1. Rationale: A is correct because a sexual factor is not included in categorizing the mental health of an individual. Individual factor (B) is defined as the biological makeup of a person including his self-esteem, capacity of growth, vitality, etc. Interpersonal factor (C) includes helping others and effective communication. Social/Cultural factors (D) includes access to resources, intolerance of violence, and support from family and friends.
2. Rationale: B is correct because Axis II is for reporting personality disorders and mental retardation. A and D are wrong because they both refer to Axis I which is for identifying all major psychiatric disorders except mental retardation and personality disorders. C is wrong because it is Axis IV use for reporting psychosocial and environmental problems.
3. Rationale: C is correct because it is not influenced by the pineal gland. A, B, and D are all influenced along with adrenals and gonads.
4. Rationale: D is correct because the frontal lobe controls moral reasoning; others include organization of though, body movement, and memories. A is wrong because it is the center for the senses of smell and hearing. B is wrong because it assist in coordinating language generation. C is wrong because it interprets sensations of taste and touch.
5. Rationale: A is correct because dopamine is synthesized from tyrosine. B is wrong because tryptophan produces niacin and serotonin. C is wrong because phenylalanine is converted into tyrosine by the body. D is wrong because it is the precursor of acetylcholine.
6. Rationale: B is correct because histamine is a neuromodulator along with neuropeptides. A and C are wrong because they are both excitatory. D is wrong because serotonin is inhibitory.
7. Rationale: C is correct because the duration is only 20-40 minutes. A is wrong because MRI takes 45 minutes. B is wrong because it takes 2-3 hours. D is wrong because it takes 1-2 hours.
8. Rationale: D is the answer because ELSI is not one of the types of the said study; rather, it is a program that focuses on the privacy and fairness in the use of genetic information towards human genetics research. A (twin studies) is used to compare the rates of certain mental illnesses or traits in monozygotic twins, who have identical genetic makeup, and dizygotic twins who have different genetic makeup. B (adoption studies) is used to determine a trait among biologic versus adoptive family members. C (family studies) is used to compare whether a trait is more common among first-degree relatives than among other distant relatives or the general population.
9. Rationale: A is correct because the dosage of medication often is adjusted to the lowest effective dosage for the client. B is wrong because older clients require lower doses of medication; they don’t need higher doses because it may take longer for a drug to achieve its full therapeutic effects to them. C is wrong because psychotropic drugs should be lowered from tapering (gradual) to abruptly; it is done to prevent rebound and/or withdrawal effects. D is wrong because a follow up care is important to ensure that the patient complies with the medical regimen.
10. Rationale: B is the answer because Amantadine is categorized as a dopaminergic agonist. A, C, and D are all anticholinergic drugs.
11. Rationale: C is correct because anticholinergic side effects usually decrease during 3-4 weeks but do not entirely remit. The other options (A, B, D) are all wrong; they are just made for distractions.
12. Rationale: D is the answer because the maintenance dosage should be as low as possible. A, B, C are all interventions in preventing TD.
13. Rationale: A is correct which is why it is very important to obtain first a baseline WBC count and differential before the initiation of this drug. In addition, there should be WBC count every week throughout treatment and 4 weeks after discontinuation of this drug. B, C, D are all wrong; they are just distractors.
14. Rationale: B is correct because Thioridazine, along with Droperidol and Mesoridazine can lengthen the QT interval, leading to potentially life-threatening cardiac dysrhythmias or cardiac arrest. A is wrong because it can cause potentially life-threatening liver damage that may lead to liver failure. C is wrong because it is used with caution in emotionally unstable clients (e.g. alcohol or drug dependence). D is wrong because it can cause agranulocytosis which is a potentially life-threatening event.
15. Rationale: C is correct because amitriptyline is one of the cyclic compounds; others include: imipramine, desipramine, and amoxapine. A is wrong because it is a monoamine oxidase inhibitor. B is wrong because it is labeled as “other compounds”; other example includes bupropion and trazodone. D is wrong because it is a type of selective serotonin reuptake inhibitors.
16. Rationale: D is the answer because patients can use stool softeners but not laxatives. A is recommended especially for patients who have photosensitivity. B is recommended because these can prevent dental caries and weight gain. C is recommended as well.
