
nervosa, pose an immediate risk to the patient's health.
12. Which complication should the nurse be most concerned Rationale: Bradycardia is common in patients with anorexia
about for a patient with binge eating disorder? nervosa due to severe malnutrition affecting cardiac function.
A. Hypertension
B. Hyperthyroidism 18. A nurse is providing education to the family of a patient
C. Hyperkalemia with bulimia nervosa. Which statement indicates the need for
D. Hypoglycemia further teaching?
Answer: A A. "We will monitor our daughter for signs of purging after
Rationale: Binge eating disorder often leads to obesity, meals."
increasing the risk for hypertension. B. "We will try to avoid keeping triggering foods in the
house."
13. A patient with bulimia nervosa has a history of dental C. "It's okay if she skips meals sometimes, as long as she
erosion. Which nursing intervention is appropriate to address doesn’t binge."
this complication? D. "We will encourage her to attend therapy regularly."
A. Provide a soft toothbrush and fluoride toothpaste Answer: C
B. Encourage the patient to drink soda to alleviate acid taste Rationale: Skipping meals can trigger bingeing and purging
C. Recommend the patient avoid brushing their teeth after behaviors. Regular meals and therapy are crucial in preventing
vomiting relapse.
D. Encourage frequent snacking to prevent acid buildup
Answer: A 19. A patient with anorexia nervosa presents with severe
Rationale: Dental erosion in bulimia nervosa is due to hypokalemia. Which complication is the nurse most
frequent vomiting; using a soft toothbrush and fluoride helps concerned about?
prevent further damage. A. Osteoporosis
B. Arrhythmias
14. A patient with binge eating disorder is preparing for C. Seizures
discharge. Which follow-up plan is most effective for long- D. Renal failure
term success? Answer: B
A. Restrictive diet with intense exercise Rationale: Hypokalemia can lead to life-threatening cardiac
B. Support group attendance and cognitive-behavioral therapy arrhythmias, a primary concern in patients with anorexia
C. Weight-loss surgery referral nervosa.
D. Frequent use of appetite suppressants
Answer: B 20. A nurse is assessing a patient with binge eating disorder.
Rationale: Support groups and cognitive-behavioral therapy Which physical assessment finding is commonly associated
help address psychological factors contributing to binge eating. with this condition?
A. Bradycardia
15. A patient with anorexia nervosa has low calcium and B. Obesity
phosphorus levels. What complication should the nurse be C. Dry, scaly skin
concerned about? D. Muscle wasting
A. Refeeding syndrome Answer: B
B. Thyroid dysfunction Rationale: Binge eating disorder is often associated with
C. Hyperparathyroidism obesity due to excessive calorie intake without purging
D. Osteoporosis behaviors.
Answer: A
Rationale: Low electrolytes, particularly calcium and 21. Which cognitive distortion is most likely to be identified
phosphorus, put patients at risk for refeeding syndrome when in a patient with anorexia nervosa?
nutritional intake is rapidly increased. A. All-or-nothing thinking
B. Personalization
16. During a group therapy session, a client with bulimia C. Catastrophizing
nervosa expresses frustration with the slow progress of D. Emotional reasoning
treatment. What is the most therapeutic nursing response? Answer: A
A. "Most clients feel frustrated at this point in treatment." Rationale: Patients with anorexia often exhibit all-or-nothing
B. "You're making progress even if it feels slow; recovery thinking, viewing food or weight in extreme, unrealistic terms.
takes time."
C. "Focusing on your frustration won't help your recovery." 22. The nurse is developing a plan of care for a patient with
D. "It sounds like you’re ready to quit; is that true?" anorexia nervosa. Which outcome is most appropriate?
Answer: B A. The patient will gain 5 pounds per week until reaching a
Rationale: Validating the client’s feelings and encouraging normal BMI.
them with positive reinforcement promotes continued B. The patient will verbalize the importance of nutrition
engagement in treatment. within 2 days.
C. The patient will demonstrate healthy coping mechanisms in
17. Which of the following symptoms is most commonly stressful situations.
associated with anorexia nervosa? D. The patient will express a desire to eat independently by
A. Obesity the end of the week.
B. Lanugo Answer: C
C. Bradycardia Rationale: Developing healthy coping mechanisms is a long-
D. Hyperactivity term goal that addresses the underlying issues contributing to
Answer: C anorexia nervosa.
23. A client with bulimia nervosa is admitted to the hospital 28. Which nursing intervention is most appropriate for a
for fluid and electrolyte imbalance. What is the priority patient with bulimia nervosa during meal times?
nursing action? A. Allow the patient to eat alone to reduce anxiety.
A. Administer anti-anxiety medication B. Offer the patient laxatives to prevent bloating.
B. Monitor heart rate and rhythm C. Supervise the patient during and after meals.
C. Initiate a low-sodium diet D. Give the patient high-calorie foods to speed up weight gain.
D. Provide distraction during mealtimes Answer: C
Answer: B Rationale: Supervision during and after meals helps prevent
Rationale: Electrolyte imbalances, particularly potassium, can purging behaviors common in bulimia nervosa.
cause cardiac arrhythmias, making cardiac monitoring a
priority. 29. A client with anorexia nervosa has been prescribed a high-
calorie diet. The client becomes distressed when served a
24. During family therapy, the parents of a patient with binge meal. What is the best nursing intervention?
eating disorder express feelings of guilt and blame for their A. Encourage the client to eat everything on their plate.
child’s condition. What is the nurse’s best response? B. Remind the client that gaining weight is part of treatment.
A. "It's important to focus on supporting your child moving C. Offer emotional support and remain with the client during
forward." meals.
B. "It’s not your fault; eating disorders are caused by D. Allow the client to skip the meal but provide a snack later.
genetics." Answer: C
C. "Maybe you could have recognized the symptoms earlier." Rationale: Offering support and remaining present during
D. "Your child’s condition is a result of emotional issues, not meals helps the patient feel less overwhelmed.
your parenting."
Answer: A 30. A patient with bulimia nervosa is started on fluoxetine.
Rationale: Shifting focus to support the patient in the present What information should the nurse provide regarding this
helps reduce feelings of guilt and blame and promotes positive medication?
family involvement in treatment. A. "This medication will prevent future episodes of purging."
B. "Fluoxetine can help decrease the urge to binge and purge.
25. A nurse is preparing to discharge a patient with bulimia You may experience relief from bingeing and purging."
nervosa. Which statement by the patient indicates a need for D. Fluoxetine should be taken on an empty stomach.
further teaching?
A. "I’ll continue going to my support group after discharge." 31. A patient with anorexia nervosa is receiving a high-calorie
B. "I can exercise intensely to maintain my weight." diet but shows signs of extreme anxiety during meals. What is
C. "I’ll keep a journal of my emotions and triggers." the nurse’s best approach to address the patient’s anxiety?
D. "I will follow my meal plan and not skip meals." A. Allow the patient to skip the meal for now
Answer: B B. Provide a smaller portion of the meal
Rationale: Excessive exercise is a common compensatory C. Engage the patient in conversation about the nutritional
behavior in bulimia nervosa and should be discouraged. benefits of the meal
D. Offer emotional support, reassuring the patient during the
26. Which meal selection by a patient with anorexia nervosa meal
indicates progress in treatment? Answer: D
A. Only fruit and yogurt Rationale: Offering emotional support helps alleviate anxiety
B. A salad with no dressing associated with eating and promotes a therapeutic relationship.
C. A sandwich with lean protein and vegetables
D. Skipping the meal but drinking water 32. A client with bulimia nervosa has been taking fluoxetine
Answer: C for one month. Which statement by the client indicates a
Rationale: A balanced meal with protein and vegetables therapeutic effect of the medication?
indicates the patient is working toward normalizing eating A. "I have fewer urges to binge and purge."
habits. B. "I feel less hungry throughout the day."
C. "I have stopped feeling guilty after meals."
27. A patient with binge eating disorder asks the nurse, "Why D. "I’ve lost a lot of weight in the past month."
can’t I just stop eating so much?" What is the best response? Answer: A
A. "You need to have more willpower to control your eating." Rationale: Fluoxetine, a selective serotonin reuptake inhibitor
B. "It’s not about willpower; it’s about learning new coping (SSRI), helps reduce the urge to binge and purge in patients
mechanisms." with bulimia nervosa.
C. "You can stop; it just takes practice and discipline."
D. "Overeating is a choice that you can control with the right 33. A patient with anorexia nervosa is at risk for developing
tools." refeeding syndrome. Which lab value should the nurse
Answer: B monitor closely to prevent this complication?
Rationale: This response emphasizes that binge eating is A. Blood glucose
related to emotional coping and not just lack of willpower. B. Hemoglobin
C. Potassium
D. Phosphate
Answer: D
Rationale: Phosphate is often depleted in refeeding syndrome
due to the body’s increased need for ATP production during
the refeeding process, leading to potentially fatal 39. A nurse is working with a patient diagnosed with anorexia
complications. nervosa who has refused meals. Which statement by the nurse
would be most appropriate to encourage the patient to eat?
34. Which psychological factor is most likely to contribute to A. "You have to eat to avoid a feeding tube."
the development of binge eating disorder? B. "I will sit with you during meals for support."
A. High self-esteem C. "You need to eat if you want to get better."
B. Strict control over emotions D. "You are hurting yourself by not eating."
C. History of childhood trauma Answer: B
D. Supportive family environment Rationale: Offering emotional support and reducing the
Answer: C anxiety associated with eating is a nonjudgmental way to
Rationale: A history of childhood trauma, particularly encourage the patient to eat.
emotional or physical abuse, is a significant risk factor for the
development of binge eating disorder. 40. Which finding would indicate that a patient with bulimia
nervosa is using self-induced vomiting as a compensatory
35. A nurse is teaching a patient with bulimia nervosa about behavior?
proper oral care. What should the nurse include in the A. Erosion of dental enamel
teaching plan? B. Rapid weight loss
A. Brush your teeth immediately after vomiting to avoid C. Lanugo on the body
damage D. Bradycardia
B. Use a fluoride rinse to help prevent enamel erosion Answer: A
C. Avoid eating anything acidic to protect your teeth Rationale: Repeated exposure to stomach acid during self-
D. Drink water after meals instead of brushing your teeth induced vomiting leads to enamel erosion, which is a common
Answer: B physical sign of bulimia nervosa.
Rationale: Using fluoride rinse helps strengthen enamel, while
brushing immediately after vomiting can worsen dental 41. A patient with anorexia nervosa is noted to have lanugo on
erosion due to exposure to stomach acid. her skin. What is the underlying cause of this finding?
A. Excessive vitamin intake
36. A patient with bulimia nervosa is being treated with B. Malnutrition and extreme weight loss
cognitive behavioral therapy (CBT). What is the main focus C. Overuse of diet supplements
of this treatment? D. Excessive carbohydrate intake
A. Changing the patient's thoughts and behaviors surrounding Answer: B
food Rationale: Lanugo, fine hair growth on the skin, develops as a
B. Improving the patient’s nutritional intake response to severe malnutrition and weight loss, as the body
C. Developing insight into childhood trauma attempts to conserve heat.
D. Encouraging the patient to gain weight
Answer: A 42. A patient with binge eating disorder is started on
Rationale: CBT is designed to change unhealthy thinking lisdexamfetamine. What is the expected therapeutic outcome
patterns and behaviors that contribute to bulimia nervosa, of this medication?
specifically focusing on thoughts related to food, body image, A. Reduced episodes of overeating
and self-esteem. B. Increased motivation for exercise
C. Weight loss
37. A patient with anorexia nervosa has been hospitalized for D. Enhanced mood stabilization
weight stabilization. What is the nurse’s primary concern Answer: A
during the initial phase of refeeding? Rationale: Lisdexamfetamine is approved for the treatment of
A. Preventing overfeeding and weight gain binge eating disorder, as it reduces the frequency of binge
B. Monitoring for signs of fluid and electrolyte imbalance episodes by regulating appetite and impulse control.
C. Teaching the patient about healthy eating habits
D. Encouraging the patient to participate in group therapy 43. A nurse is developing a care plan for a patient with
Answer: B anorexia nervosa. Which long-term goal is most appropriate
Rationale: The initial concern during refeeding is the risk of for this patient?
refeeding syndrome, which involves shifts in fluids and A. The patient will gain 10 pounds by the end of the week
electrolytes that can lead to life-threatening complications. B. The patient will verbalize understanding of proper nutrition
C. The patient will establish a healthy relationship with food
38. A patient with binge eating disorder states, "I feel so out and body image
of control during binge episodes." Which nursing intervention D. The patient will stop restricting caloric intake
is most appropriate to help the patient regain control over Answer: C
eating? Rationale: The long-term goal for a patient with anorexia
A. Encourage the patient to fast after a binge nervosa is to develop a healthy relationship with food and
B. Help the patient identify triggers for binge episodes body image, which is essential for sustained recovery.
C. Suggest the patient try a new diet
D. Instruct the patient to avoid eating carbohydrates
Answer: B
Rationale: Identifying triggers for binge episodes is crucial in
developing effective coping strategies to prevent future
episodes and regain control over eating behavior.
44. A patient with bulimia nervosa is at risk for which 49. Which nursing diagnosis is most appropriate for a patient
electrolyte imbalance due to frequent vomiting? with bulimia nervosa who engages in frequent purging?
A. Hypernatremia A. Deficient fluid volume related to vomiting
B. Hyperkalemia B. Disturbed sensory perception related to body image
C. Hypokalemia distortion
D. Hypercalcemia C. Chronic low self-esteem related to lack of control over
Answer: C eating
Rationale: Frequent vomiting can lead to significant loss of D. Imbalanced nutrition, more than body requirements
potassium, resulting in hypokalemia, which can have serious Answer: A
cardiovascular effects. Rationale: Frequent purging can lead to dehydration and fluid
imbalances, making "deficient fluid volume" the most
45. The nurse is teaching a patient with binge eating disorder appropriate diagnosis.
about relapse prevention strategies. Which statement should
the nurse include? 50. Which complication is most likely to occur in a patient
A. "Focus on avoiding all types of high-calorie foods." with anorexia nervosa who is severely malnourished?
B. "Keep a food diary to identify patterns and triggers." A. Heart failure
C. "Weigh yourself daily to monitor progress." B. Gastroesophageal reflux disease (GERD)
D. "Avoid any social events where food is present." C. Gallbladder disease
Answer: B D. Hypertension
Rationale: Keeping a food diary helps patients with binge Answer: A
eating disorder identify triggers for overeating and develop Rationale: Severe malnutrition in anorexia nervosa can lead to
strategies for managing them, which can prevent relapse. cardiac complications, including heart failure, due to muscle
wasting and electrolyte imbalances.
46. A patient with anorexia nervosa is admitted with severe
dehydration and electrolyte imbalance. Which is the priority
nursing intervention?
A. Start an IV line to administer fluids and electrolytes
B. Monitor the patient’s weight daily
C. Offer small, frequent meals with nutritional supplements
D. Provide emotional support and reassurance
Answer: A
Rationale: In cases of severe dehydration and electrolyte
imbalance, the priority intervention is to stabilize the patient’s
physiological condition through fluid and electrolyte
replacement.

