PRELIM EXAMINATION

NCM117 PSYCHIATRIC NURSING

DURING THE PROGRESS OF THE EXAMINATION: Talking, conversing with each other, using cell phone, making signs
or other unnecessary movements are strictly prohibited.
I. MULTIPLE CHOICE. Write the correct answer beside the number. In capital letter please.

DIRECTION: Choose the best answer for each given question

1. Which neurotransmitter is primarily associated with the regulation of mood, sleep, and appetite?
A) Dopamine B) Serotonin C) Norepinephrine D) Acetylcholine
Answer: B) Serotonin

2. Excessive dopamine activity is implicated in which psychiatric disorder?

A) Schizophrenia B) Bipolar disorder C) Generalized anxiety disorder D) Obsessive-compulsive disorder
Answer: A) Schizophrenia

3. Decreased levels of which neurotransmitter are associated with Parkinson's disease?

A) Acetylcholine B) Serotonin C) Dopamine D) Norepinephrine
Answer: C) Dopamine

4. Imbalances in which neurotransmitter are associated with symptoms of depression?

A) Dopamine B) Serotonin C) Norepinephrine D) Glutamate
Answer: B) Serotonin

5. A Brain Imaging technology that has serial x-rays of brain, it gets the structural images and its duration is 20-40
minutes.
A) CT-Scan B) MRI C) PET D) SPECT
Answer: A) CT-Scan

6. A Brain Imaging technology that has Radio waves from brain detected from magnet, it gets the structural images and its
duration is 45 minutes.
A) CT-Scan B) MRI C) PET D) SPECT
Answer: B) MRI

7. A Brain Imaging technology that has Radioactive tracer injected into bloodstream
and monitored as client performs activities it gets the functional images and its 2-3 hours duration.
A) CT-Scan B) MRI C) PET D) SPECT
Answer: C) PET

8. A Brain Imaging technology that has Radioactive tracer injected into bloodstream
and monitored as client performs activities it gets the functional images and its 1-2 hours duration.
A) CT-Scan B) MRI C) PET D) SPECT
Answer: D) SPECT

9. What does self-awareness mean in the context of psychiatric nursing?

A) Knowing everything about one's personal life B) Understanding one's own thoughts, feelings, and reactions
C) Having complete knowledge of psychiatric disorders D) Being aware of others' thoughts and emotions
Answer: B)

10. Why is self-awareness important for psychiatric nurses?

A) It helps nurses avoid interacting with patients. B) It enhances therapeutic communication and relationship-building. C)
It allows nurses to control patients' behaviors. D) It enables nurses to impose their beliefs on patients.
Answer: B)

11. Which of the following statements best describes the relationship between self-awareness and empathy in psychiatric
nursing?
A) Self-awareness hinders the development of empathy. B) Self-awareness and empathy are unrelated concepts.
C) Self-awareness enhances the development of empathy. D) Self-awareness replaces the need for empathy.
Answer: C)

12. How can a psychiatric nurse improve self-awareness?

A) By ignoring personal biases and beliefs B) By avoiding reflective practices
C) By seeking feedback from colleagues and patients D) By focusing solely on patients' experiences
Answer: C)

13. Which of the following is an example of practicing self-awareness in psychiatric nursing?

A) Assuming all patients with depression have the same experiences
B) Recognizing one's own biases and stereotypes about mental illness
C) Avoiding introspection and self-reflection
D) Imposing personal values and beliefs on patients
Answer: B

14. How does self-awareness contribute to the therapeutic relationship between a psychiatric nurse and a patient?
A) It creates a power imbalance in favor of the nurse. B) It fosters mutual respect and trust.
C) It increases resistance and defensiveness in the patient. D) It promotes dependency on the nurse.
Answer: B)

15. Which of the following best describes the concept of mindfulness in psychiatric nursing?
A) Being fully present and engaged in the moment without judgment
B) Ignoring patients' emotions and experiences
C) Focusing solely on medical interventions
D) Disregarding personal biases and beliefs
Answer: A)