17. Rationale: A is correct because it can explain why using MAOIs should be in extreme caution; other reasons include risk of potentially fatal drug interactions with tricyclic antidepressants, meperidine, etc. B is wrong because it is a warning for bupropion. C is wrong because it is a warning for carbamazepine. D is wrong because it is a warning for lamotrigine.
18. Rationale: B is the answer because the plasma levels should be checked 12 hours after the last dose. A, C, and D are all correct for patients who are taking lithium and anticonvulsants.
19. Rationale: C is the answer because it correctly defines intellectualization; the person acknowledges the facts but not the emotions. A is wrong because it talks about identification. B is wrong because it talks about rationalization. D is wrong because it talks about dissociation.
20. Rationale: D is the correct answer. B is wrong because this is the task during autonomy versus shame and doubt. A is wrong because this is the task during initiative versus guilt. C is wrong because this is the task during industry versus inferiority.
21. Rationale: A is correct because during the juvenile stage where the shift to the syntaxic mode begins. B is wrong because it is the shift to the parataxic mode. C is wrong because it is the major shift to syntaxic mode. D is wrong because it is just a distractor.
22. Rationale: B is correct because William Glasser is the proponent of reality therapy. A is wrong because the proponent is Albert Ellis. C is wrong because the proponent is Viktor Frankl. D is wrong because the proponent is Frederick Perls.
23. Rationale: C is correct because 4-12 feet is indicated for social zones. A is wrong because it is indicated for public zone. B is wrong because it is indicated for personal zone. D is wrong because it is indicated for intimate zone.
24. Rationale: D is correct; it also includes “air kisses” that women use to greet acquaintances or when a gentle hand guides someone in a direction. A is wrong because it involves tight hugs and kisses between lovers or close relatives. B is wrong because it involves a hug in greeting, an arm thrown around the shoulder of a good friend, etc. C is wrong because it is used in examinations or procedures such as when the nurse touches a client to assess skin turgor.
25. Rationale: A is the answer because the nurse should interpret and respond to the client objectively. B, C, and D are all correct because they support the given statement above.
26. Rationale: B is correct because it is used in asking the patient to appraise the quality of his/her experiences. A is wrong because it is used to delve further into a subject or idea. C is wrong because it is used in concentrating on a single point. D is wrong because it gives the patient the encouragement to continue.
27. Rationale: C is correct because it is used to organize and summing up that which has gone before. A is wrong because it is used when a nurse offers the patient to share, strive, and work for his benefit. B is wrong because it is used when a nurse wants the patient to verbalize his feelings. D is wrong because it is used by a nurse if she wants to express uncertainty about the reality of the client’s perceptions.
28. Rationale: D is correct. C is wrong because nurses should establish rapport with the clients by being empathetic. B and A are wrong; this explains why we need to stop using nontherapeutic techniques
29. Rationale: A is the answer because if dissatisfied with the results, they should select another alternative and continue the process. B, C, and D are all correct.
30. Rationale: B is the answer because stress is not included in hardiness. A (commitment) is defined as an active involvement in life activities. C (control) is defined as the ability to make appropriate decisions in life activities. D (challenge) is defined as the ability to perceive change as beneficial rather than just stressful.
31. Rationale: C is correct because it is the illness belief of Filipinos. D is wrong because it is the belief of Cubans. B is wrong because it is the belief of African Americans. A is wrong because it is the belief of Japanese Americans.
32. Rationale: D is the answer because the nurse should recognize any negative feelings rather than positive. A, B, and C are all correct.
33. Rationale: A is the answer because it is the correct definition of tangential thinking. B is wrong because it describes circumstantial thinking. C is wrong because of the flight of ideas. D is wrong because it describes loose associations.
34. Rationale: B correctly defines blunted affect. A is wrong because it defines broad affect. C is wrong because it defines flat affect. D is wrong because it defines restricted affect.
35. Rationale: C is the correct term. A is wrong because it is defined as maintenance of posture or position. B is wrong because it is defined as repeated purposeless behaviors which often indicate anxiety. D is wrong because it is the inventing of words that only the client can understand.
Source: Psychiatric Mental Health Nursing 4th Edition by Sheila Videbeck