47. Which therapy is most effective in the long-term treatment

of patients with eating disorders?
A. Cognitive-behavioral therapy (CBT)
B. Electroconvulsive therapy (ECT)
C. Pharmacotherapy
D. Psychoanalysis
Answer: A
Rationale: Cognitive-behavioral therapy (CBT) is the most
effective treatment for eating disorders, as it focuses on
modifying the distorted thoughts and behaviors that contribute
to the disorder.

48. The family of a patient with anorexia nervosa asks the

nurse how they can support the patient's recovery. What
should the nurse include in the response?
A. "Encourage your family member to eat large meals."
B. "Be supportive without focusing on food or weight."
C. "Avoid discussing the disorder to reduce anxiety."
D. "Monitor your family member’s food intake closely."
Answer: B
Rationale: Family members should provide emotional support
and avoid focusing on food or weight, as this can increase
anxiety and resistance in patients with anorexia nervosa.
II. Gender Identity Disorders 7. A patient diagnosed with gender dysphoria is interested in
transitioning. What is the nurse's role?
1. A 22-year-old presents with persistent discomfort with their A. Refer the patient to psychiatry immediately
biological sex and identifies as the opposite gender. What is B. Provide education on treatment options including hormonal
the most appropriate initial intervention? therapy and surgery
A. Hormone therapy C. Discourage transitioning until the patient has seen a
B. Psychiatric hospitalization psychologist
C. Supportive counseling and referral to a gender therapist D. Advise the patient to delay transitioning until middle age
D. Surgical transition procedure Answer: B
Answer: C Rationale: Nurses should educate patients about available
Rationale: Counseling is the first step to assess and support treatments while remaining non-directive.
individuals exploring their gender identity.
8. What is a common psychosocial issue faced by individuals
2. Which of the following best describes gender dysphoria? with gender dysphoria?
A. A mismatch between one’s sexual orientation and behavior A. Lack of sexual interest
B. Distress due to incongruence between assigned gender and B. Suicidal ideation due to rejection and stigma
experienced gender C. Inability to perform daily tasks
C. Inability to form intimate relationships D. Hypersexuality
D. A pattern of recurrent sexual thoughts about non-human Answer: B
objects Rationale: Gender dysphoria can lead to depression and
Answer: B suicidal ideation, especially when faced with social rejection.
Rationale: Gender dysphoria involves a conflict between one's
physical or assigned gender and the gender with which they 9. A client with gender dysphoria is prescribed hormone
identify. therapy. Which of the following is an expected outcome?
A. Immediate surgical intervention
3. Which is the most effective long-term treatment for patients B. Improved alignment with gender identity
with gender dysphoria? C. Development of depression
A. Hormonal replacement therapy (HRT) D. Worsening body dysmorphia
B. Cognitive-behavioral therapy (CBT) Answer: B
C. Gender-affirming surgery Rationale: Hormone therapy helps align physical traits with
D. Both A and C gender identity, often improving mental health.
Answer: D
Rationale: HRT and surgery can help align the body with 10. What is the primary goal of therapy for individuals with
gender identity, which may reduce dysphoria. gender dysphoria?
A. Encourage living in their biological sex
4. Which psychosocial intervention can help improve the B. Transition them into their desired gender as fast as possible
quality of life for individuals with gender identity disorder? C. Reduce dysphoria and improve quality of life
A. Group therapy with others experiencing similar challenges D. Prevent them from seeking surgery
B. Immediate gender-affirming surgery Answer: C
C. Avoiding any discussion of gender Rationale: The goal is to reduce distress and improve the
D. Prescribing antidepressants individual's overall well-being.
Answer: A
Rationale: Group therapy provides social support, which is 11. Which diagnostic criterion is required to diagnose gender
critical for mental health. dysphoria in children?
A. Desire to wear clothes of the opposite sex
5. When counseling a patient with gender dysphoria, the nurse B. Strong desire to be of the other gender
should focus on which of the following? C. Refusal to engage in same-sex play
A. Explaining the risks of transitioning D. Hyperactivity
B. Helping the patient explore their gender identity without Answer: B
judgment Rationale: Children with gender dysphoria express a strong
C. Convincing the patient to live as their biological sex desire to be of the opposite gender.
D. Encouraging psychiatric hospitalization
Answer: B 12. Which of the following might indicate that a child is
Rationale: Non-judgmental support is crucial in gender experiencing gender dysphoria?
exploration and transition. A. Playing with toys typically associated with the opposite sex
B. Dressing in clothes of the opposite gender and insisting on
6. Which of the following is a key component of care for a being treated as such
patient seeking gender transition surgery? C. Interest in sports
A. Immediate surgical referral D. Having a best friend of the opposite sex
B. Psychological evaluation and counseling Answer: B
C. Avoiding hormone therapy Rationale: Persistent identification with the opposite gender
D. Encouraging the patient to avoid transitioning can indicate gender dysphoria.
Answer: B
Rationale: A psychological evaluation is important before
undergoing transition surgery.
13. For adolescents with gender dysphoria, which is a key 19. A female patient complains of pain during intercourse and
factor for successful transition? avoids intimacy due to fear of discomfort. What diagnosis is
A. Immediate surgery most likely?
B. Psychological support and family acceptance A. Erectile dysfunction
C. Early school counseling B. Hypoactive sexual desire disorder
D. Avoiding public attention C. Vaginismus
Answer: B D. Sexual aversion disorder
Rationale: Family acceptance and psychological support are Answer: C
critical to a successful transition process. Rationale: Vaginismus is the involuntary contraction of
vaginal muscles, making intercourse painful.
14. Which medical management option should be considered
for a transgender male seeking to masculinize his appearance? 20. Which intervention would be most effective for a woman
A. Estrogen therapy diagnosed with vaginismus?
B. Testosterone therapy A. Surgery
C. Gender reassignment surgery without hormonal therapy B. Use of vaginal dilators and relaxation techniques
D. Avoiding any treatment until adulthood C. Medication for anxiety
Answer: B D. Avoiding sexual activity altogether
Rationale: Testosterone therapy helps develop male secondary Answer: B
sexual characteristics in transgender males. Rationale: Gradual use of dilators and relaxation exercises can
help reduce vaginismus symptoms.
15. Which of the following should be included in patient
teaching for someone receiving hormone therapy for gender 21. Hypoactive sexual desire disorder (HSDD) in women is
transition? commonly treated with:
A. Only psychological effects will be felt immediately A. Testosterone therapy
B. Physical changes are gradual and may take several months B. Cognitive-behavioral therapy
to appear C. Oral contraceptives
C. Hormone therapy results in instant visible changes D. Antidepressants
D. Hormones have minimal effects on secondary sexual Answer: B
characteristics Rationale: Therapy is commonly used to address
Answer: B psychological factors affecting sexual desire.
Rationale: Hormonal changes occur gradually, often over
months to years. 22. Which medical condition can contribute to female sexual
dysfunction?
III. Sexual Dysfunction A. Hyperthyroidism
B. Osteoporosis
16. Which of the following is the most common sexual C. DepressionHere’s the continuation of your quiz on Sexual
dysfunction in men? Dysfunction and Paraphilia based on the given structure:
A. Erectile dysfunction (ED)
B. Hypoactive sexual desire disorder
C. Vaginismus 23. A male patient complains of premature ejaculation during
D. Premature ejaculation sexual activity. Which treatment is commonly prescribed?
Answer: A A. Fluoxetine (Prozac)
Rationale: ED is one of the most common sexual dysfunctions B. Sildenafil (Viagra)
in men. C. Benzodiazepines
D. Cognitive therapy
17. Which medication is typically prescribed for erectile Answer: A
dysfunction? Rationale: Selective serotonin reuptake inhibitors (SSRIs) like
A. Sildenafil (Viagra) Fluoxetine are often prescribed for premature ejaculation to
B. Fluoxetine (Prozac) delay orgasm.
C. Lorazepam (Ativan)
D. Diazepam (Valium) 24. Which psychosocial factor is a common cause of erectile
Answer: A dysfunction in young men?
Rationale: Sildenafil is a common treatment for ED by A. Cardiovascular disease
enhancing blood flow to the penis. B. Stress and anxiety
C. Diabetes
18. A patient reports difficulty maintaining an erection. Which D. Hypertension
physical condition might be the underlying cause? Answer: B
A. Hypertension Rationale: Stress and anxiety are common causes of erectile
B. Diabetes mellitus dysfunction, especially in younger men.
C. Obesity
D. Hyperlipidemia
Answer: B
Rationale: Diabetes can damage blood vessels and nerves,
leading to ED.
25. A patient is diagnosed with hypoactive sexual desire IV. Paraphilia
disorder (HSDD). Which hormone might be checked as part
of the diagnostic workup? 31. A patient exhibits sexual arousal to non-consenting adults.
A. Insulin What is the likely diagnosis?
B. Testosterone A. Voyeurism
C. Thyroid hormone B. Exhibitionism
D. Cortisol C. Pedophilia
Answer: B D. Fetishism
Rationale: Low testosterone levels can contribute to reduced Answer: B
sexual desire in both men and women. Rationale: Exhibitionism is characterized by sexual arousal
from exposing oneself to non-consenting adults.
26. A patient with erectile dysfunction is prescribed tadalafil
(Cialis). What teaching should the nurse include? 32. Which of the following is a treatment option for
A. Take the medication immediately before sexual activity. individuals with pedophilia?
B. Avoid taking nitrates while using this medication. A. Hormone therapy to reduce sexual drive