16. How does self-awareness contribute to the ongoing professional development of psychiatric nurses?
A) It prevents nurses from seeking feedback and learning opportunities.
B) It fosters a closed-minded attitude towards new ideas and perspectives.
C) It encourages reflection, self-assessment, and continuous learning.
D) It leads to complacency and stagnation in nursing practice.
Answer: C

17. How does self-awareness influence the therapeutic milieu in a psychiatric setting?
A) It disrupts the therapeutic environment by creating tension between staff members.
B) It fosters a supportive and empathetic atmosphere conducive to healing.
C) It leads to a competitive atmosphere among staff members.
D) It encourages a hierarchical structure where patients feel inferior.
Answer: B)

18. Which of the following is a potential consequence of a lack of self-awareness in psychiatric nursing?
A) Enhanced therapeutic communication
B) Improved patient outcomes
C) Unintentional reinforcement of stigmatizing beliefs about mental illness
D) Strengthened therapeutic relationships
Answer: C)

19. What role does self-awareness play in managing personal biases in psychiatric nursing?
A) It reinforces biases and stereotypes. x B) It prevents the recognition of biases.
C) It enables the recognition and mitigation of biases. D) It encourages the imposition of biases onto patients.
Answer: C)

20. How can self-awareness contribute to reducing burnout among psychiatric nurses?
A) By increasing workloads and responsibilities
B) By promoting self-care practices and boundary setting
C) By discouraging supportive relationships with colleagues
D) By ignoring signs of stress and exhaustion
Answer: B)

21. Which of the following is an example of self-awareness in action during a therapeutic interaction with a patient?
A) Ignoring the patient's emotions and experiences
B) Making assumptions about the patient's background without exploration
C) Reflecting on one's own emotional reactions to the patient's behavior
D) Imposing personal beliefs and values onto the patient
Answer: C)

22. What is efficacy in pharmacology?

A) The strength of the drug's effect B) The maximum response a drug can produce
C) The dose required to produce a response D) The duration of action of the drug
Answer: B)

23. Potency in pharmacology refers to:

A) The strength of the drug's effect B) The maximum response a drug can produce
C) The dose required to produce a response D) The duration of action of the drug
Answer: C)

24. Drug A has a higher efficacy than Drug B, what can be inferred?
A) Drug A is more toxic than Drug B. B) Drug A has a greater therapeutic effect than Drug B.
C) Drug A has a lower binding affinity than Drug B. D) Drug A has a longer duration of action than Drug B.
Answer: B

25. Which of the following statements about potency is true?

A) Potency is directly related to efficacy. B) Potency indicates the strength of the drug's effect.
C) Drugs with higher potency always have higher efficacy. D) Potency is determined by the drug's duration of action.
Answer: B)
26. Which of the following drugs is most likely to have a longer duration of action?
A) Drug with low potency and high efficacy B) Drug with high potency and low efficacy
C) Drug with high potency and high efficacy D) Drug with low potency and low efficacy
Answer: C)

27. Which of the following statements best describes the relationship between potency and therapeutic index?
A) Potency and therapeutic index are unrelated concepts.
B) Drugs with higher potency always have a narrower therapeutic index.
C) Drugs with lower potency tend to have a wider therapeutic index.
D) Potency and therapeutic index are synonymous terms.
Answer: C)

28. Which of the following drugs is most likely to have a faster onset of action?
A) Drug with high potency and low efficacy B) Drug with low potency and high efficacy
C) Drug with low potency and low efficacy D) Drug with high potency and high efficacy
Answer: D)

29. If two drugs have similar efficacy but different potencies, what can be concluded?
A) The drug with higher potency will always have higher efficacy.
B) The drugs will have identical therapeutic effects.
C) The drug with lower potency will have higher efficacy.
D) The drugs may have different therapeutic effects at equivalent doses.
Answer: D)

