PERSONALITY AND MOOD
DISORDERS NCLEX PRACTICE QUIZ:
110 QUESTIONS
Question
The nursing diagnosis that would be most appropriate for a 22-
year old client who uses ritualistic behavior would be:
o A. Ineffective coping
o B. Impaired adjustment
o C. Personal identity disturbance
o D. Sensory/perceptual alterations
Correct Answer: A. Ineffective coping
Ineffective coping is the impairment of a person’s adaptive
behaviors and problem-solving abilities in meeting life’s
demands; ritualistic behavior fits under this category as a
defining characteristic. During the beginning of treatment, allow
plenty of time for rituals. Do not be judgmental or verbalize
disapproval of the behavior. To deny the client this activity can
precipitate panic level of anxiety.
Option B: Gradually limit the amount of time allotted
for ritualistic behavior as the client becomes more
involved in unit activities. Anxiety is minimized when
the client is able to replace ritualistic behaviors with
more adaptive ones. Encourage independence and
give positive reinforcement for independent behaviors.
Positive reinforcement enhances self-esteem and
encourages repetition of desired behaviors.
Option C: Personal identity disturbance is not a
priority diagnosis for the client. Assess client’s level of
anxiety. Investigate the types of situations that
increase anxiety and result in ritualistic behaviors.
Helping the client recognize the precipitating factors is
the first step in teaching the client to interrupt the
escalating anxiety. Initially meet the client’s
, dependency needs as necessary. Sudden and
complete elimination of avenues for dependency
would create anxiety and will burden the client more.
Option D: This nursing diagnosis is appropriate, but it
is not the priority. Encourage the recognition of
situations that provoke obsessive thoughts or
ritualistic behaviors. Recognition of precipitating
factors is the first step in teaching the client to
interrupt escalation of anxiety. Provide positive
reinforcement for non-ritualistic behaviors. Positive
reinforcement enhances self-esteem and encourages
repetition of desired behaviors.
2. 2. Question
A psychiatrist prescribes an anti-obsessional agent for a client
who is using ritualistic behavior. A common anti-anxiety
medication used for this type of client would be:
A. fluvoxamine (Luvox)
B. benztropine (Cogentin)
C. amantadine (Symmetrel)
D. diphenhydramine (Benadryl)
Correct Answer: A. fluvoxamine (Luvox).
This drug blocks the uptake of serotonin. Fluvoxamine is used to
treat obsessive-compulsive disorder (bothersome thoughts that
won’t go away and the need to perform certain actions over and
over) and social anxiety disorder (extreme fear of interacting with
others or performing in front of others that interferes with normal
life). Fluvoxamine is in a class of medications called selective
serotonin reuptake inhibitors (SSRIs). It works by increasing the
amount of serotonin, a natural substance in the brain that helps
maintain mental balance.
Option B: Benztropine belongs to the synthetic class
of muscarinic receptor antagonists (anticholinergic
drug). Thus, it has a structure similar to that of
diphenhydramine and atropine. However, it is long-
acting so that its administration can be with less
, frequency than diphenhydramine. It also induces less
CNS stimulation effect compared to that of
trihexyphenidyl, making it a preferable drug of choice
for geriatric patients. Moreover, benztropine is FDA
approved as adjunctive therapy of all forms of
parkinsonism.
Option C: Amantadine is now used mostly for
Parkinson’s disease. Clinical trials have shown that
amantadine decreases symptoms of bradykinesia,
rigidity, and tremor. There is a combined synergistic
effect with added levodopa, which is converted to
dopamine by striatal enzymes in the CNS. There can
be a transient benefit to the drug, so short-term
therapy for patients with the mild disease is best.
Option D: Diphenhydramine, which is available as an
over-the-counter medication, is a first-generation
antihistamine that is used in a variety of conditions to
treat and prevent dystonias, insomnia, pruritus,
urticaria, vertigo, and motion sickness. It also
possesses local anesthetic properties for those
patients who have allergies to other, more commonly
used local anesthetics; however, this is an off-label
use of the medication. An additional off-label use is for
the treatment of oral mucositis.