C. Expect immediate results within 5 minutes. B. Surgical removal of genital organs
D. The drug can be used alongside alcohol with no issues. C. Allowing the individual to live in isolation
Answer: B D. Avoiding any therapy
Rationale: Tadalafil should not be taken with nitrates, as it can Answer: A
cause a dangerous drop in blood pressure. Rationale: Hormonal treatments (anti-androgens) can reduce
sexual drive in individuals with pedophilia.
27. A 30-year-old female reports an inability to reach orgasm
despite sufficient stimulation. What is the diagnosis? 33. A person with fetishistic disorder is aroused by:
A. Sexual aversion disorder A. Observing others undress
B. Anorgasmia B. Non-living objects like shoes or underwear
C. Hypoactive sexual desire disorder C. Causing physical harm to others
D. Vaginismus D. Engaging in non-consensual sex
Answer: B Answer: B
Rationale: Anorgasmia is the inability to achieve orgasm Rationale: Fetishistic disorder involves sexual arousal from
despite adequate sexual stimulation. non-living objects or specific body parts not typically
considered erotic.
28. Which of the following can be a cause of female sexual
arousal disorder (FSAD)? 34. A patient diagnosed with voyeurism disorder is most
A. Anxiety and relationship problems likely to:
B. Cardiovascular diseases A. Engage in sexually risky behaviors
C. Vaginal dryness B. Achieve sexual arousal from watching others who are
D. All of the above unaware
Answer: D C. Frequently display aggressive behaviors
Rationale: FSAD can be caused by both psychological factors D. Seek sexual arousal through non-sexual activities
(anxiety) and physical issues (vaginal dryness or medical Answer: B
conditions). Rationale: Voyeurism involves sexual arousal from watching
others who are naked or engaging in sexual activities without
29. A patient is prescribed a topical estrogen cream for their knowledge.
vaginal dryness due to menopause. What should the nurse
advise? 35. A patient reports that they experience sexual arousal by
A. Apply the cream daily for best results. causing psychological suffering to their partner. Which
B. Stop using the cream after one week. diagnosis is likely?
C. Use the cream only after sexual activity. A. Sexual masochism disorder
D. Apply the cream only during menstruation. B. Sexual sadism disorder
Answer: A C. Frotteuristic disorder
Rationale: Topical estrogen is often applied daily to alleviate D. Fetishistic disorder
vaginal dryness and improve sexual function. Answer: B
Rationale: Sexual sadism disorder involves arousal from
30. Which of the following is a psychosocial intervention for a inflicting pain or humiliation on others.
patient with sexual dysfunction related to anxiety?
A. Anti-anxiety medication 36. In frotteuristic disorder, the individual becomes sexually
B. Cognitive-behavioral therapy aroused by:
C. Physical therapy A. Observing others in a sexual act
D. Antibiotics B. Rubbing against a non-consenting person
Answer: B C. Watching themselves in a mirror
Rationale: Cognitive-behavioral therapy (CBT) is effective in D. Using objects during sexual activity
treating sexual dysfunction caused by anxiety. Answer: B
Rationale: Frotteurism involves touching or rubbing against a
non-consenting person, often in public places.
37. Which therapeutic approach is most often used for 43. A person with sexual sadism disorder should be assessed
individuals with paraphilic disorders? for:
A. Psychodynamic therapy A. Anxiety related to inflicting pain
B. Cognitive-behavioral therapy B. Risk of causing harm to others
C. Surgical interventions C. Desire for sexual abstinence
D. Long-term psychiatric hospitalization D. Avoidance of sexual activity altogether
Answer: B Answer: B
Rationale: Cognitive-behavioral therapy is commonly used to Rationale: Individuals with sexual sadism may pose a risk of
help individuals understand and change their paraphilic physical harm to others due to their sexual urges.
behaviors.
44. Which behavior is most characteristic of fetishistic
38. Which medication might be prescribed to reduce sexual disorder?
urges in individuals with paraphilic disorders? A. Rubbing against strangers in public places
A. Antipsychotics B. Sexual arousal from objects like shoes orIt seems like I got
B. SSRIs cut off! Here's the completion of the quiz question I was
C. Anti-androgens writing:
D. Benzodiazepines
Answer: C 45. Which behavior is most characteristic of fetishistic
Rationale: Anti-androgens are used to reduce sexual drive in disorder?
paraphilic disorders, particularly in cases involving risk of A. Rubbing against strangers in public places
harm to others. B. Sexual arousal from objects like shoes or clothing
C. Observing others engaging in sexual acts
39. A person with sexual masochism disorder is likely to D. Engaging in risky sexual behaviors
achieve arousal through: Answer: B
A. Causing suffering to others Rationale: Fetishistic disorder involves sexual arousal focused
B. Becoming the recipient of pain or humiliation on non-living objects or specific body parts not typically
C. Observing non-consenting individuals considered sexual
D. Sexual activity with inanimate objects
Answer: B 46. Which nursing intervention is most appropriate when
Rationale: Sexual masochism disorder involves arousal from caring for a patient with voyeuristic disorder?
receiving pain or humiliation. A. Encourage the patient to keep their behaviors secret.
B. Help the patient explore triggers for the behavior.
40. Which of the following is a characteristic of pedophilic C. Suggest medications to suppress libido.
disorder? D. Support the patient’s right to privacy.
A. Sexual attraction to adults Answer: B
B. Sexual interest in prepubescent children Rationale: Helping the patient identify triggers can encourage
C. Consensual sexual activities with minors self-awareness and assist in managing voyeuristic disorder
D. Disinterest in sexual activity altogether behaviorally.
Answer: B
Rationale: Pedophilia involves sexual attraction to 47. A nurse is planning care for a client diagnosed with
prepubescent children. erectile dysfunction (ED). Which of the following should be
included in the care plan?
41. A person with exhibitionistic disorder will most likely A. Prescribing testosterone therapy immediately.
seek treatment for: B. Encouraging open communication with the partner.
A. Sexual arousal from dressing in opposite-gender clothes C. Advising the patient to avoid any sexual activity.
B. Exposing their genitals to unsuspecting individuals D. Scheduling surgery as the primary treatment.
C. Engaging in consensual BDSM activity Answer: B
D. Participating in group sexual activities Rationale: Open communication between partners can reduce
Answer: B stress and anxiety, which often contribute to ED.
Rationale: Exhibitionism involves exposing oneself to non-
consenting individuals. 48. In assessing a client with gender dysphoria, which of the
following statements by the client should the nurse explore
42. The goal of treatment for individuals with paraphilic further?
disorders is to: A. “I feel trapped in a body that doesn’t match who I am.”
A. Encourage them to act on their sexual urges B. “I’ve always preferred activities that people associate with
B. Help them manage or reduce inappropriate sexual the opposite gender.”
behaviors C. “Sometimes I wish I could make everything go away
C. Punish them for past behaviors permanently.”
D. Isolate them from society D. “I think people don’t understand me when I talk about my
Answer: B identity.”
Rationale: The goal of treatment is to manage or reduce Answer: C
harmful sexual behaviors. Rationale: This statement suggests potential suicidal ideation,
which requires immediate attention and intervention.
49. Which medication would most likely be prescribed for a V. SEXUAL DISORDER
client with premature ejaculation?
A. Sildenafil (Viagra) 1. Which substance is most commonly abused in the U.S.?
B. Fluoxetine (Prozac) A. Alcohol
C. Testosterone therapy B. Cocaine
D. Clomipramine (Anafranil) C. Heroin
Answer: B D. Cannabis
Rationale: SSRIs like fluoxetine are often prescribed for Answer: A. Alcohol
premature ejaculation because they can delay ejaculation. Rationale: Alcohol remains the most commonly abused
substance, often resulting in legal, social, and health
50. A patient diagnosed with sexual masochism disorder consequences.
reports distress over their sexual behaviors. What should the
nurse prioritize? 2. A nurse suspects opioid abuse in a patient. Which clinical
A. Avoid discussing the patient's sexual preferences. sign would support this suspicion?
B. Ensure the patient knows their behavior is abnormal. A. Constricted pupils
C. Provide information on how to minimize risky behavior. B. Tachycardia
D. Encourage the patient to suppress their desires. C. Dilated pupils
Answer: C D. Hyperactivity
Rationale: Harm reduction is an essential approach when Answer: A. Constricted pupils
working with clients with paraphilic disorders, focusing on Rationale: Opioid use causes pinpoint pupils, known as miosis,
reducing risky or dangerous behaviors. and is a key clinical sign.
What is the primary goal of therapy for a patient with gender
dysphoria? 3. Which of the following is an effect of chronic alcohol abuse
A. To change the patient's gender identity on the liver?
B. To reduce the patient's distress related to gender A. Cirrhosis
incongruence B. Hypoglycemia
C. To prevent the patient from undergoing gender C. Renal failure
reassignment surgery D. Anemia
D. To encourage the patient to conform to societal norms Answer: A. Cirrhosis
Answer: B Rationale: Chronic alcohol abuse can lead to liver cirrhosis, a
Rationale: The main goal of therapy in gender dysphoria is to progressive and irreversible scarring of the liver.
alleviate the distress caused by the mismatch between one’s
gender identity and assigned sex at birth. 4. A patient is taking methadone as part of opioid withdrawal
management. What is the primary purpose of methadone in
this case?
A. To treat opioid cravings
B. To prevent relapse
C. To induce euphoria
D. To cause withdrawal symptoms
Answer: A. To treat opioid cravings
Rationale: Methadone helps reduce withdrawal symptoms and
opioid cravings in a controlled manner without causing
euphoria.