30. Which of the following is not a common extrapyramidal side effect of antipsychotic medications?
A) Akathisia B) Dystonia C) Hypertension D) Parkinsonism
Answer: C) Hypertension

31. Dystonia is characterized by:

A) Involuntary rhythmic movements B) Abnormal muscle tone or spasm
C) Restlessness and pacing D) Bradykinesia and tremors
Answer: B)

32. Which of the following is a treatment option for akathisia, a common extrapyramidal side effect?
A) Increasing the dose of antipsychotic medication
B) Administering an anticholinergic medication
C) Decreasing the dose of antipsychotic medication
D) Prescribing a benzodiazepine
Answer: D)

33. Parkinsonism, a common EPS, is characterized by:

A) Abnormal muscle tone or spasms B) Restlessness and pacing
C) Tremors, bradykinesia, and rigidity D) Involuntary rhythmic movements
Answer: C)

34. Tardive dyskinesia (TD), a late-onset EPS, is characterized by:

A) Sudden, jerky movements of the face and body B) Restlessness and pacing
C) Tremors, bradykinesia, and rigidity D) Dystonic reactions and muscle spasms
Answer: A)

35. Which neurotransmitter imbalance is primarily implicated in the development of extrapyramidal side effects?
A) Dopamine excess B) Serotonin deficiency
C) Acetylcholine excess D) GABA deficiency
Answer: A)

36. Which of the following medications is commonly used to prevent extrapyramidal side effects in patients taking
antipsychotic drugs?
A) Benzodiazepines B) Antihypertensives C) Anticholinergic agents
D) Selective serotonin reuptake inhibitors (SSRIs)
Answer: C)

37. A patient develops sudden-onset muscle spasms and twisting movements of the neck and back shortly after receiving
an antipsychotic injection. This is most likely indicative of:
A) Tardive dyskinesia B) Akathisia C) Dystonia D) Parkinsonism
Answer: C)

38. Which of the following EPS can be a life-threatening emergency due to involvement of the muscles of respiration and
swallowing?
A) Akathisia B) Dystonia C) Parkinsonism D) Neuroleptic malignant syndrome (NMS)
Answer: D)

39. Which of the following statements regarding EPS is true?

A) EPS are always reversible upon discontinuation of antipsychotic medication.
B) EPS are primarily caused by serotonin receptor blockade.
C) EPS are not commonly seen in patients taking antipsychotic medications.
D) EPS can occur with both typical and atypical antipsychotics.
Answer: D)

40. Which of the following is not a characteristic of akathisia?

A) Restlessness B) Involuntary movements C) Pacing D) Feeling of inner tension or unease
Answer: B)

41. Which of the following is considered a first-line treatment for acute dystonic reactions?
A) Anticholinergic medication B) Benzodiazepine C) Beta-blocker
D) Selective serotonin reuptake inhibitor (SSRI)
Answer: A)

42. Which of the following EPS is characterized by a subjective feeling of restlessness and an urge to move?
A) Tardive dyskinesia B) Dystonia C) Akathisia D) Parkinsonism
Answer: C)

43. What distinguishes tardive dyskinesia (TD) from other extrapyramidal side effects (EPS)?
A) It presents immediately after starting antipsychotic medication.
B) It is characterized by sudden, involuntary muscle spasms.
C) It typically occurs in the early stages of treatment.
D) It develops after prolonged use of antipsychotic medication.
Answer: D)

44. Which EPS is most commonly associated with the use of typical antipsychotic medications?
A) Akathisia B) Tardive dyskinesia C) Parkinsonism D) Dystonia
Answer: B)

45. What is the first step in managing a patient experiencing extrapyramidal side effects (EPS)?
A) Discontinuing the antipsychotic medication B) Administering an anticholinergic medication
C) Assessing the severity and type of EPS D) Ordering laboratory tests
Answer: C)

