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					                                            INNOVATIVE HEALTH CARE
                                            Psychiatric Nurse Competency Exam



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A client is admitted to the hospital’s psychiatric unit one                     possible replies by the nurse would be best?
month after he retired involuntarily. The nurse notes that he                   a. “I’m sure she’s doing the best she can.”
keeps his head bowed in a dejected manner and that his                          b. “It’s all right. We have been treated worse.”
facial expression is sad.                                                       c. “It must be hard for you to see her like this.”
                                                                                d. “I understand. What happened to set her off like
1.   The nurse visualizes the client’s depression from a                           this?”
     holistic framework. According to holististic
     theory, the client’s depression should be viewed                      6.   The nurse notes that the client is too busy
     as a:                                                                      investigating the unit and overseeing the activities
     a. Reaction to a stressful event                                           of other clients to eat dinner. To help the client
     b. Symptom of high sugar intake                                            obtain sufficient nourishment, which of the
     c. Disturbance caused by numerous factors                                  following plans would be best?
     d. Disturbance caused by destructive environmental                         a. Serve foods that she can carry with her.
        influences.                                                             b. Allow her to send out for her favorite foods
                                                                                c. Serve food in small, attractively arranged portions
2.   Using the holistic framework in one-to-one                                 d. Allow her to enter the unit kitchen for extra food as
     interactions with the client, the nurse should plan                            necessary
     to focus primarily on the client’s:
     a. Dreams and free associations                                       A client is admitted involuntarily by court order to a
     b. Childhood and past life history                                    psychiatric hospital for 90 days. Documents sent with her
     c. Current feelings and experiences                                   cite, among other things, that she will not eat because she
     d. Underlying conflicts and defense mechanisms                        feels her stomach “is missing” and her bowels have “turned
                                                                           to jelly,” and that she views this as “just punishment for my
3.   Which of the following client behaviors would best                    past wickedness and for the evil I’ve brought on my family.”
     indicate to the nurse that the relationship with the
     client is in the working phase?                                       7.   To be evaluated as being legally committable,
     a. The clients attempts to familiarize himself with the                    which of the following criteria did the client most
         nurse                                                                  likely have to meet?
     b. The client makes an effort to describe his problem                      a. Psychotic
         in detail                                                              b. Tried to harm self or others
     c. The client tries to summarize his progress in the                       c. Unable to afford private treatment
         relationship                                                           d. Made threatening remarks to friends or relatives.
     d. The client starts to challenge the boundaries or
         outer limits of the relationship                                  8.   Which of the following rights did the client lose by
                                                                                being admitted involuntarily to a psychiatric
A client is admitted to a psychiatric unit accompanied by                       hospital? The right to:
her husband. She brings six suitcases, She orders the                           a. Send and receive mail
nurse to carry her bags, to set up her typewriter, and to not                   b. Vote in a national election
touch any of her papers. Her husband states that she has                        c. Make a will or a legally binding contract
been purchasing items that they cannot afford and has not                       d. Sign out of the hospital against medical advice
slept for 4 nights.
                                                                           9.   When the client expresses feelings of
4.   Which additional information would be a priority                           unworthiness, how would the nurse best respond?
     for the nurse to seek from the client’s husband?                           a. “Your family loves you even if you feel unworthy
     The nurse would ask about:                                                 b. “Your feeling of being unworthy is just your
     a. The client’s fluid and food intake                                         imagination.”
     b. Their current financial status                                          c. “It would be best to try to forget the idea that you
     c. The client’s usual sleeping pattern                                        are unworthy.”
     d. Whether the client becomes agitated easily                              d. “As you begin to feel better, your feelings of
                                                                                   unworthiness will begin to disappear.”
5.   The husband apologizes to the nurse for his wife’s
     demanding behavior. Which of the following


                                             1605 W. Wilson Street, Suite 105, Batavia, IL 60510
                                                          630.221.9680 (voice)
                                                               Page 1 of 2
                                               INNOVATIVE HEALTH CARE
                                              Psychiatric Nurse Competency Exam



An adolescent female is brought to the hospital emergency                    15. As a charge RN you notice inappropriate chatter
room in a state of unconsciousness after having swallowed                        by the mental health counselors who are within
“a bottle of red pills” 45 minutes earlier. The pills are                        earshot of the patients. You:
identified as seconal. A suicide note is found that asks for                     a. Laugh, as what they said was funny.
her forgiveness and states, “I can’t live without my                             b. Cue them to be cautious as the patients could hear
boyfriend.”                                                                         them.
                                                                                 c. Do nothing, but tell them latter it was inappropriate.
10. Which of the following measures should the nurse                             d. Yell at them to “Get to work.”
    be prepared to carry out when this client is
    admitted?                                                                16. You are working on the adolescent floor and you
    a. Forcing fluids                                                            note a MHC having a power struggle with a patient,
    b. Giving a diuretic                                                         which escalated to the point that the pt was
    c. Inducing vomiting                                                         directed to the QR. You:
    d. Lavaging the stomach                                                      a. Put the patient in locked seclusion, as it seemed
                                                                                    the safest alternative.
11. Which of the following interventions should be of                            b. Provided clear direction of expectations to the client
    primary concern to the nurse after the client’s                                 and then process with the staff and patient to
    physical condition is no longer critical?                                       provide support the staff that was struggling
    a. Providing the client with a safe environment                              c. Don’t get involved. They made their bed, now they
    b. Ensuring that the client’s diet is high in fiber                             need to lie in it.
    c. Providing the client with quiet periods of reflection                     d. Later, tell the MHC that they were power struggling
    d. Ensuring that the client’s fluid intake is generous                          with the patient.

12. After the client regains consciousness, she says to                      17. A client comes up to you med seeking without a
    the nurse, “I can’t even kill myself.”                                       wristband or photo id. You then…
    a. “These feelings will pass.”                                               a. Believe him and give him his med
    b. “Is that how you’re feeling?”                                             b. Tell him to come back later
    c. “Why would you feel that way?”                                            c. Confirm his identity and then pass the med
    d. “You have a great deal to live for”                                       d. Letter c. and take his picture and provide a
                                                                                    wristband.
13. When evaluating the effectiveness of the client’s
    behavior shows an improvement in her:                                    18. A patient on the Adult unit is getting agitated and
    a. Appetite                                                                  refuses to go to bed. You then…
    b. Self concept                                                              a. Review with him any history of taking prn
    c. Activity level                                                               medication and their effectivenss, before you call
    d. A gender identity conflict                                                   the MD
14. At the time of this patient’s discharge, which must                          b. Hope that he settles down
    be noted by the RN on the discharge form?                                    c. Call the physician
    a. Pt denies suicidal ideation
    b. Parents to dispense all medication and keep
       secured between dosages
    c. Pt able to verbalize safety plan
    d. All of the above



This exam is only one measure utilized to evaluate the effectiveness and best placement for a Psychiatric RN. Innovative Health Care encourages
ongoing education. Also, you are representing Innovative Health Care. Always communicate any concerns you have during your shifts with the Charge
RN or if more appropriate the Nursing Supervisor. We will also schedule supervision with you during business hours.



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                                               1605 W. Wilson Street, Suite 105, Batavia, IL 60510
                                                            630.221.9680 (voice)
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