5. A patient has been using stimulants. Which symptom would

the nurse expect?
A. Bradycardia
B. Hypertension
C. Sedation
D. Hypotension
Answer: B. Hypertension
Rationale: Stimulant abuse typically increases heart rate and
blood pressure.

6. Inhalants are primarily abused because of their ability to:

A. Produce stimulant effects
B. Induce hallucinations
C. Cause euphoria quickly
D. Act as sedatives
Answer: C. Cause euphoria quickly
Rationale: Inhalants are abused for their rapid euphoric effects,
but they pose serious health risks.
7. What is the first nursing action in managing alcohol 13. A patient is admitted for alcohol intoxication. Which
withdrawal? electrolyte imbalance is a priority to monitor?
A. Administer thiamine A. Hypernatremia
B. Start IV fluids B. Hypocalcemia
C. Provide seizure precautions C. Hypokalemia
D. Administer lorazepam D. Hypomagnesemia
Answer: D. Administer lorazepam Answer: D. Hypomagnesemia
Rationale: Benzodiazepines like lorazepam are first-line Rationale: Alcohol abuse can lead to hypomagnesemia, which
medications to manage alcohol withdrawal symptoms and is important to correct as it can contribute to arrhythmias.
prevent seizures.
14. Which statement by the nurse best explains polysubstance
8. Which of the following drugs is classified as a hallucinogen? abuse?
A. LSD A. "Abuse of more than one substance, such as alcohol and
B. Cocaine cocaine."
C. Heroin B. "Using multiple medications for a single condition."
D. Marijuana C. "Using drugs from the same category, like opioids and
Answer: A. LSD benzodiazepines."
Rationale: LSD is a potent hallucinogen, altering perception, D. "Combining prescription medications with herbal
mood, and cognitive functions. supplements."
Answer: A. "Abuse of more than one substance, such as
9. The nurse is teaching a client about naltrexone for alcohol alcohol and cocaine."
use disorder. Which statement by the client indicates Rationale: Polysubstance abuse refers to the concurrent use of
understanding? more than one psychoactive substance.
A. "This will prevent withdrawal symptoms."
B. "It will make me violently ill if I drink alcohol." 15. What is the most concerning withdrawal symptom from
C. "It will reduce my craving for alcohol." sedative-hypnotics?
D. "I can drink small amounts of alcohol while on this A. Insomnia
medication." B. Seizures
Answer: C. "It will reduce my craving for alcohol." C. Anxiety
Rationale: Naltrexone helps reduce cravings for alcohol, but it D. Headache
does not cause a reaction like disulfiram. Answer: B. Seizures
Rationale: Sedative-hypnotic withdrawal can lead to life-
10. A patient is being discharged after treatment for stimulant threatening seizures.
abuse. What is the priority nursing intervention?
A. Teach relaxation techniques 16. A patient is experiencing severe withdrawal symptoms
B. Refer to outpatient counseling after stopping sedative-hypnotic use. What is the priority
C. Provide education on long-term health effects nursing intervention?
D. Administer a stimulant antidote A. Administer anticonvulsants as prescribed
Answer: B. Refer to outpatient counseling B. Start a fluid bolus
Rationale: Long-term follow-up, including counseling, is key C. Encourage deep breathing exercises
to managing addiction and preventing relapse. D. Provide emotional support
Answer: A. Administer anticonvulsants as prescribed
11. Which symptom is most commonly seen in cannabis Rationale: Seizures are a severe withdrawal symptom from
intoxication? sedative-hypnotic abuse, and anticonvulsants are essential for
A. Aggressiveness preventing them.
B. Conjunctival injection
C. Hypertension 17. A client is brought to the emergency department after a
D. Respiratory depression suspected opioid overdose. What is the nurse's first action?
Answer: B. Conjunctival injection A. Perform CPR
Rationale: Reddened eyes (conjunctival injection) are a B. Administer naloxone
common sign of cannabis use. C. Monitor respiratory rate
D. Administer fluids
12. What is the primary purpose of disulfiram in treating Answer: B. Administer naloxone
alcohol dependence? Rationale: Naloxone is the first-line treatment for opioid
A. To reduce alcohol cravings overdose to reverse respiratory depression and prevent fatality.
B. To prevent the metabolism of alcohol
C. To induce an unpleasant reaction to alcohol 18. A patient with alcohol use disorder is admitted for acute
D. To alleviate withdrawal symptoms pancreatitis. Which lab value is most important to monitor?
Answer: C. To induce an unpleasant reaction to alcohol A. Serum calcium
Rationale: Disulfiram blocks alcohol metabolism, causing B. Serum amylase
symptoms like nausea and headache when alcohol is C. Blood glucose
consumed. D. Platelet count
Answer: B. Serum amylase
Rationale: Elevated serum amylase levels are indicative of
pancreatitis, which is common in chronic alcohol abuse.
19. The nurse is caring for a patient who has been using 24. A client is receiving naloxone after an opioid overdose.
methamphetamines. Which behavioral sign should the nurse Which complication should the nurse monitor for after
anticipate? administration?
A. Lethargy and apathy A. Severe vomiting
B. Aggression and paranoia B. Hyperglycemia
C. Depression and anxiety C. Respiratory distress
D. Euphoric and talkative D. Rebound opioid toxicity
Answer: B. Aggression and paranoia Answer: D. Rebound opioid toxicity
Rationale: Methamphetamine use can cause paranoia, Rationale: Naloxone can wear off before the opioid is fully
hallucinations, and aggressive behavior due to its stimulant cleared, leading to a recurrence of overdose symptoms.
effects on the central nervous system.
25. A client is undergoing alcohol detoxification. Which of
20. A client who has been abusing benzodiazepines for years the following symptoms would indicate severe alcohol
is experiencing severe withdrawal symptoms. What should the withdrawal?
nurse prepare to administer? A. Sweating and agitation
A. Lorazepam B. Tachycardia and tremors
B. Methadone C. Hallucinations and seizures
C. Diazepam D. Nausea and vomiting
D. Naloxone Answer: C. Hallucinations and seizures
Answer: C. Diazepam Rationale: Severe alcohol withdrawal can lead to delirium
Rationale: Diazepam is a long-acting benzodiazepine often tremens, characterized by hallucinations and seizures,
used in a tapering schedule to manage benzodiazepine requiring immediate medical intervention.
withdrawal safely.
26. A client reports using cocaine regularly. What
21. A client is undergoing treatment for alcohol use disorder cardiovascular complication is the nurse most concerned
and is prescribed disulfiram. Which patient statement about?
indicates a need for further teaching? A. Hypertension
A. "I should avoid alcohol-based cough syrups." B. Myocardial infarction
B. "I can have a glass of wine during special occasions." C. Heart failure
C. "I will need to avoid alcohol for at least two weeks after D. Arrhythmias
stopping the medication." Answer: B. Myocardial infarction
D. "I will experience nausea if I consume alcohol while on Rationale: Cocaine use significantly increases the risk of
this medication." myocardial infarction due to its vasoconstrictive effects on
Answer: B. "I can have a glass of wine during special coronary arteries.
occasions."
Rationale: Disulfiram causes an adverse reaction when 27. A patient in withdrawal from benzodiazepines is
alcohol is consumed, so no alcohol should be ingested during experiencing agitation and confusion. Which of the following
treatment. should the nurse anticipate administering?
A. Haloperidol
22. A patient has a history of polysubstance abuse and is B. Diazepam
being treated for heroin withdrawal. Which of the following C. Naloxone
interventions is most critical in the first 24 hours? D. Lorazepam
A. Monitor for severe vomiting Answer: D. Lorazepam
B. Administer IV fluids Rationale: Lorazepam is commonly used to manage
C. Assess for signs of respiratory depression withdrawal symptoms in patients dependent on
D. Administer methadone as prescribed benzodiazepines.
Answer: D. Administer methadone as prescribed
Rationale: Methadone is used to treat opioid withdrawal 28. A patient presents with suspected hallucinogen
symptoms and prevent relapse, making it a critical intoxication. Which symptom is most concerning to the nurse?
intervention. A. Visual hallucinations
B. Paranoid ideation
23. A nurse is assessing a client suspected of inhalant abuse. C. Severe hyperthermia
Which finding is most likely associated with long-term Answer: C. Severe hyperthermia
inhalant use? Rationale: Hallucinogens can lead to dangerous hyperthermia,
A. Liver cirrhosis which requires immediate medical intervention to prevent
B. Cardiac arrhythmias organ damage.
C. Seizures
D. Peripheral neuropathy 29. A patient experiencing withdrawal from stimulants reports
Answer: D. Peripheral neuropathy extreme fatigue. What is the best nursing intervention?
Rationale: Chronic inhalant abuse can lead to neurological A. Administer a stimulant
damage, including peripheral neuropathy. B. Monitor for suicidal ideation
C. Provide small, frequent meals
Answer: B. Monitor for suicidal ideation
Rationale: Withdrawal from stimulants often leads to
depression and suicidal ideation, making psychological
support crucial.
30. A nurse is providing discharge instructions to a patient prevent and manage delirium tremens, a life-threatening
being treated for alcohol use disorder. Which dietary complication of alcohol withdrawal.
recommendation is most appropriate?
A. High-protein diet 36. A client presents to the emergency department following
B. Low-fat diet the ingestion of a large quantity of barbiturates. What is the
C. Thiamine-rich foods nurse’s priority action?
Answer: C. Thiamine-rich foods A. Induce vomiting
Rationale: Chronic alcohol use leads to thiamine deficiency, B. Administer activated charcoal
increasing the risk of Wernicke-Korsakoff syndrome. A C. Insert an intravenous catheter
thiamine-rich diet is essential. D. Prepare for intubation
Answer: D. Prepare for intubation
31. A patient with a history of opioid use disorder is Rationale: Barbiturate overdose can lead to severe respiratory
prescribed buprenorphine/naloxone for maintenance therapy. depression. Airway management, including intubation, is the
What is the primary goal of this treatment? priority to maintain oxygenation.
A. Prevent withdrawal symptoms
B. Reduce euphoria from opioids 37. A client with a history of heroin addiction is prescribed
D. Prevent relapse naltrexone. What is the purpose of this medication?
Answer: D. Prevent relapse A. To prevent withdrawal symptoms
Rationale: Buprenorphine/naloxone is used in maintenance B. To reverse overdose symptoms
therapy to prevent relapse by reducing cravings and blocking C. To block opioid effects
the effects of opioids. D. To reduce cravings
Answer: C. To block opioid effects
32. A client with a history of alcohol abuse is prescribed Rationale: Naltrexone is an opioid antagonist that blocks the
acamprosate. What is the intended effect of this medication? euphoric and sedative effects of opioids, preventing relapse by
A. To reduce withdrawal symptoms reducing the reward sensation.
B. To decrease alcohol craving
C. To prevent seizures 38. A patient in withdrawal from alcohol presents with
Answer: B. To decrease alcohol craving diaphoresis, tremors, and agitation. Which of the following
Rationale: Acamprosate helps maintain abstinence by additional findings would indicate the need for immediate
reducing cravings for alcohol. medical intervention?
A. Hypoglycemia
33. A client with chronic cannabis use presents with B. Hallucinations
complaints of nausea and vomiting. Which syndrome should C. Headache
the nurse suspect? D. Nausea
A. Hyperemesis syndrome Answer: B. Hallucinations
B. Cannabinoid hyperemesis syndrome Rationale: Hallucinations in alcohol withdrawal indicate
D. Acute gastritis severe withdrawal, such as delirium tremens, which requires
Answer: B. Cannabinoid hyperemesis syndrome immediate medical attention to prevent complications like
Rationale: Long-term cannabis use can lead to a rare condition seizures.
called cannabinoid hyperemesis syndrome, characterized by
recurrent nausea and vomiting. 39. A nurse is caring for a patient admitted with acute
cannabis intoxication. Which of the following symptoms
34. A client with a long history of opioid use is receiving would be most concerning?
treatment with methadone. During the assessment, the nurse A. Increased appetite
notes a respiratory rate of 10 breaths per minute. What is the B. Tachycardia
most appropriate nursing intervention? C. Psychotic episodes
A. Administer naloxone as prescribed D. Lethargy
B. Monitor the client closely and continue with methadone Answer: C. Psychotic episodes
C. Increase oxygen delivery Rationale: Psychosis and hallucinations during cannabis
D. Encourage deep breathing exercises intoxication indicate a severe response, requiring immediate
Answer: A. Administer naloxone as prescribed medical and psychological intervention.
Rationale: A respiratory rate below 12 indicates respiratory
depression, a common side effect of opioid treatment. 40. A client undergoing withdrawal from cocaine reports
Naloxone should be administered immediately to reverse the extreme depression and suicidal ideation. What is the priority
opioid effects. nursing intervention?
A. Referral to a mental health specialist
35. A patient with severe alcohol withdrawal is at risk for B. Continuous monitoring for safety
delirium tremens (DTs). What is the priority nursing C. Administration of antidepressants
intervention to prevent DTs? D. Provide emotional support
A. Provide a calm environment Answer: B. Continuous monitoring for safety
B. Administer benzodiazepines as prescribed Rationale: The priority is to ensure the client’s safety due to
C. Monitor vital signs every four hours the high risk of self-harm or suicide during severe cocaine
D. Administer IV fluids withdrawal.
Answer: B. Administer benzodiazepines as prescribed
Rationale: Benzodiazepines are the first-line treatment to
41. A nurse is assessing a patient with chronic alcohol use and 46. A patient undergoing opioid detoxification reports severe
notices jaundice, ascites, and spider angiomas. What muscle aches and anxiety. What is the most appropriate
underlying condition should the nurse suspect? intervention for symptom relief?
A. Alcoholic hepatitis A. Administer methadone as prescribed
B. Cirrhosis B. Provide warm compresses
C. Acute pancreatitis C. Encourage relaxation techniques
D. Wernicke encephalopathy D. Monitor for withdrawal seizures
Answer: B. Cirrhosis Answer: A. Administer methadone as prescribed
Rationale: Jaundice, ascites, and spider angiomas are Rationale: Methadone helps alleviate withdrawal symptoms,
characteristic signs of cirrhosis, a common long-term including muscle aches and anxiety, during opioid
consequence of chronic alcohol abuse. detoxification.

