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PSYCH NURSING EXAM LATEST UPDATES - 2025/2026- ACTUAL
QUESTIONS WITH VERIFIED ANSWERS ALREADY GRADED A+
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A child was admitted to the children's unit, having been sexually abused by an acquaintance of her family. The child refuses to talk and participate in unit activities, choosing to stay in her room with her stuffed animals. Which therapeutic intervention will best help the child release pent-up feelings about the abuse? a. Family therapy b. Play therapy c. Individual communication with the nurse d. Role-play with other children on the unit ANS: B Play helps communicate and release feelings about the child's problems. A child may have difficulty expressing feelings verbally. Family therapy may be useful, but it is not designed for releasing feelings. Role-playing is more effective with older children or adults. Nurses coping with angry clients may find it helpful to remember that anger and aggression begin as feelings of which personal characteristic? A. Isolation B. Confidence C. Hopelessness D. Vulnerability
D. Vulnerability A young child is being evaluated in the Emergency Department for injuries her mother reports resulted from a fall down the stairs. Which of these findings indicates that physical abuse may be a chronic problem for the child? a. The mother's description of the child as being 'clumsy' b. Several fractures revealed on x-ray in varying degrees of healing c. Clinging to her mother as she attempted to leave the examining room d. Struggling with the staff when attempts to obtain a blood specimen were made ANS: B Unhealed fractures indicate both numerous injuries and that medical intervention was not sought at the time of injury. Although unkind, the mother's description of the child is not reason to believe chronic abuse has occurred. The remaining options reflect normal behavior, especially if pain or separation is suspected. Child Abuse and Neglect The intentional harm or mistreatment of a child under 18 years old; it involves any recent act or failure to act on the part of a parent or caregiver; it results in death, serious physical or emotional harm, sexual abuse, or exploitation; and it presents a likely or immediate risk for harm spousal abuse domestic violence or any other form of abuse directed at a spouse
The nurse is considering making a child abuse or neglect report to protective services. To make the report, the nurse needs to: a. Have strong evidence that the abuse/neglect has occurred. b. Obtain the supervisor's permission to make the report. c. Notify the parents of the intent to file the report. d. Have suspicions that the abuse has occurred. ANS D Suspicions are all that are required by state mandatory child abuse and neglect reporting laws. The agency bears the burden of collecting evidence. As a mandated reporter, the nurse does not need anyone's permission to make the report. Only a suspicion is required. Parent notification is unnecessary Medications (Commonly) used for aggression and impulsivity Olanzapine (Zyprexa).Ziprasidone (Geodon).Haloperidol (Haldol).Other medications to treat underlying disorder such as SSRIs, mood stabilizers, sedative/hypnotics. Phases in cycle of violence in families Tension-building phase Acute battering phase Honeymoon phase Eventually, cycle begins again.
Periods of escalation and de-escalation continue with shorter and shorter periods in between. Emotions increase in intensity. Repeated episodes of violence lead to feelings of helplessness. Violence phase- Tension-building phase: Abuser has minor episode of anger, may be verbally abusive or cause minor physical violence. Victim is tense and tends to accept blame. Violence phase-Acute battering phase: Tension becomes too much to bare and serious abuse takes place. Victim may cover up injury or get help. Violence phase- Honeymoon phase: Situation is defused for a while after violent episode. Abuser becomes loving, promises change, and is sorry. Victim wants to believe this and hopes for change. Eventually, cycle begins again. To provide nursing care to abused children and their families, the nurse must first: a. Recommend removal of the children from the family. b. Complete a comprehensive physical and mental assessment. c. Refer each case to the appropriate social worker for follow-up. d. Examine personal feelings regarding the trauma of child abuse and neglect.