3. 3. Question
A 20-year old college student has been brought to the psychiatric
hospital by her parents. Her admitting diagnosis is borderline
personality disorder. When talking with the parents, which
information would the nurse expect to be included in the client’s
history? Select all that apply.
A. Impulsiveness
B. Lability of mood
C. Ritualistic behavior
D. Psychomotor retardation
, E. Self-destructive behavior
Correct Answers: Answer: A, B, & E
Borderline personality disorder (BPD) is a serious psychological
condition that’s characterized by unstable moods and emotions,
relationships, and behavior. It’s one of several personality
disorders recognized by the American Psychiatric Association
(APA). Personality disorders are psychological conditions that
begin in adolescence or early adulthood, continue over many
years, and, when left untreated, can cause a great deal of
distress. Thankfully, the right treatments targeted for BPD can
help significantly.
Option A: Impulsivity in at least two areas that are
potentially self-damaging, for example, spending,
substance abuse, reckless driving, sex, binge eating,
etc. Note: Do not include suicidal or self-mutilating
behavior covered in criterion 5. BPD is associated with
a tendency to engage in risky and impulsive
behaviors, such as going on shopping sprees, drinking
excessive amounts of alcohol or abusing drugs,
engaging in promiscuous or risky sex, or binge eating.
Also, people with BPD are more prone to engage in
self-harming behaviors, such as cutting or burning and
attempting suicide.
Option B: Affective instability caused by a marked
reactivity of mood, for example, intense episodic
dysphoria, anxiety, or irritability, usually lasting a few
hours and rarely more than a few days. Emotional
instability is a key feature of BPD. Individuals feel like
they’re on an emotional roller coaster with quick mood
shifts (i.e., going from feeling OK to feeling extremely
down or blue within a few minutes). Mood changes can
last from minutes to days and are often intense.
Anger, anxiety, and overwhelming emptiness are
common as well.
Option C: Obsessive-compulsive disorder (OCD) is
often a disabling condition consisting of bothersome
intrusive thoughts that elicit a feeling of discomfort. To
reduce the anxiety and distress associated with these
thoughts, the patient may employ compulsions or
rituals. These rituals may be personal and private, or
they may involve others to participate; the rituals are
DISORDERS NCLEX PRACTICE QUIZ:
110 QUESTIONS
Question
The nursing diagnosis that would be most appropriate for a 22-
year old client who uses ritualistic behavior would be:
o A. Ineffective coping
o B. Impaired adjustment
o C. Personal identity disturbance
o D. Sensory/perceptual alterations
Correct Answer: A. Ineffective coping
Ineffective coping is the impairment of a person’s adaptive
behaviors and problem-solving abilities in meeting life’s
demands; ritualistic behavior fits under this category as a
defining characteristic. During the beginning of treatment, allow
plenty of time for rituals. Do not be judgmental or verbalize
disapproval of the behavior. To deny the client this activity can
precipitate panic level of anxiety.
Option B: Gradually limit the amount of time allotted
for ritualistic behavior as the client becomes more
involved in unit activities. Anxiety is minimized when
the client is able to replace ritualistic behaviors with
more adaptive ones. Encourage independence and
give positive reinforcement for independent behaviors.
Positive reinforcement enhances self-esteem and
encourages repetition of desired behaviors.
Option C: Personal identity disturbance is not a
priority diagnosis for the client. Assess client’s level of
anxiety. Investigate the types of situations that
increase anxiety and result in ritualistic behaviors.
Helping the client recognize the precipitating factors is
the first step in teaching the client to interrupt the
escalating anxiety. Initially meet the client’s
, dependency needs as necessary. Sudden and
complete elimination of avenues for dependency
would create anxiety and will burden the client more.
Option D: This nursing diagnosis is appropriate, but it
is not the priority. Encourage the recognition of
situations that provoke obsessive thoughts or
ritualistic behaviors. Recognition of precipitating
factors is the first step in teaching the client to
interrupt escalation of anxiety. Provide positive
reinforcement for non-ritualistic behaviors. Positive
reinforcement enhances self-esteem and encourages
repetition of desired behaviors.