42. A patient with a history of inhalant use disorder is brought 47. A client is admitted with symptoms of alcohol-induced
to the emergency department after an episode of sudden death. Wernicke-Korsakoff syndrome. What is the priority nursing
What is the most likely cause of death in this situation? intervention?
A. Hypoxia A. Administer thiamine as prescribed
B. Asphyxiation B. Start IV fluids with electrolytes
C. Sudden sniffing death syndrome C. Administer benzodiazepines
D. Acute respiratory failure D. Encourage high-protein foods
Answer: C. Sudden sniffing death syndrome Answer: A. Administer thiamine as prescribed
Rationale: Inhalant abuse can result in sudden sniffing death Rationale: Wernicke-Korsakoff syndrome is caused by
syndrome, where cardiac arrhythmias lead to sudden death, thiamine deficiency due to chronic alcohol use. Thiamine
even after one use. administration is essential to prevent progression.

43. A patient receiving methadone maintenance therapy for 48. A patient with polysubstance abuse reports that they have
opioid use disorder asks why they need regular been using both alcohol and benzodiazepines regularly. What
electrocardiograms (ECGs). What is the nurse's best response? is the nurse’s primary concern?
A. "To monitor for changes in your heart function." A. Risk of seizure
B. "Methadone can cause changes in the heart rhythm." B. Risk of respiratory depression
C. "ECGs help us ensure your overall well-being." C. Risk of delirium tremens
D. "We want to prevent complications from withdrawal." D. Risk of gastrointestinal bleeding
Answer: B. "Methadone can cause changes in the heart Answer: B. Risk of respiratory depression
rhythm." Rationale: Both alcohol and benzodiazepines are central
Rationale: Methadone can prolong the QT interval, increasing nervous system depressants, and their combined use increases
the risk of life-threatening arrhythmias, making ECG the risk of life-threatening respiratory depression.
monitoring essential.
49. A nurse is assessing a client with suspected opioid
44. A patient being treated for benzodiazepine overdose is withdrawal. Which clinical finding is most consistent with
showing signs of severe central nervous system depression. opioid withdrawal?
Which medication should the nurse prepare to administer? A. Pinpoint pupils
A. Naloxone B. Bradycardia
B. Flumazenil C. Diaphoresis
C. Diazepam D. Euphoria
D. Activated charcoal Answer: C. Diaphoresis
Answer: B. Flumazenil Rationale: Diaphoresis, along with yawning, muscle aches,
Rationale: Flumazenil is a benzodiazepine antagonist that and irritability, is a hallmark symptom of opioid withdrawal.
reverses CNS depression caused by benzodiazepine overdose.
50. A client who has been abusing sedative-hypnotics for
45. A client is admitted with suspected hallucinogen years suddenly stops taking them. Which complication should
intoxication. Which clinical feature requires immediate the nurse monitor for?
intervention? A. Bradycardia
A. Pupil dilation B. Seizures
B. Visual hallucinations C. Hyperglycemia
C. Hyperthermia D. GI bleeding
D. Auditory hallucinations Answer: B. Seizures
Answer: C. Hyperthermia Rationale: Abrupt discontinuation of sedative-hypnotics can
Rationale: Severe hyperthermia is a life-threatening condition lead to withdrawal seizures, making it critical to taper these
that can occur with hallucinogen use and requires immediate medications gradually.
medical treatment to prevent organ failure.
NEURODEVELOPMENTAL DISORDER (ASD AND 7. A 6-year-old with ASD has difficulty with transitions.
ADHD) Which nursing strategy is most helpful?
A. Provide detailed verbal explanations
1. A 4-year-old with Autism Spectrum Disorder is admitted B. Use a visual schedule and give advance notice
for evaluation. Which behavior is most indicative of ASD? C. Change activities without warning
A. Initiating conversations with peers D. Encourage the child to ignore routine changes
B. Avoiding eye contact and displaying repetitive hand- Answer: B
flapping Rationale: Using visual schedules and advance warnings help
C. Actively seeking comfort when upset children with ASD handle transitions more smoothly.
D. Using imaginative play appropriately
Answer: B 8. During hospitalization, a child with ASD becomes agitated
Rationale: Avoiding eye contact and engaging in repetitive due to environmental changes. The best nursing action is:
movements like hand-flapping are key indicators of ASD. A. Move the child to a new, quieter room
B. Allow the child to play with electronic devices
2. A child with ASD shows signs of hyperactivity and C. Minimize noise, lights, and unnecessary interactions
aggression during therapy. What is the nurse's priority action? D. Encourage the child to verbalize feelings
A. Increase the therapy session length Answer: C
B. Offer sensory stimulation toys Rationale: Reducing sensory stimuli helps prevent agitation in
C. Provide a structured environment and reduce stimuli children with ASD.
D. Encourage group therapy
Answer: C 9. A nurse is planning care for a child with ASD who has
Rationale: Children with ASD often respond well to difficulty with communication. Which intervention is
structured environments with minimal sensory overload. appropriate?
A. Speak in abstract terms to challenge the child
3. The nurse is caring for a child with ASD. Which B. Encourage spontaneous speech without prompts
intervention is most effective in improving communication? C. Use concrete, clear language and gestures
A. Speaking loudly and slowly D. Ask complex questions to stimulate thought
B. Using picture boards and visual aids Answer: C
C. Asking open-ended questions Rationale: Children with ASD respond best to clear, direct
D. Allowing the child to initiate conversations communication.
Answer: B
Rationale: Visual aids and picture boards help children with 10. A child with ASD is being assessed for new behavioral
ASD who may have difficulty with verbal communication. issues. The nurse knows that which coexisting condition is
common in ASD?
4. A parent of a child with ASD expresses frustration about A. Conduct disorder
the child's lack of social interaction. The nurse should advise: B. Seizure disorder
A. "This behavior will improve over time." C. Oppositional defiant disorder
B. "Let's focus on structured play sessions to improve social D. Depression
skills." Answer: B
C. "Encourage the child to play independently for now." Rationale: Seizure disorders are common in children with
D. "Discipline the child when they avoid social interactions." ASD.
Answer: B
Rationale: Structured play sessions are effective in helping 11. A mother reports her child with ASD only eats certain
children with ASD develop social skills. foods. The nurse’s best response is:
A. "You should force the child to eat a variety of foods."
5. A child with ASD is prone to head banging. What is the B. "This is common in ASD. Let's explore nutrient-rich
nurse's priority intervention? alternatives."
A. Allow the behavior, as it is self-soothing C. "Avoid giving in to the child's food preferences."
B. Restrain the child's arms D. "A food aversion can be ignored as long as the child is
C. Provide a helmet to protect the child's head eating." Answer: B
D. Offer calming strategies like a weighted blanket Rationale: Selective eating is common in children with ASD,
Answer: D and exploring alternatives can help meet nutritional needs.
Rationale: Offering calming strategies addresses the child's
sensory needs while promoting safety. 12. A child with ASD begins therapy focused on improving
social skills. Which is an expected goal?
6. Which dietary modification is often suggested for children A. Improved eye contact during interactions
with ASD to improve behavior? B. Participation in group therapy
A. High-protein diet C. Initiating conversation with others
B. Gluten-free, casein-free diet D. Engaging in competitive sports
C. Vegetarian diet Answer: A
D. Low-sodium diet Rationale: Eye contact is often a challenge for children with
Answer: B ASD and may be a realistic goal for social therapy.
Rationale: A gluten-free, casein-free diet has been suggested
to help improve behaviors in some children with ASD.
13. The nurse is discussing behavioral management with the 19. A 9-year-old with ASD and limited verbal skills uses an
parents of a child with ASD. Which technique is most augmentative communication device. What is the nurse’s
appropriate? priority?
A. Time-outs for inappropriate behavior A. Ensure the device is always accessible
B. Positive reinforcement for desired behaviors B. Discourage the use of the device to promote verbal speech
C. Ignoring all negative behaviors C. Limit the device’s use to structured times
D. Giving lengthy verbal explanations of rules Answer: A
Answer: B Rationale: Ensuring that the child has access to their
Rationale: Positive reinforcement helps reinforce desired communication device at all times promotes autonomy and
behaviors in children with ASD. effective communication.