Autistic spectrum disorder any of several disorders characterized by inadequate social skills, impaired communication, and unusual play Rett's disorder Progressive neurological developmental disorder featuring constant hand- wringing, mental retardation, and impaired motor skills. Most common in girls. Childhood Disintegrative Disorder Pervasive developmental disorder involving severe regression in language, adaptive behavior, and motor skills after a 2- to 4-year period of normal development. play therapy an approach to treating childhood disorders that helps children express their conflicts and feelings indirectly by drawing, playing with toys, and making up stories While planning care for a preschool child who has been physically and sexually abused, the nurse includes play therapy because it assists the child to: a. Learn adaptive behaviors through acting. b. Express feelings that cannot easily be verbalized.
c. Act out aggression in a sociably acceptable manner. d. Interact with other children in the appropriate age group. ANS: B Abused children, especially young children, are unable to put feelings into words as they describe events. Play therapy affords the tools through which the child can access and work through feelings. The other options are not purposes of play therapy Forensic Nursing help investigate crimes like sexual and physical assault and accidental death Forensic Evidence Collection for Sexual Assault Victims Forensic evidence collection is a systematic process that follows state and Federal guidelines. The references pertaining to evidence collection should be readily available in every setting. Most evidence collection kits will contain instructions for using the items contained within them. The nurse who sees a number of battered elderly females each year decides to put together a set of guidelines for nurses. An appropriate guideline to include would be to: a. Make protective services aware of the abuse. b. Take at least two photographs of each trauma area. c. Begin the interview by asking the least sensitive questions. d. Assess for the presence of sexually transmitted diseases
Conversion disorder is a loss of or change in body function resulting from a psychological conflict, the physical symptoms of which cannot be explained by any known medical disorder or pathophysiological mechanism. Body dysmorphic disorder This disorder, formerly called dysmorphophobia, is characterized by the exaggerated belief that the body is deformed or defective in some specific way. Symptoms of somatoform disorder include Pain symptoms-headache, pain in the abdomen, head, joints, back, chest, rectum; pain during urination, menstruation, or sexual intercourse. Gastrointestinal symptoms-nausea, bloating, vomiting (other than during pregnancy), diarrhea, or intolerance of several foods. Sexual symptoms- erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding. Pseudo-neurologic symptoms, paralysis or localized weakness. Conversion (pseudo-neurological) symptoms such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in throat, aphonia, urinary retention, hallucinations, loss of touch or pain sensation, double vision, blindness, deafness, and seizures. Assisting the client to express emotions(Somatoform)
Clients may keep a detailed journal of their physical symptoms- the nurse might ask them to describe the situation at the time such as whether they were alone or with others, whether any disagreements were occurring, and so forth. Treatment outcomes (Somatoform) include
- The client was able to identify the relationship between stress and physical symptoms. 2. The client was able to verbally express emotional feelings. 3. The client was able to follow an established daily routine. 4. The client was able to demonstrate alternative ways to deal with stress, anxiety, and other feelings. A patient comes to the ED exhibiting severe physical and emotional symptomology. When no physical cause can be found for the symptoms, the patient is diagnosed with severe anxiety with panic attack symptoms. Which assessment data supports this diagnosis? Select all that apply. a. Blood pressure 158/90; 15 minutes later 130/ b. Claims that she feels like she going to die c. Random but controlled thoughts d. Unable to follow instructions e. Dry, flushed skin ANS: A, B, D Blood pressure will begin to drop in a panic attack as the sympathetic nervous system release occurs; the patient may express an emotional sensation of doom and the patient will not be able to concentrate and so will be unable to follow instructions. Thoughts during a panic attack are uncontrolled and the skin is diaphoretic.
