SIMULATION COURSE (S7) ACTUAL
EXAM PAPER 2026 QUESTIONS WITH
ANSWERS GRADED A+
◍ 1. A community health nurse is planning a substance abuse prevention
program. Whichgroup would be the best target audience for the nurse to
plan a program?A) Teenagers in a high school health classB) School-age
children in an after-school programC) Parents attending a parentñteacher
association meetingD) Elementary school teachers and counselors.
Answer: Ans: BFeedback:Forty-three percent of all Americans have been
exposed to alcoholism in their families.Children of alcoholics are four times
more likely than the general population to developproblems with alcohol.
Many adult people in treatment programs as adults report havinghad their
first drink of alcohol as a young child, when they were younger than age
10.With the increasing rates of use being reported among young people
today, this problemcould spiral out of control unless great strides can be
made through programs forprevention, early detection, and effective
treatment.
◍ 2. Which statements are important reasons for why the problem of substance
abuse mustbe addressed? Select all that apply.A) Increasing numbers of
infants are suffering the physiologic and emotionalconsequences of prenatal
exposure to alcohol or drugs.B) Chemical abuse results in increased
violence.C) Drug abuse costs business and industry an estimated $102
billion annually.D) Alcohol abuse is a too frequent cause of or contributor to
death.E) Substance abuse is decreasing..
Answer: Ans: A, B, C, DFeedback:Increasing numbers of infants are
suffering the physiologic and emotional consequencesof prenatal exposure
to alcohol or drugs. Chemical abuse results in increased violence.Drug
, abuse costs business and industry an estimated $102 billion annually.
Alcoholabuse is a too frequent cause of or contributor to death. Substance
use/abuse and relateddisorders are a national health problem.
◍ A young adult client says to the nurse, "All my friends are married and have
children. I can't seem to meet anyone, and I know I'll never be happy until I
meet someone I can care about enough to marry." Which statement by the
nurse would assist the client in reframing the situation?.
Answer: D "You can't seem to meet someone that you care about? You can
still find enjoyment in friendships, work, books, and other things as well."
Rationale: Focus on the subject, reframing. Recalling that reframing is a
positive response in which the client redefines the situation to view both its
positive and negative sides will direct you to the correct option. Review this
coping behavior if you had difficulty with this question.
◍ A client who has been admitted to a surgical unit with a diagnosis of cancer
is scheduled for surgery in the morning. When the nurse enters the room and
begins the surgical preparation, the client states, "I'm not having surgery —
you must have the wrong person! My test results were negative. I'll be going
home tomorrow." The nurse recognizes that the client is engaging in the
defense mechanism of:.
Answer: A Denial Rationale: Defense mechanisms protect us against
anxiety. Denial is the defense mechanism used to block out painful or
anxiety-inducing events or feelings. In this case, the client cannot deal with
the upcoming cancer surgery and therefore denies that he or she is ill.
Psychosis and delusions are not defense mechanisms. Displacement is
acting out in anger or frustration with people who did not arouse the
feelings.
◍ A client who delivered a baby 4 weeks ago says, "I'm feeling as if I'm
hanging on by a thread to keep my wits about me." Which statement by the
nurse would be therapeutic?.
Answer: C "Can you share with me more specifically how you feel that
you're hanging on by a thread? Are you having thoughts of hurting
, yourself?" Rationale: The correct option is therapeutic because the client is
asked to clarify her feelings.
◍ 3. Which of the following groups could benefit most from prevention
programs?A) Children, prior to first useB) Adults who have already engaged
in substance abuseC) Older adultsD) Infants.
Answer: Ans: AFeedback:Poor outcomes have been associated with an
earlier age at onset and longer periods ofsubstance use. Children who have
not yet used substances may be easily influencedbecause of their age and the
fact that they have not already become addicted. Adultswho have already
engaged in substance abuse will not benefit as greatly fromprevention
programs as will children. Older adults will not benefit as greatly
fromprevention programs as will children. Infants will not benefit from
prevention programsas they do not have self-efficacy.
◍ 4. Which of the following neurochemical influences is a probable cause of
substanceabuse?A) Imbalances of serotonin and norepinephrine in the
brainB) Inhibition of GABA in the brainC) Excessive serotonin activity in
the CNSD) Stimulation of dopamine pathways in the brain.