46. Which of the following symptoms is not associated with Parkinsonism, an EPS?
A) Tremors B) Bradykinesia C) Akathisia D) Rigidity
Answer: C) Akathisia

47. Which antipsychotic medication is less likely to cause extrapyramidal side effects (EPS) compared to typical
antipsychotics?
A) Haloperidol B) Risperidone C) Chlorpromazine D) Fluphenazine
Answer: B)

48. Which of the following is a risk factor for developing tardive dyskinesia (TD)?
A) Short-term use of antipsychotic medication B) Younger age C) Female gender
D) Older age and prolonged use of antipsychotic medication
Answer: D)

49. Which EPS is characterized by sudden-onset, painful muscle spasms, particularly affecting the neck and jaw?
A) Parkinsonism B) Akathisia C) Dystonia D) Tardive dyskinesia
Answer: C)

50. Acute dystonia is characterized by:

A) Sudden onset of involuntary muscle contractions B) Restlessness and pacing
C) Tremors and rigidity D) Jerky movements of the face and body
Answer: A

51. Torticollis refers to:

A) Involuntary rolling movements of the eyes B) Involuntary twisting or tilting of the neck
C) Involuntary arching of the back D) Involuntary jerking movements of the limbs
Answer: B)

52. Opisthotonus is characterized by:

A) Involuntary rolling movements of the eyes B) Involuntary arching of the back
C) Involuntary twisting or tilting of the neck D) Involuntary jerking movements of the limbs
Answer: B)

53. Oculogyric crisis involves:

A) Involuntary rolling movements of the eyes B) Involuntary twisting or tilting of the neck
C) Involuntary arching of the back D) Involuntary jerking movements of the limbs
Answer: A)

54. Acute dystonia is most commonly associated with the use of:
A) Benzodiazepines B) Selective serotonin reuptake inhibitors (SSRIs)
C) Antipsychotic medications D) Anticonvulsants
Answer: C)
55. Which of the following factors increases the risk of developing acute dystonia?
A) Younger age B) Female gender C) Older age D) Higher doses of antipsychotic medication
Answer: D)

56. Which of the following interventions is appropriate for managing acute dystonia?
A) Increasing the dose of antipsychotic medication B) Administering an anticholinergic medication
C) Prescribing a benzodiazepine D) Discontinuing antipsychotic medication abruptly
Answer: B)

57. A patient presents with involuntary twisting movements of the neck shortly after starting a new antipsychotic
medication. This is most likely indicative of:
A) Akathisia B) Dystonia C) Parkinsonism D) Tardive dyskinesia
Answer: B)

58. What distinguishes opisthotonus from other forms of acute dystonia?

A) Involuntary rolling movements of the eyes B) Involuntary twisting or tilting of the neck
C) Involuntary arching of the back D) Involuntary jerking movements of the limbs
Answer: C)

59. Which of the following symptoms is not associated with acute dystonia?
A) Involuntary jerking movements of the limbs B) Involuntary twisting of the neck
C) Sustained muscle contractions D) Involuntary rolling movements of the eyes
Answer: A)

60. Which neurotransmitter imbalance is primarily implicated in the development of acute dystonia?
A) Dopamine excess B) Serotonin deficiency C) Acetylcholine excess D) GABA deficiency
Answer: C)

61. Which of the following interventions is contraindicated in the management of acute dystonia?
A) Administering an anticholinergic medication B) Applying heat to affected muscles
C) Discontinuing the antipsychotic medication D) Prescribing a benzodiazepine
Answer: B)

62. Which of the following conditions is characterized by sudden involuntary muscle contractions and abnormal postures,
typically involving the neck, face, or tongue?
A) Akathisia B) Dystonia C) Parkinsonism D) Tardive dyskinesia
Answer: B

63. Pseudoparkinsonism is a medication-induced condition characterized by:

A) Excessive muscle rigidity B) Involuntary tremors at rest
C) Bradykinesia and cogwheel rigidity D) Rapid, jerky movements of the limbs
Answer: C) Bradykinesia and cogwheel rigidity

