Q.1. An example of an antidepressant drug is:
a) Chlorpromazine
b) Haloperidol
c) Diazepam
d) Imipramine
Q.2 When caring for a client receiving chlorpromazine, the nurse would assess for which of the following?
a) Extrapyramidal symptoms
b) Hypersalivation
c) Oversedation
d) Hypertensive episodes.
Q.3 The predominant mechanism of action of anxiolytics is:
a. Dopamine receptor antagonist
b. GABA receptor agonist
c. Inhibition of re-uptake of nor-adrenaline or serotonin or both
d. Inhibition of brain mono-amine oxidase (MAO).
Q.4 What patient behavior would prompt the nurse to ask deeper question during mental health assessment?
a) Can verbalize emotions
b) Is always happy and smiling
c) Is able to cope with bad news
d) Maintain some close, personal relationships
Q.5 Which of the following client behaviour indicate to the nurse that the relationship with the client is in the working phase?
a) The client attempts to familiarise himself with the nurse
b) The client makes an effort to describe his problems in detail
c) The client tries to summarise his progress in the relationship
d) The client tries to challenge the boundaries or outer limits of the relationship
Q.6 A crisis can BEST be defined as:
a) an imbalance of life
b) a threat to homeostasis
c) the perception of the problem by the client
d) a situation requiring help other than personal resources
Q.7 Lithium carbonate therapy is an appropriate treatment for
a) Hypothyroidism
b) Mania
c) Dementia
d) Depression
Q.8 The most appropriate approach when providing therapeutic milieu for clients is:
a) Using psychotropic drugs primarily
b) Fostering dependent client behaviour
c) Accepting behaviour as meaningful and motivated
d) Meeting ones own needs while helping clients meet their needs
Q9. The correct sequence of the body’s response to stress according to Dr. Hans Selye is:
a) Resistance stage, alarm stage, exhaustion stage
b) Exhaustion stage, alarm stage, resistance stage
c) Alarm stage, exhaustion stage, resistance stage
d) Alarm stage, resistance stage, exhaustion stage
10. For question 10, match the terms in column A with statements in column B by indicating the correct number in the answer sheet provided.
COLUMN A COLUMN B
a) Waxy flexibility 1. A state of extreme psychomotor agitation
b) Flat affect 2.Voluntary assumption of bizarre positions
3 3 Emotional tone incongruent with the circumstances
4. Being void of emotional tone, a feeling or response
Q.11 The central concept in Gestalt therapy is:
a) Awareness
b) Self-fulfillment
c) Self-control
d) Desensitization
Q 12 The techniques used in behavior modification:
a) Are capable to a very limited rang of psychological problems
b) Employ the principal of learning
c) Stress interpersonal interactions
d) All involve some sort of operant conditioning
Q 13 Client-centered therapy is most consistent with the:
a) Behavioral approach
b) Cognitive approach
c) Psychodynamic approach
d) Humanistic approach
Q.14 Primary difference between nursing model of psychiatric care and the psychosocial, behavioral and medical models is?
a) Centre on health instead of illness.
b) Incorporate a holistic view of the person.
c) Focus on the person as an individual.
d) Have a psychosocial not psychobiologic perspective.
Q.15 The prototype of the modern intelligence test for children was first developed by:
a) Stanford
b) Binet
c) Terman
e) None of these
Q.16 Psychoneurosis tends to be:
a) About the same severity as the psychoses
b) Milder than neuroses
c) Milder than psychoses
d) Severe than the psychoses
Q.17 Developmental psychologists believe that two factors that influence human development are:
a) Self and others
b) Genetic make-up and experience
c) Rewards and punishments
d) Motivation and emotion
Q.18 Freud was among the first to suggest that abnormal behavior:
a) Can have a hereditary basis
b) Is not the result of demonic possession?
c) Is psychology caused?
d) Can result from biological factors
Q.19 The cause of abnormal behavior is only physiological, it is explained by:
a) Psycho model
b) Medical model
c) Psychosocial model
d) None of these
Q.20 Addictive disorders include:
a) Sociopathalogy
b) Overeating
c) Alcoholism and drug addiction
d) All the above
Section B: Short Answer Questions (40 Marks).
1) Explain five (5) feature of psychotherapy (5 marks).
2) Outline five (5) techniques used during behaviour therapy in a systematic form (5 marks).
3) Explain five (5) roles of a nurse during mental health examination (MSE) (5 marks)
4) Define the following terms: (5 marks).
i. Dystonia
ii. Oculogyric crisis
iii. Torticolic
iv. Akathesia
v. Akinesia
5) Describe four (4) interneconnected components of self-awareness theories
that were identified by Campbell (1980). (5 marks).
6) Explain four (4) disorders of memory (4 marks).
7) Describe the concept of mental health and mental illness concept,
giving relevant examples ( 4 marks).
8) Identify four (5) indication of involuntary admission according to Mental
Health Act of Kenya (5marks).
9) Name two neurodegenerative disorder of the elderly person. (2 marks).
Section C: Long Answer Questions (40 Marks).