14. A 3-year-old diagnosed with ASD is not responding to 20. The nurse is developing a care plan for a child with ASD.
their name. What is the nurse’s best advice to the parents? Which goal is most realistic?
A. "Let the child play independently to reduce stress." A. The child will communicate using complete sentences
B. "Try using the child's favorite toy to get attention." B. The child will make and maintain eye contact during all
C. "This is common in ASD. Use visual and auditory cues." conversations
D. "Your child may need a hearing test." C. The child will use a picture exchange communication
Answer: C system (PECS)
Rationale: Children with ASD may not respond to their names, Answer: C
and alternative communication strategies like visual and Rationale: A PECS is a realistic and effective communication
auditory cues can help. goal for many children with ASD.

15. During an assessment of a child with ASD, the nurse notes 21. A nurse is teaching the parents of a child with ASD about
repetitive behaviors and hand-flapping. The priority safety concerns. Which of the following is a priority?
intervention is to: A. Teaching the child to swim
A. Allow the behavior if it is not harmful B. Encouraging the child to play outside alone
B. Stop the behavior immediately C. Using GPS tracking for the child
C. Provide toys to redirect the behavior Answer: C
D. Restrain the child’s hands Rationale: Children with ASD are at risk of wandering, and
Answer: A using GPS tracking ensures their safety.
Rationale: Repetitive behaviors in children with ASD can be
self-soothing and should not be interrupted unless harmful. 22. The nurse is observing a therapy session for a child with
ASD. Which finding requires further intervention?
16. A 7-year-old with ASD is hospitalized. The nurse prepares A. The child rocks back and forth during the session
the child for procedures by: B. The child engages with a therapist using a visual aid
A. Providing written instructions C. The child responds to questions with short phrases
B. Using role play and a visual schedule D. The child exhibits extreme distress when transitioning
C. Allowing the child to choose procedures between activities
D. Minimizing verbal explanations Answer: D
Answer: B Rationale: Extreme distress during transitions may indicate
Rationale: Role play and visual schedules help children with that the child needs additional support and coping strategies to
ASD understand and prepare for procedures. manage changes in routine.

17. The parents of a child with ASD are concerned about the 23. During a nursing assessment, the nurse notices that a child
child’s lack of verbal skills. The nurse should: with ASD avoids group activities and prefers solitary play.
A. Encourage early enrollment in speech therapy What is the best nursing diagnosis for this child?
B. Suggest waiting to see if speech develops naturally A. Impaired social interaction
C. Recommend reducing interaction to prevent frustration B. Ineffective coping
D. Provide a strict regimen of language exercises C. Risk for self-directed violence
Answer: A D. Disturbed thought processes
Rationale: Early speech therapy can help children with ASD Answer: A
develop communication skills. Rationale: Avoidance of group activities and preference for
solitary play indicate impaired social interaction, a common
18. A child with ASD becomes agitated when placed in a issue in children with ASD.
group activity. The best intervention is:
A. Encourage participation in the group activity 24. A nurse is teaching a parent about the use of visual
B. Allow the child to leave the group and engage in a solo schedules for a child with ASD. Which statement by the
activity parent indicates a need for further education?
C. Ignore the child’s agitation A. "This will help my child understand what to expect."
Answer: B B. "I should change the schedule frequently to keep it
Rationale: Children with ASD often have difficulty with interesting."
group activities, and allowing solo activities can help reduce C. "Using pictures will help my child follow daily routines."
agitation. Answer: B
Rationale: Changing the schedule frequently can create
confusion and anxiety for a child with ASD; consistency is
key.
25. A child with ASD exhibits aggressive behavior when 30. A parent reports their child with ADHD is frequently
asked to participate in group activities. What is the most losing belongings and forgetting tasks. What nursing
appropriate nursing intervention? diagnosis is most appropriate?
A. Encourage the child to engage with peers regardless of A. Impaired memory
behavior B. Risk for injury
B. Use a one-on-one approach to gradually introduce group C. Ineffective coping
activities D. Noncompliance
C. Ignore the aggressive behavior to avoid reinforcement Answer: A
D. Implement time-out as a consequence for aggression Rationale: Impaired memory is a common issue in children
Answer: B with ADHD, leading to forgetfulness and disorganization.
Rationale: A one-on-one approach allows for gradual
desensitization to group activities, which may reduce anxiety 31. A child with ADHD is being evaluated for behavioral
and aggression. therapy. Which goal is most realistic?
A. The child will complete all homework assignments without
26. A 7-year-old diagnosed with ADHD has difficulty assistance
completing homework. What strategy should the nurse B. The child will follow classroom rules without reminders
suggest to the parents? C. The child will use a planner to track daily assignments
A. Provide a quiet area free of distractions for study time D. The child will improve academic performance to grade-
B. Allow the child to complete homework whenever they feel level standards
like it Answer: C
C. Increase the amount of homework assigned to improve Rationale: Using a planner is a realistic and achievable goal
focus that can help the child with organization.
D. Encourage the child to study with friends to increase
motivation 32. A nurse is discussing dietary considerations with the
Answer: A parents of a child with ADHD. Which recommendation is
Rationale: A quiet, distraction-free environment helps most appropriate?
children with ADHD concentrate better. A. Increase sugar intake to boost energy levels
B. Provide a high-protein breakfast to help with concentration
27. The nurse is educating a group of parents about ADHD. C. Eliminate all carbohydrates from the diet
Which statement indicates the need for further teaching? D. Encourage caffeine consumption to enhance focus
A. "ADHD can affect academic performance and social Answer: B
interactions." Rationale: A high-protein breakfast can help stabilize blood
B. "Children with ADHD often have trouble sitting still and sugar and improve concentration.
paying attention."
C. "Medications are the only effective treatment for ADHD." 33. During a classroom observation, the nurse notes that a
D. "Behavioral therapies can be beneficial for managing child with ADHD is disruptive and inattentive. What is the
symptoms." most appropriate intervention for the teacher?
Answer: C A. Remove the child from the classroom for disruptive
Rationale: While medications can help, behavioral therapies behavior
and other interventions are also effective in managing ADHD. B. Give the child frequent reminders to stay on task
C. Implement a visual schedule and break tasks into smaller
28. A child with ADHD exhibits impulsive behavior in class. steps
What is the best intervention for the teacher to implement? D. Assign the child a peer buddy to help maintain focus
A. Provide immediate consequences for impulsive actions Answer: C
B. Allow the child to move freely around the classroom Rationale: Breaking tasks into smaller steps and using visual
C. Implement a reward system for appropriate behavior schedules can help manage inattention and improve focus.
D. Ignore the impulsive behavior to reduce attention-seeking
Answer: C 34. A child with ADHD is prescribed atomoxetine. What
Rationale: A reward system encourages positive behavior and should the nurse monitor for?
can help manage impulsivity. A. Increased appetite
B. Mood swings and irritability
29. During a medication review for a child with ADHD, the C. Decreased focus during activities
nurse notes the child is taking methylphenidate. What is a D. Symptoms of hypertension
priority nursing assessment? Answer: B
A. Monitoring the child's weight Rationale: Atomoxetine can cause mood swings and
B. Checking for signs of anxiety irritability, which require monitoring.
C. Assessing blood pressure and heart rate
D. Evaluating the child's sleep patterns 35. The nurse is assessing a child with ADHD. Which finding
Answer: C is most indicative of the disorder?
Rationale: Methylphenidate can increase heart rate and blood A. Consistent focus during long tasks
pressure, making cardiovascular monitoring essential. B. Avoiding tasks requiring sustained mental effort
C. Ability to follow multi-step directions
D. Frequent participation in group activities
Answer: B
Rationale: Avoiding tasks that require sustained mental effort
is a characteristic behavior of ADHD.
36. A 9-year-old child with ADHD is often criticized for 42. A nurse is teaching a child with ADHD strategies to
being disruptive in class. What is the best approach for the improve organizational skills. Which statement indicates
teacher to adopt? successful understanding?
A. Use a punishment system to deter disruptive behavior A. "I can keep everything in one place, and it won’t get lost."
B. Implement a behavior modification plan with clear rewards B. "I will start a homework planner and check it every day."
C. Ignore the behavior to reduce its frequency C. "I should remember everything in my head."
D. Call the parents to discuss the child's behavior D. "I will ask my parents to remind me of my tasks."
Answer: B Answer: B
Rationale: A behavior modification plan with clear rewards Rationale: Using a homework planner and checking it daily
can effectively reduce disruptive behavior. helps children with ADHD manage tasks and improve
organizational skills.
37. During a follow-up visit, the nurse notes a child with
ADHD is experiencing insomnia. What should the nurse 43. A teacher notices that a child with ADHD has difficulty
recommend? following multi-step directions. What is the best instructional
A. Increase screen time before bedtime approach for this child?
B. Establish a consistent bedtime routine A. Provide written instructions for all tasks
C. Allow the child to choose bedtime B. Give directions verbally without any visual aids
D. Encourage physical activity right before bed C. Break down tasks into single-step directions
Answer: B D. Allow the child to choose which directions to follow
Rationale: A consistent bedtime routine promotes better sleep Answer: C
hygiene and can help with insomnia. Rationale: Breaking tasks into single-step directions can make
them more manageable for a child with ADHD.
38. A child with ADHD is struggling with peer relationships.
What intervention can the nurse suggest to the parents? 44. A nurse is evaluating a child with ADHD who is taking
A. Encourage solitary play to avoid conflict stimulant medication. Which side effect should the nurse
B. Arrange playdates with structured activities monitor most closely?
C. Limit social interactions until behavior improves A. Drowsiness
D. Discourage friendships to focus on academics B. Weight loss
Answer: B C. Increased energy
Rationale: Structured playdates can help children with ADHD D. Improved attention span
learn social skills and improve peer relationships. Answer: B
Rationale: Stimulant medications can cause decreased appetite
39. A parent expresses concern about their child's impulsivity and weight loss, which should be monitored.
associated with ADHD. Which nursing response is
appropriate? 45. During a session with a child with ADHD, the nurse
A. "Children with ADHD will eventually outgrow observes frequent interruptions. What intervention is most
impulsivity." effective to encourage appropriate behavior?
B. "It's important to set firm boundaries and consequences." A. Give the child a warning about the behavior
C. "Consider medications as the first line of treatment." B. Reward the child for remaining quiet for a set time
D. "Impulsivity is a phase that doesn't need intervention." C. Immediately remove the child from the session
Answer: B D. Ignore the interruptions to avoid reinforcing them
Rationale: Setting firm boundaries and consequences can help Answer: B
manage impulsivity in children with ADHD. Rationale: Rewarding the child for appropriate behavior
encourages positive changes and reinforces self-control.
40. A child with ADHD is using a fidget spinner during class.
The teacher is concerned about distraction. What is the best 46. A nurse is working with a child with ADHD who exhibits
action for the nurse to recommend? anger outbursts. What is the most appropriate nursing
A. Prohibit the use of the fidget spinner in class intervention?
B. Allow the spinner but limit its use to specific times A. Ignore the outbursts to decrease attention-seeking behavior
C. Encourage the child to use it only when they feel restless B. Teach the child coping strategies to manage anger
D. Suggest other sensory tools that are less distracting C. Punish the child for exhibiting angry behavior
Answer: D D. Encourage the child to express feelings through writing
Rationale: Suggesting less distracting sensory tools can help Answer: B
the child manage restlessness without disrupting class. Rationale: Teaching coping strategies can help the child
manage anger and develop healthier responses.
41. During a parent-teacher meeting, a teacher reports a child
with ADHD struggles with transitions between activities. 47. A child with ADHD has been referred for cognitive-
What is the best recommendation for the teacher? behavioral therapy (CBT). What is the primary goal of this
A. Give the child warnings before transitions intervention?
B. Allow the child to stay with one activity for longer periods A. To improve academic performance
C. Change activities more frequently to keep the child B. To change negative thought patterns and behaviors
engaged C. To reduce the need for medication
D. Ignore the behavior as the child will adapt over time D. To enhance social skills through group therapy
Answer: A Answer: B
Rationale: CBT aims to modify negative thought patterns and
behaviors that contribute to ADHD symptoms.
48. A nurse is assessing the effectiveness of a behavioral
intervention for a child with ADHD. Which outcome would
indicate success?
A. The child exhibits fewer symptoms of hyperactivity
B. The child completes homework more frequently
C. The child’s teachers report increased compliance
D. All of the above
Answer: D
Rationale: Success in behavioral interventions can manifest in
multiple areas, including reduced hyperactivity, increased
homework completion, and improved compliance.