Due to a recent increase in reported cases of dissociative amnesia involving previously forgotten early childhood memories, assessing such memories would have priority with this patient. Obsessive-compulsive disorder is not generally viewed as a co-morbid disorder of dissociative amnesia. The remaining options would not provide much specific information for this patient's condition Violence in the family familial emotional, physical or sexual abuse; victims are usually non-dominant members of the family such as elders, females, or children Which nursing assessment finding would support a diagnosis of somatoform disorder? a. Patient reports a family history of depression b. The onset of symptoms beginning at age 38 c. An abnormality of the patient's left heart ventricle d. Complaints of diarrhea and an erratic menstrual cycle ANS: D The diagnosis of somatization disorder requires that symptoms indicate there is involvement of multiple organ systems (e.g., gastrointestinal, reproductive, neurologic). Structural anomalies would indicate a medical problem exists. An early onset of symptoms (prior to age 30) is not recognized as a criterion for the diagnosis. A family history of depression is not a criterion for the diagnosis. DIF: Cognitive Level: Application REF: Page 209
To differentiate between somatoform and conversion disorders, the nurse will direct the assessment to determine the presence of the critical defining factor associated with conversion disorder. Which is true about a conversion reaction? a. Symptoms are generally associated with pain or sexual function. b. Symptoms are not accounted for by a medical condition. c. Symptoms are precipitated by psychological factors. d. Symptoms are under the patient's voluntary control. ANS: C Symbolic psychological factors are identified as being related to the onset or exacerbation of a conversion symptom. An absence of a medical cause is present in both the case of conversion and somatization disorders. The conversion symptom is not limited to pain or sexual function nor is not under voluntary control. DIF: Cognitive Level: Application REF: Page 210 A diagnosis of dissociative identity disturbance has been identified for a patient who has stated that he is unable to distinguish between himself and his surroundings. What is an appropriate outcome for this patient? a. Refers to himself as "the patient" b. Identifies the onset of increasing anxiety
an anxiety disorder in which the symptom affects voluntary sensory or motor function and mimics a neurological disorder as a result of extreme anxiety, such as learning of his wife's desire to divorce him. There is no organic basis for the hearing loss but it is not under the patient's voluntary control. Most traumas are not dealt with by developing a mental illness but by rather coping effectively. Males are as likely as females to display conversion disorder symptoms. DIF: Cognitive Level: Application REF: Page 208 A patient reports severe pain during intercourse since being sexually assaulted three years ago. What is the first step in confirming the diagnosis of a pain disorder? a. Evaluating the patient's understanding of the emotional effects of the assault b. Asking the patient to keep a journal of her feelings regarding the assault c. Assessing the patient for posttraumatic stress disorder d. Ruling out a physical cause of the pain ANS: D While psychological factors have an important role in the onset, severity, exacerbation, or maintenance of the pain, initially the presence of a physical cause of the pain must be
ruled out. The assessment of the patient's understanding of the disorder or recording of feelings regarding the trauma are not priorities until a diagnosis of pain disorder is made. Posttraumatic stress disorder is not generally characterized with reports of sustained pain. DIF: Cognitive Level: Application REF: Page 210 A patient has developed an acute loss of hearing and is diagnosed with a conversion disorder. Which nursing diagnosis would be most appropriate? a. Hearing impairment b. Panic-level anxiety c. Disturbed sensory perception d. Denial due to a medical condition ANS: C The diagnosis of conversion disorder in this case results in a disruption of the patient's ability to perceive sensations, not a true loss or impairment of hearing. There is no 71evidence to support panic-level anxiety or a medical condition causing denial. DIF: Cognitive Level: Application REF: Page 210
d. The rape victim is assured quality physical and mental healthcare. ANS: B The specialized attention of these nurses has addressed the long-standing issue of retraumatizing victims. The ED staff may still be involved in the physical care of the victim. The focus is not on the rights of the potential rapist. The physical and mental health needs of the victim are not the sole responsibility of the SANE nurse. DIF: Cognitive Level: Application REF: Pages 555- 556 When providing care to an assault victim, the forensic nurse will initially: a. Notify the police that an assault has occurred. b. Assess the individual for any resulting physical trauma. c. Bag all clothing to preserve any relevant evidence. d. Determine whether the victim as been sexually assaulted as well. ANS: B It is the role of the forensic nurse to immediately assess the assault victim for evidence of acute physical injuries. The remaining options do not have the priority that the individual's physical health needs demand. Which intervention demonstrates the SANE nurse's unique attention to the assessment of a sexual assault?
a. Conducting the assessment in the most private exam room b. Not directly questioning the patient about the attack or the attacker c. Identifying that the patient is showing signs of anxiety by withdrawing d. Meticulously assessing the patient for signs of any resulting physical trauma ANS: C Throughout the physical examination, the SANE nurse will be attuned to the victim's mental status and monitor him or her for signs and symptoms of anxiety, panic, and grief. The event and the assailant are topics that must be discussed. The remaining options identify interventions that are considered a nursing responsibility and not unique to the role of the SANE nurse. DIF: Cognitive Level: Application REF: Page 556 To best address the assault victim's psychosocial needs, the forensic nurse: a. Warns the family that the patient will likely be suicidal b. Suggests that the family provide continuous supervision of the patient for at least 30 days c. Encourages the patient to discuss medication therapy with the physician prior to discharge from the ED d. Provides education to both the patient and the family regarding the signs of