Answer: Ans: DFeedback:Neurochemical influences on substance use
patterns have been studied primarily inanimal research (Jaffe & Anthony,
2005). The ingestion of mood-altering substancesstimulates dopamine
pathways in the limbic system, which produces pleasant feelings ora ìhighî
that is a reinforcing, or positive, experience.Page 3
◍ A client says to the nurse at the mental health clinic, "My husband and
sister-in-law both have terminal illnesses, and my family thinks that because
I'm a nurse I should be able to handle everything." Which nursing response
would be therapeutic?.
Answer: D "You've seen your loved ones dealing with some troubling
events recently. Sounds as if you feel that your family expects more from
you than from others in the family because you're a nurse." Rationale: The
therapeutic response is the one in which the nurse makes observations and
then clarifies his or her perception of what the client has said.
, ◍ The wife of a client who is dying says to the nurse, "I am able to take off the
6 months from work our doctor feels that my husband will live, but what if
he lives beyond that time?" Which therapeutic response should the nurse
make?.
Answer: C "Are there other options for you in taking work leave? Perhaps
you could simply reduce your work hours at first so that you can extend
your compassionate leave." Rationale: In end-of-life nursing care, the
caregiver is often asked, "How long?" or "What should I do?" by family
members and the dying clients themselves. The nurse can convey
information and make limited but realistic predictions, such as presenting
the client's stable or deteriorating physiological condition. Discussing
options and alternative solutions with the family that can be added to the
process of decision-making can be helpful. Simple alternatives can be used
as examples if the family or client seems unable to begin to problem-solve.
◍ A 56-year-old client says to the nurse, "I'm a guidance counselor at the
middle school, and the kids like to come to see me for help, but I just found
out from my wife that my 22-year-old daughter is a lesbian, and now I'm the
one who needs advice. How am I supposed to accept that? She was the boy
we didn't have, and I made a tomboy of her by taking her to baseball games
with me. Is that why she's gay?" Which statement by the nurse would be
therapeutic?.
Answer: D "It sounds like you and your daughter were very close but she
kept her sexual orientation from you." Rationale: The therapeutic response
is the one that reflects the client's thinking back to the client and makes
observations for the client to organize, reflect on, and validate or discount.
This will help place the information that the client's daughter is a lesbian
into perspective.
◍ The parents of an adopted child schedule an appointment at a psychiatric
clinic, and when they arrive the nurse conducts an initial assessment. One of
the parents says to the nurse, "We need to speak to a psychiatrist about our
adopted daughter. Could you please get one for us?" Which of the following
EXAM PAPER 2026 QUESTIONS WITH
ANSWERS GRADED A+
◍ 1. A community health nurse is planning a substance abuse prevention
program. Whichgroup would be the best target audience for the nurse to
plan a program?A) Teenagers in a high school health classB) School-age
children in an after-school programC) Parents attending a parentñteacher
association meetingD) Elementary school teachers and counselors.
Answer: Ans: BFeedback:Forty-three percent of all Americans have been
exposed to alcoholism in their families.Children of alcoholics are four times
more likely than the general population to developproblems with alcohol.
Many adult people in treatment programs as adults report havinghad their
first drink of alcohol as a young child, when they were younger than age
10.With the increasing rates of use being reported among young people
today, this problemcould spiral out of control unless great strides can be
made through programs forprevention, early detection, and effective
treatment.
◍ 2. Which statements are important reasons for why the problem of substance
abuse mustbe addressed? Select all that apply.A) Increasing numbers of
infants are suffering the physiologic and emotionalconsequences of prenatal
exposure to alcohol or drugs.B) Chemical abuse results in increased
violence.C) Drug abuse costs business and industry an estimated $102
billion annually.D) Alcohol abuse is a too frequent cause of or contributor to
death.E) Substance abuse is decreasing..
Answer: Ans: A, B, C, DFeedback:Increasing numbers of infants are
suffering the physiologic and emotional consequencesof prenatal exposure
to alcohol or drugs. Chemical abuse results in increased violence.Drug
, abuse costs business and industry an estimated $102 billion annually.
Alcoholabuse is a too frequent cause of or contributor to death. Substance
use/abuse and relateddisorders are a national health problem.
◍ A young adult client says to the nurse, "All my friends are married and have
children. I can't seem to meet anyone, and I know I'll never be happy until I
meet someone I can care about enough to marry." Which statement by the
nurse would assist the client in reframing the situation?.
Answer: D "You can't seem to meet someone that you care about? You can
still find enjoyment in friendships, work, books, and other things as well."
Rationale: Focus on the subject, reframing. Recalling that reframing is a
positive response in which the client redefines the situation to view both its
positive and negative sides will direct you to the correct option. Review this
coping behavior if you had difficulty with this question.