62. Which of the following medications is most commonly associated with the development of pseudoparkinsonism?
A) Benzodiazepines B) Selective serotonin reuptake inhibitors (SSRIs)
C) Antipsychotic medications D) Anticonvulsants
Answer: C)

63. The pathophysiology of pseudoparkinsonism involves:

A) Dopamine excess in the basal ganglia B) Serotonin deficiency in the substantia nigra
C) Acetylcholine excess in the motor cortex D) Dopamine blockade in the nigrostriatal pathway
Answer: D

64. Which of the following symptoms is not typically associated with pseudoparkinsonism?
A) Bradykinesia B) Cogwheel rigidity C) Resting tremor D) Choreiform movements
Answer: D)

65. Pseudoparkinsonism is most likely to occur with which class of antipsychotic medications?
A) First-generation (typical) antipsychotics B) Second-generation (atypical) antipsychotics
C) Tricyclic antidepressants D) Monoamine oxidase inhibitors (MAOIs)
Answer: A)

66. he onset of pseudoparkinsonism typically occurs:

A) Immediately after starting antipsychotic medication B) Within a few hours of starting antipsychotic medication
C) Within days to weeks of starting antipsychotic medication D) After prolonged use of antipsychotic medication
Answer: C)

67. What is akathisia?

A) A skin condition B) A neurological disorder C) A movement disorder D) A psychiatric illness
Answer: C)

68. Which of the following medications is commonly associated with akathisia?

A) Antidepressants B) Antibiotics C) Antihistamines D) Antipsychotics
Answer: D) Antipsychotics

69. Which of the following is a common symptom of akathisia?

A) Tremors B) Excessive sweating C) Restlessness D) Slurred speech
Answer: C) Restlessness

70. Akathisia is most commonly associated with which class of psychiatric medications?
A) Benzodiazepines B) Antidepressants C) Antipsychotics D) Mood stabilizers
Answer: C)

71. How is akathisia typically managed?

A) Increasing the dosage of the causative medication B) Discontinuing the causative medication
C) Prescribing benzodiazepines D) Administering antihistamines
Answer: B)

72. Which of the following activities may exacerbate symptoms of akathisia?

A) Walking B) Sitting still C) Deep breathing exercises D) Watching television
Answer: B)

73. Akathisia can be differentiated from restless leg syndrome by:

A) Symptoms occurring primarily at night B) Symptoms being relieved by movement
C) Symptoms associated with specific medications D) Symptoms being present only during periods of stress
Answer: C)

74. Which of the following psychiatric conditions is commonly associated with akathisia as a side effect of treatment?
A) Schizophrenia B) Bipolar disorder C) Major depressive disorder D) Generalized anxiety disorder
Answer: A)

75. Akathisia can lead to an increased risk of:

A) Falls B) Hypertension C) Hypothermia D) Respiratory depression
Answer: A) Falls

76. Which of the following is a subjective experience reported by individuals with akathisia?
A) Muscle weakness B) Rapid heartbeat C) Crawling sensations in the legs D) Difficulty swallowing
Answer: C)

77. Akathisia is thought to result from alterations in which neurotransmitter system?

A) Dopamine B) Serotonin C) Acetylcholine D) GABA
Answer: A)

78. Which of the following statements regarding akathisia is true?

A) It is always a permanent condition B) It typically develops gradually over several months
C) It can occur as an acute or chronic condition D) It is more common in children than in adults
Answer: C)

79. Which of the following types of akathisia is characterized by sudden and intense episodes of restlessness?
A) Acute akathisia B) Tardive akathisia C) Chronic akathisia D) Neuroleptic-induced akathisia
Answer: A)

80. Akathisia is most commonly associated with which class of antipsychotic medications?
A) First-generation (typical) antipsychotics B) Second-generation (atypical) antipsychotics
C) Tricyclic antidepressants D) Selective serotonin reuptake inhibitors (SSRIs)
Answer: A