49. A child with ADHD is prescribed a non-stimulant

medication. Which medication is most likely to be prescribed?
A. Methylphenidate
B. Amphetamine salts
C. Atomoxetine
D. Dexmethylphenidate
Answer: C
Rationale: Atomoxetine is a non-stimulant medication
commonly prescribed for ADHD.

50. During an educational session about ADHD, a parent

expresses concern about their child’s impulsivity in social
situations. What is the best nursing response?
A. "Impulsivity will decrease as your child matures."
B. "It is important to consistently set clear expectations and
consequences."
C. "Encourage your child to avoid social interactions to
prevent issues."
D. "There’s no need to worry; many children act impulsively."
Answer: B
Rationale: Consistent expectations and consequences can help
manage impulsivity and improve social interactions for
children with ADHD.
Nurse-Client Relationship and Therapeutic 7. During a counseling session, a client states, "I feel so
Communication alone." The nurse responds, "It sounds like you're feeling
isolated." What technique is the nurse using?
1. A nurse is entering the orientation phase of a client A) Reflecting
relationship. Which action should the nurse prioritize? B) Summarizing
A) Establishing a treatment plan C) Encouraging comparison
B) Setting mutual goals with the client D) Voicing doubt
C) Introducing oneself and explaining the role Answer: A) Reflecting
Answer: C) Introducing oneself and explaining the role Rationale: Reflecting restates the client's feelings to validate
Rationale: In the orientation phase, it's crucial for the nurse to their experience.
establish rapport and explain their role to the client.
8. A nurse is conducting a therapeutic group session. One
2. During the working phase, the client expresses frustration member frequently interrupts others. What is the best
with their treatment. Which therapeutic communication approach for the nurse to take?
technique should the nurse use to encourage the client’s A) Ignore the interruptions to avoid confrontation
expression of feelings? B) Advise the member to let others speak
A) Offering advice C) Redirect the discussion back to the other members
B) Using silence D) Set ground rules for speaking during the session
C) Encouraging expression Answer: D) Set ground rules for speaking during the session
Answer: C) Encouraging expression Rationale: Establishing ground rules helps create an inclusive
Rationale: Encouraging the expression of feelings helps and respectful environment for all members.
clients process their emotions and enhances communication.
9. A nurse uses silence during a session with a grieving client.
3. A nurse is working with a client who has difficulty What is the primary purpose of this technique?
understanding their diagnosis. What technique should the A) To encourage the client to speak
nurse use to clarify the client's understanding? B) To allow the client time to process emotions
A) Reflecting C) To emphasize the nurse's authority
B) Presenting reality D) To create discomfort in the client
C) Consensual validation Answer: B) To allow the client time to process emotions
Answer: C) Consensual validation Rationale: Silence can provide clients with the space they
Rationale: Consensual validation helps ensure both the nurse need to reflect on their feelings.
and client have a shared understanding of the information
discussed. 10. A nurse is concerned that a client is not adhering to their
medication regimen. What is the most appropriate therapeutic
4. In the termination phase, what is the primary focus of the technique to explore this issue?
nurse? A) Probing
A) Implementing the discharge plan B) Offering advice
B) Reviewing the goals achieved during the relationship C) Giving recognition
C) Preparing the client for future health challenges D) Exploring
D) Establishing a follow-up appointment Answer: D) Exploring
Answer: B) Reviewing the goals achieved during the Rationale: Exploring the reasons for non-adherence allows for
relationship a better understanding of the client’s perspective and barriers.
Rationale: The termination phase focuses on reflecting on the
progress made and reinforcing the client’s accomplishments. 11. A nurse observes that a client appears confused about their
medication. The nurse should first:
5. A nurse observes a client exhibiting signs of anxiety during A) Explain the medication again
a session. What non-therapeutic technique might the nurse B) Validate the client's feelings of confusion
unintentionally be using? C) Ask if the client has any questions
A) Offering self D) Provide written information about the medication
B) Giving literal responses Answer: B) Validate the client's feelings of confusion
C) Making observations Rationale: Validating feelings can help the client feel heard
D) Seeking information and encourage further discussion.
Answer: B) Giving literal responses
Rationale: Giving literal responses can minimize the client's 12. In a session, a client mentions they feel “hopeless.” The
feelings and may increase anxiety instead of providing nurse responds, “It’s understandable to feel that way given
support. what you’re going through.” What communication technique
is the nurse using?
6. When discussing treatment options with a client, which of A) Voicing doubt
the following is the best example of the "offering self" B) Agreeing
technique? C) Belittling feelings expressed
A) "You will feel better after treatment." D) Accepting
B) "I am here to help you through this process." Answer: D) Accepting
C) "I understand how you feel." Rationale: Accepting the client’s feelings demonstrates
Answer: B) "I am here to help you through this process." empathy and understanding.
Rationale: Offering self demonstrates the nurse's willingness
to be present and supportive.
13. Which of the following is an example of a non-therapeutic 20. In the termination phase, which statement should a nurse
communication technique? avoid?
A) Encouraging exploration A) "I will miss our sessions."
B) Probing B) "You have made significant progress."
Answer: B) Probing C) "I hope you can manage on your own."
Rationale: Probing can make clients feel uncomfortable and D) "Let’s schedule our next meeting."
defensive. Answer: D) "Let’s schedule our next meeting."
Rationale: This statement is inappropriate in the termination
14. A nurse is discussing the importance of medication phase, as it suggests ongoing support when the relationship is
adherence with a client. Which technique would best concluding. The focus should be on reflecting on the progress
encourage the client’s participation in the discussion? made and encouraging independence.
A) Suggesting collaboration
B) Advising the client 21. A nurse encounters a client who expresses feelings of
Answer: A) Suggesting collaboration inadequacy. What is the most appropriate therapeutic response?
Rationale: Suggesting collaboration fosters a partnership · A) "Everyone feels inadequate sometimes."
between the nurse and the client. B) "You need to work on your self-esteem."
C) "Can you tell me more about these feelings?"
15. A client expresses doubt about the effectiveness of their D) "That’s just how life is."
treatment. How should the nurse respond to validate the Answer: C) "Can you tell me more about these feelings?"
client's feelings? Rationale: This encourages the client to express their feelings
A) "That's not true; the treatment will work." further and validates their experience.
B) "I understand you have concerns about the treatment."
C) "Let’s talk about what you think is wrong." 22. In a psychiatric unit, a nurse observes that a client has
Answer: B) "I understand you have concerns about the withdrawn from group activities. What should the nurse do
treatment." first?
Rationale: Acknowledging the client’s feelings fosters trust · A) Encourage the client to participate more
and opens the door for further discussion. B) Assess the client’s feelings about the withdrawal
C) Discuss the importance of group activities
16. During a mental health assessment, a client reveals a D) Ignore the behavior
traumatic experience but struggles to articulate their feelings. Answer: B) Assess the client’s feelings about the withdrawal
The best nursing response would be: Rationale: Understanding the client's perspective is crucial
A) "You need to be more specific." before suggesting changes.
B) "Tell me more about how that made you feel."
C) "Everyone goes through tough times." 23· During a counseling session, a client states, "I don't
Answer: B) "Tell me more about how that made you feel." believe my therapist understands me." The nurse responds,
Rationale: This encourages the client to explore their feelings "What makes you feel that way?" What communication
further. technique is the nurse using?
· A) Seeking information
17. A nurse is concerned about a client’s lack of engagement B) Encouraging comparison
in their treatment plan. What is the best initial response? C) Reflecting
A) "Why don’t you want to follow the plan?" Answer: A) Seeking information
B) "Let’s discuss any barriers you may have." Rationale: This encourages the client to elaborate on their
C) "You need to understand the consequences." feelings.
Answer: B) "Let’s discuss any barriers you may have."
Rationale: This approach encourages open dialogue about 24· A nurse is developing a therapeutic relationship with a
obstacles and supports problem-solving. new client. Which action should the nurse take to build trust
during the orientation phase?
18. A nurse is assessing a client who frequently changes the · A) Share personal experiences
subject during discussions. Which non-therapeutic technique B) Discuss the treatment plan in detail
may this behavior indicate? C) Establish clear boundaries and expectations
A) Anxiety Answer: C) Establish clear boundaries and expectations
B) Acceptance Rationale: Clear boundaries help create a safe environment for
C) Open communication the client.
Answer: A) Anxiety
Rationale: Changing the subject can be a defense mechanism 25. · A client expresses that they are feeling suicidal. The
for anxiety or discomfort. nurse responds, "That sounds very serious. Can you tell me
more about what's going on?" What communication technique
19. During a session, a nurse states, “You shouldn’t feel that is the nurse using?