Question 1.
Discuss four stages of historical development of mentally and psychiatric nursing in the world
(20 marks).
Question 2.
One of the role of the nursing in psychiatry unit is to assess and interview patient prior to admissions. Identify and discus ten guidelines used in conducting interview. (20 marks)
Marking key
1. D 6.A 11.A 16.D
2. A 7.B 12.C 17.D
3. C 8.C 13.D 18.C
4. B 9.D 14.C 19.B
5. C 10. (A-2 and B-4) 15.B 20.B
1. Explain five (5) feature of psychotherapy (5 marks).
Perception
Thinking
Speech
Motor activity
Memory
Orientation
Consciousness
Cognitive (Intellectual functioning)
Mood affect
Insight
Judgment
2. Outline five (5) techniques used during behaviour therapy in a systematic form (5 marks).
Systematic desensitization
Exposure
Flooding
Aversion
Modelling
Biofeedback
3. Explain five (5) roles of a nurse during mental health examination (MSE) (5 marks)
Explain nature of procedure to client
Offer comfort and assurance and reassurance
Keenly use common sense to note nonverbal communication.
Prevent distractors
Use a guided/prepared blank page document to fill in information
4. Define the following terms: (5 marks).
i) Dystonia; muscle spasm- painful & may lead to contortions.
ii) Oculogyric crisis: presenting as fixed upward gaze from spasm of oculomotor muscles.
iii) Torticolic that is, pulling of the head to the side from the spasms of the cervical muscles
iv) Akathesia; continuous motor restlessness.
v) Akinesia; lack of body movement especially the arms.
5. Describe four (4) interconnected components of self-awareness theories that were identified by Campbell (1980). (5 marks).
The psychological component includes knowledge of emotions, motivation. Being psychological self-aware means being sensitive to feeling and outside events that affect those feelings.
The physical component is the knowledge of personal and general physiology, as well as bodily sensations, body image, and physical potential.
The environmental component consists of the sociocultural environment, relationships with others, and knowledge of the relationship between humans and nature.
The philosophical component is the sense of life having. A personal philosophy of life and having meaning. A personal philosophy of life may or may not have spiritual being, but it does take into consideration the responsibility to the world and ethics of behavior
6. Explain four (4) disorders of memory (4 marks).
Anterograde amnesia. Loss of memory for occurring for events taking place after the incident causing amnesia, occur after a period of unconsciousness impairment of memory for events between end complete unconsciousness and the restoration of consciousness.
Retrograde amnesia. Loss of memory for the events that occurred before the precipitating incident or loss of memory before the onset of unconsciousness e.g. after ETC or head injury memory
Confabulation; unconscious invention of experience to cover gaps in memory to recent events. Gaps in patient memory filled with fabrication of the patient which he/she nevertheless accepts has facts.
Jamais vu- failure to recognize events that have been encountered before.
Dejavu- recognition of events as familiar when they have never been encountered.
Amnesic syndrome. Differentiate impairment where memory of the recent events is most affected and semantic memory.
7. Describe the concept of mental health and mental illness concept, giving relevant examples ( 4 marks).
Mental health. .It is a state of well-being associated with happiness, contentment, satisfactory, achievement, optimism or hope among other good things in life
Mental health consist of a number of criteria which forms the basis of the optimum of mental health. They are not absolute since each person has limits. Normal, not many people reaches the ideal in this criterion which includes: Healthy conformist and unhealthy conformist. Healthy deviant and unhealthy deviant. Whereas, mental illness is the inability of an individual to perform the norms duties or live with others people well within his/her environment due to impairment of judgment, memory and a change of behavior
8. Identify four (5) indication of emergency admission according to Mental Health Act of Kenya (5marks).
Any person whom he/she believes to be suffering from mental disorder and is more likely to herm him/her self
Any person believes is dangerous to himself or to others, or who, because of the mental disorder acts or is likely to act in a manner offensive to public decency;
Any mental person who as refused to take medications and is harmful to other
Any person whom he believes to be suffering from mental disorder and is not under proper care and control, or is being cruelly treated or neglected by any relative or other person having charge of him.
Anny Kenyan with mental ailment and is found to our of the country needs to be brought back and admitted
9. Name two neurodegenerative disorder of the elderly person. (2 marks).
Delirium
Dementia
Section C: Long Answer Questions (40 Marks).
Question 1.
Discuss four stages of historical development of mentally and psychiatric nursing in the world
(20 marks).
1. Demonological
2. Political
3. Humanistic
4. Scientific
Question 2.
One of the role of the nursing in psychiatry unit is to assess and interview patient prior to admissions. Identify and discus ten guidelines used in conducting interview. (20 marks)
Provide privacy and confidentiality.
Offer assurance
Show interest in patient’s conditions
Avoid technical judgment
Avoid technical questions.
Maintain eye contact
Seek further clarifications to avoid misjudgment.
Allow patient to complete their answers without interference.
Responds to patients concerns.
Allow patients to answers ask questions at the end of interview
Arrange/ allocate TCA.