81. Which of the following interventions is NOT typically recommended for managing akathisia?
A) Benzodiazepines B) Anticholinergic medications C) Increasing the dose of the causative medication
D) Beta-blockers
Answer: C)

82. Which of the following factors may increase the risk of developing akathisia?
A) Older age
B) Female gender
C) Low body mass index (BMI)
D) History of substance abuse
Answer: A)

83. Akathisia can lead to nonadherence to medication treatment due to:

A) Improved sleep quality B) Reduced anxiety C) Discomfort and agitation D) Increased appetite
Answer: C)

84. Which of the following medications is commonly used to treat acute dystonia, a type of extrapyramidal side effect?
A) Diphenhydramine B) Propranolol C) Haloperidol D) Fluoxetine
Answer: A)
85. Which class of medications is commonly used to prevent and treat drug-induced parkinsonism?
A) Antidepressants B) Antipsychotics C) Antihistamines D) Anticholinergics
Answer: D)

86. Which medication is commonly used to manage akathisia, a distressing extrapyramidal side effect?
A) Lorazepam B) Olanzapine C) Quetiapine D) Haloperidol
Answer: A)

87. Which of the following medications is NOT commonly used to treat tardive dyskinesia?
A) Valbenazine B) Clozapine C) Tetrabenazine D) Risperidone
Answer: D)

88. Which medication is specifically FDA-approved for the treatment of tardive dyskinesia?
A) Haloperidol B) Clozapine C) Valbenazine D) Quetiapine
Answer: C

89. Which of the following medications is NOT an anticholinergic commonly used to manage extrapyramidal side effects?
A) Benztropine B) Diphenhydramine C) Trihexyphenidyl D) Olanzapine
Answer: D)

90. What is the mechanism of action of anticholinergic medications in managing extrapyramidal side effects?
A) Blocking dopamine receptors B) Increasing dopamine release
C) Blocking acetylcholine receptors D) Increasing acetylcholine synthesis
Answer: C)

91. Which medication is commonly used to treat both akathisia and acute dystonia?
A) Benztropine B) Lorazepam C) Valbenazine D) Clozapine
Answer: A)

92. Which of the following medications is a selective serotonin reuptake inhibitor (SSRI) that may be used to manage
tardive dyskinesia?
A) Fluoxetine B) Risperidone C) Quetiapine D) Haloperidol
Answer: A)

93. Which medication is a vesicular monoamine transporter 2 (VMAT2) inhibitor commonly used to treat tardive
dyskinesia?
A) Clozapine B) Risperidone C) Valbenazine D) Olanzapine
Answer: C

94. Which of the following medications is commonly used as a prophylactic treatment for drug-induced parkinsonism?
A) Olanzapine B) Haloperidol C) Benztropine D) Clozapine
Answer: C)

95. Which medication may exacerbate extrapyramidal side effects and should be avoided in individuals prone to such
reactions?
A) Diazepam B) Lorazepam C) Risperidone D) Haloperidol
Answer: D

96. Which of the following medications is NOT commonly used to manage akathisia?
A) Benztropine B) Lorazepam C) Olanzapine D) Propranolol
Answer: C)

97. Which medication is commonly used to manage neuroleptic-induced akathisia?

A) Haloperidol B) Benztropine C) Propranolol D) Lorazepam
Answer: D)

98. Which medication is commonly used to manage drug-induced parkinsonism in elderly patients?
A) Risperidone B) Benztropine C) Quetiapine D) Olanzapine
Answer: B

99. Which of the following medications is commonly used to manage acute dystonic reactions in emergency settings?
A) Clozapine B) Diphenhydramine C) Olanzapine D) Quetiapine
Answer: B)

100. hich of the following medications is NOT commonly used to treat tardive dyskinesia?
A) Tetrabenazine B) Amantadine C) Olanzapine D) Valbenazine
Answer: C) Olanzapine