2. 2. Question
A psychiatrist prescribes an anti-obsessional agent for a client
who is using ritualistic behavior. A common anti-anxiety
medication used for this type of client would be:
A. fluvoxamine (Luvox)
B. benztropine (Cogentin)
C. amantadine (Symmetrel)
D. diphenhydramine (Benadryl)
Correct Answer: A. fluvoxamine (Luvox).
This drug blocks the uptake of serotonin. Fluvoxamine is used to
treat obsessive-compulsive disorder (bothersome thoughts that
won’t go away and the need to perform certain actions over and
over) and social anxiety disorder (extreme fear of interacting with
others or performing in front of others that interferes with normal
life). Fluvoxamine is in a class of medications called selective
serotonin reuptake inhibitors (SSRIs). It works by increasing the
amount of serotonin, a natural substance in the brain that helps
maintain mental balance.
Option B: Benztropine belongs to the synthetic class
of muscarinic receptor antagonists (anticholinergic
drug). Thus, it has a structure similar to that of
diphenhydramine and atropine. However, it is long-
acting so that its administration can be with less
, frequency than diphenhydramine. It also induces less
CNS stimulation effect compared to that of
trihexyphenidyl, making it a preferable drug of choice
for geriatric patients. Moreover, benztropine is FDA
approved as adjunctive therapy of all forms of
parkinsonism.
Option C: Amantadine is now used mostly for
Parkinson’s disease. Clinical trials have shown that
amantadine decreases symptoms of bradykinesia,
rigidity, and tremor. There is a combined synergistic
effect with added levodopa, which is converted to
dopamine by striatal enzymes in the CNS. There can
be a transient benefit to the drug, so short-term
therapy for patients with the mild disease is best.
Option D: Diphenhydramine, which is available as an
over-the-counter medication, is a first-generation
antihistamine that is used in a variety of conditions to
treat and prevent dystonias, insomnia, pruritus,
urticaria, vertigo, and motion sickness. It also
possesses local anesthetic properties for those
patients who have allergies to other, more commonly
used local anesthetics; however, this is an off-label
use of the medication. An additional off-label use is for
the treatment of oral mucositis.
3. 3. Question
A 20-year old college student has been brought to the psychiatric
hospital by her parents. Her admitting diagnosis is borderline
personality disorder. When talking with the parents, which
information would the nurse expect to be included in the client’s
history? Select all that apply.
A. Impulsiveness
B. Lability of mood
C. Ritualistic behavior
D. Psychomotor retardation
, E. Self-destructive behavior
Correct Answers: Answer: A, B, & E
Borderline personality disorder (BPD) is a serious psychological
condition that’s characterized by unstable moods and emotions,
relationships, and behavior. It’s one of several personality
disorders recognized by the American Psychiatric Association
(APA). Personality disorders are psychological conditions that
begin in adolescence or early adulthood, continue over many
years, and, when left untreated, can cause a great deal of
distress. Thankfully, the right treatments targeted for BPD can
help significantly.
Option A: Impulsivity in at least two areas that are
potentially self-damaging, for example, spending,
substance abuse, reckless driving, sex, binge eating,
etc. Note: Do not include suicidal or self-mutilating
behavior covered in criterion 5. BPD is associated with
a tendency to engage in risky and impulsive
behaviors, such as going on shopping sprees, drinking
excessive amounts of alcohol or abusing drugs,
engaging in promiscuous or risky sex, or binge eating.
Also, people with BPD are more prone to engage in
self-harming behaviors, such as cutting or burning and
attempting suicide.
Option B: Affective instability caused by a marked
reactivity of mood, for example, intense episodic
dysphoria, anxiety, or irritability, usually lasting a few
hours and rarely more than a few days. Emotional
instability is a key feature of BPD. Individuals feel like
they’re on an emotional roller coaster with quick mood
shifts (i.e., going from feeling OK to feeling extremely
down or blue within a few minutes). Mood changes can
last from minutes to days and are often intense.
Anger, anxiety, and overwhelming emptiness are
common as well.
Option C: Obsessive-compulsive disorder (OCD) is
often a disabling condition consisting of bothersome
intrusive thoughts that elicit a feeling of discomfort. To
reduce the anxiety and distress associated with these
thoughts, the patient may employ compulsions or
rituals. These rituals may be personal and private, or
they may involve others to participate; the rituals are