way; it’s not that bad.” This response is an example of: · A) Presenting reality
A) Validating the client's feelings B) Verbalizing the implied
B) Minimizing the client's feelings C) Encouraging expression
C) Encouraging expression Answer: C) Encouraging expression
D) Reflecting Rationale: This response encourages the client to share more
Answer: B) Minimizing the client's feelings about their feelings and situation.
Rationale: This response dismisses the client’s emotions,
which can hinder communication.
26· A nurse is working with a client who feels hopeless. Answer: A) "I see you’ve been coming to sessions regularly."
What would be a non-therapeutic response? Rationale: Recognizing the client's commitment fosters a
· A) "Have you tried thinking positively?" supportive relationship.
B) "Let’s discuss what is making you feel this way."
C) "I understand this is a difficult time for you." 33. · During an evaluation of a treatment plan, a client says,
Answer: A) "Have you tried thinking positively?" "This isn’t working for me." The nurse's best response is:
Rationale: This response can invalidate the client's feelings · A) "You need to give it more time."
and may come off as dismissive. B) "What do you think might work better?"
C) "Many clients feel the same way initially."
27 · While discussing a treatment plan, the client states, "I Answer: B) "What do you think might work better?"
don’t think I can do this." What should the nurse's therapeutic Rationale: This response encourages the client to take an
response be? active role in their treatment.
· A) "You have to try harder."
B) "Why do you feel that way?" 34. · A nurse is working with a client who has a history of
C) "I understand this seems difficult. Let's explore your substance abuse. The client says, “I think I’ll never get better.”
concerns." The most therapeutic response would be:
Answer: C) "I understand this seems difficult. Let's explore · A) "That’s not true; many people recover."
your concerns." B) "What makes you feel that way?"
Rationale: This response validates the client’s feelings and C) "You need to stay positive."
opens the dialogue for discussion. Answer: B) "What makes you feel that way?"
Rationale: This encourages exploration of the client's feelings
28 · During a session, a client says, "I can’t believe this is and underlying thoughts.
happening to me!" What is the best initial response from the
nurse? 35. · A nurse is conducting a family session with a client
· A) "It’s not as bad as you think." diagnosed with depression. What is an important therapeutic
B) "What do you mean by that?" technique to use?
C) "Many people go through tough times." · A) Probing family members for details
D) "This is a normal reaction to stress." B) Encouraging each family member to express their feelings
Answer: B) "What do you mean by that?" C) Dominating the conversation to ensure everyone hears the
Rationale: This invites the client to elaborate on their feelings treatment plan
and thoughts. Answer: B) Encouraging each family member to express their
feelings
29 · A nurse reflects on a client’s previous statements during Rationale: This promotes open communication and
a session. What technique is the nurse using? understanding among family members.
· A) Summarizing
B) Encouraging exploration 36. · In a group therapy session, a client shares a personal
D) Reflecting story but receives little response from the others. What should
Answer: D) Reflecting the nurse do?
Rationale: Reflecting allows the nurse to show that they are · A) Change the subject to another topic
actively listening and understanding the client’s emotions. B) Encourage the group to respond and engage with the client
C) Conclude the session early
30. · A nurse is conducting a session with a client who is Answer: B) Encourage the group to respond and engage with
experiencing a crisis. What non-therapeutic technique should the client
be avoided? Rationale: Encouraging group engagement fosters a
· A) Offering reassurance supportive environment.
B) Challenging the client’s perception 37. · A nurse is assessing a client’s understanding of their
C) Encouraging exploration mental health condition. The client states, “I think my
Answer: B) Challenging the client’s perception condition is just in my head.” The best response would be:
Rationale: Challenging can create resistance and may escalate · A) "That’s a common misconception."
the crisis. B) "What do you think might help you?"
C) "Let’s talk about the physical symptoms."
31. · A client in therapy mentions feeling angry but states, “I Answer: B) "What do you think might help you?"
don’t want to talk about it.” The nurse should respond with: Rationale: This encourages the client to reflect on their
· A) "It’s not healthy to keep it inside." thoughts and consider proactive steps.
B) "Let’s focus on something else."
C) "That’s understandable; you can share when you’re ready." 38. · A nurse is speaking with a client who appears
Answer: C) "That’s understandable; you can share when withdrawn. Which approach is most appropriate?
you’re ready." · A) Pressuring the client to open up
Rationale: This response respects the client’s boundaries and B) Offering time and space for the client to respond
encourages a safe environment for future sharing. C) Ignoring the behavior
Answer: B) Offering time and space for the client to respond
32. · Which of the following responses by the nurse Rationale: Allowing the client to engage at their own pace
demonstrates the technique of "giving recognition"? fosters comfort and trust.
· A) "I see you’ve been coming to sessions regularly."
B) "How does that make you feel?"
C) "Can you explain what you mean?"
39. · When using therapeutic communication, what is the 46. · A client expresses feeling misunderstood by family
primary goal of summarizing the client’s statements? members. The nurse's most appropriate response would be:
· A) To clarify the nurse's understanding · A) "They just don’t know what you’re going through."
B) To redirect the conversation B) "Why do you think they feel that way?"
C) To evaluate the client’s feelings C) "Let’s talk about how you can communicate better with
Answer: A) To clarify the nurse's understanding them."
Rationale: Summarizing helps ensure that the nurse accurately Answer: C) "Let’s talk about how you can communicate better
understands the client's concerns and feelings. with them."
Rationale: This encourages the client to consider strategies for
40. · During a session, a client expresses frustration about better communication, promoting self-efficacy.
their treatment plan. What is the most therapeutic response
from the nurse? 47. · Which statement by the nurse demonstrates the use of
· A) "You shouldn’t feel that way; the plan is good." non-therapeutic communication?
B) "I understand you’re frustrated. Can we talk about why?" · A) "I’m here to listen if you want to talk."
C) "Many people feel frustrated with treatment." B) "You’re making a big deal out of nothing."
Answer: B) "I understand you’re frustrated. Can we talk about C) "Can you tell me more about that?"
why?" Answer: B) "You’re making a big deal out of nothing."
Rationale: This response validates the client’s feelings and Rationale: This statement dismisses the client's feelings and is
opens a discussion to explore their concerns. judgmental.

41. · A nurse observes a client struggling to articulate their 48. · A nurse finds a client who appears disheveled and
thoughts. What is the best response? unkempt. What should the nurse do first?
· A) "Just take your time; you’ll get it." · A) Suggest the client take a shower
B) "Let’s focus on something easier." B) Assess the client’s mental and physical state
C) "Can you describe that differently?" C) Offer to help the client clean up
Answer: C) "Can you describe that differently?" Answer: B) Assess the client’s mental and physical state
Rationale: This encourages the client to express their thoughts Rationale: Assessing the client's condition is essential before
in a different way without judgment. making any suggestions.

42. · What communication technique is a nurse using when 49. · In a therapeutic group setting, a client states, "I feel like
they say, "It sounds like you’re saying that you feel alone"? nobody cares about me." The nurse should respond:
· A) Paraphrasing · A) "That’s not true; everyone here cares."
B) Reflecting B) "Why would you feel that way?"
C) Clarifying D) "Can you tell us more about that feeling?"
D) Summarizing Answer: D) "Can you tell us more about that feeling?"
Answer: A) Paraphrasing Rationale: This encourages the client to explore and express
Rationale: This technique rephrases the client's words to their feelings further.
demonstrate understanding.
50. · When a client expresses anger towards their illness,
43. · A client states, “I’m worried about my upcoming what should the nurse’s response focus on?
surgery.” What is the best initial response by the nurse? · A) Minimizing the client’s feelings
· A) "Don't worry; everything will be fine." B) Acknowledging the client’s feelings
B) "What specifically worries you about the surgery?" C) Redirecting the conversation to solutions
C) "Surgery is always a little scary." D) Confronting the client about their anger
Answer: B) "What specifically worries you about the Answer: B) Acknowledging the client’s feelings
surgery?" Rationale: Acknowledgment validates the client’s emotions
Rationale: This response invites the client to share their and promotes further discussion.
specific concerns, allowing for deeper discussion.

44. · During a therapeutic session, a client shares a recent

trauma. Which response from the nurse is most appropriate?
· A) "It could have been worse."
B) "That must have been very difficult for you."
C) "You need to move on."
Answer: B) "That must have been very difficult for you."
Rationale: This response validates the client’s experience and
shows empathy.

45. · When a nurse provides feedback to a client about their

behavior, which of the following should be avoided?
· A) Using "I" statements
B) Being specific about the behavior
C) Making judgments about the client’s character
Answer: C) Making judgments about the client’s character
Rationale: Feedback should be constructive and focused on
behaviors, not character judgments.