◍ A client who has been admitted to a surgical unit with a diagnosis of cancer
is scheduled for surgery in the morning. When the nurse enters the room and
begins the surgical preparation, the client states, "I'm not having surgery —
you must have the wrong person! My test results were negative. I'll be going
home tomorrow." The nurse recognizes that the client is engaging in the
defense mechanism of:.
Answer: A Denial Rationale: Defense mechanisms protect us against
anxiety. Denial is the defense mechanism used to block out painful or
anxiety-inducing events or feelings. In this case, the client cannot deal with
the upcoming cancer surgery and therefore denies that he or she is ill.
Psychosis and delusions are not defense mechanisms. Displacement is
acting out in anger or frustration with people who did not arouse the
feelings.
◍ A client who delivered a baby 4 weeks ago says, "I'm feeling as if I'm
hanging on by a thread to keep my wits about me." Which statement by the
nurse would be therapeutic?.
Answer: C "Can you share with me more specifically how you feel that
you're hanging on by a thread? Are you having thoughts of hurting
, yourself?" Rationale: The correct option is therapeutic because the client is
asked to clarify her feelings.
◍ 3. Which of the following groups could benefit most from prevention
programs?A) Children, prior to first useB) Adults who have already engaged
in substance abuseC) Older adultsD) Infants.
Answer: Ans: AFeedback:Poor outcomes have been associated with an
earlier age at onset and longer periods ofsubstance use. Children who have
not yet used substances may be easily influencedbecause of their age and the
fact that they have not already become addicted. Adultswho have already
engaged in substance abuse will not benefit as greatly fromprevention
programs as will children. Older adults will not benefit as greatly
fromprevention programs as will children. Infants will not benefit from
prevention programsas they do not have self-efficacy.
◍ 4. Which of the following neurochemical influences is a probable cause of
substanceabuse?A) Imbalances of serotonin and norepinephrine in the
brainB) Inhibition of GABA in the brainC) Excessive serotonin activity in
the CNSD) Stimulation of dopamine pathways in the brain.
Answer: Ans: DFeedback:Neurochemical influences on substance use
patterns have been studied primarily inanimal research (Jaffe & Anthony,
2005). The ingestion of mood-altering substancesstimulates dopamine
pathways in the limbic system, which produces pleasant feelings ora ìhighî
that is a reinforcing, or positive, experience.Page 3
◍ A client says to the nurse at the mental health clinic, "My husband and
sister-in-law both have terminal illnesses, and my family thinks that because
I'm a nurse I should be able to handle everything." Which nursing response
would be therapeutic?.
Answer: D "You've seen your loved ones dealing with some troubling
events recently. Sounds as if you feel that your family expects more from
you than from others in the family because you're a nurse." Rationale: The
therapeutic response is the one in which the nurse makes observations and
then clarifies his or her perception of what the client has said.
, ◍ The wife of a client who is dying says to the nurse, "I am able to take off the
6 months from work our doctor feels that my husband will live, but what if
he lives beyond that time?" Which therapeutic response should the nurse
make?.
Answer: C "Are there other options for you in taking work leave? Perhaps
you could simply reduce your work hours at first so that you can extend
your compassionate leave." Rationale: In end-of-life nursing care, the
caregiver is often asked, "How long?" or "What should I do?" by family
members and the dying clients themselves. The nurse can convey
information and make limited but realistic predictions, such as presenting
the client's stable or deteriorating physiological condition. Discussing
options and alternative solutions with the family that can be added to the
process of decision-making can be helpful. Simple alternatives can be used
as examples if the family or client seems unable to begin to problem-solve.
◍ A 56-year-old client says to the nurse, "I'm a guidance counselor at the
middle school, and the kids like to come to see me for help, but I just found
out from my wife that my 22-year-old daughter is a lesbian, and now I'm the
one who needs advice. How am I supposed to accept that? She was the boy
we didn't have, and I made a tomboy of her by taking her to baseball games
with me. Is that why she's gay?" Which statement by the nurse would be
therapeutic?.
Answer: D "It sounds like you and your daughter were very close but she
kept her sexual orientation from you." Rationale: The therapeutic response
is the one that reflects the client's thinking back to the client and makes
observations for the client to organize, reflect on, and validate or discount.
This will help place the information that the client's daughter is a lesbian
into perspective.
◍ The parents of an adopted child schedule an appointment at a psychiatric
clinic, and when they arrive the nurse conducts an initial assessment. One of
the parents says to the nurse, "We need to speak to a psychiatrist about our
adopted daughter. Could you please get one for us?" Which of the following
