CNUR 304 – Textbook UPDATED ACTUAL
Questions and CORRECT Answers
The nurse is caring for a patient who is experiencing a crisis. Which symptoms would indicate that the patient is in the
stage of alarm?
a. Constricted pupils
b. Dry mouth
c. Decrease in heart rate
d. Sudden drop in blood pressure - CORRECT ANSWER B
If it is determined that a patient will benefit from guided imagery, what teaching should the nurse provide?
a. Focus on a visual object or sound.
b. Become acutely aware of your breathing paern.
c. Envision an image of a place that is peaceful.
d. Develop deep abdominal breathing. - CORRECT ANSWER C
A patient is going to undergo biofeedback. Which patient statement requires further teaching by the nurse?
a. "This will measure my muscle activity, heart rate, and blood pressure."
b. "It will help me recognize how my body responds to stress."
c. "I will feel a small shock of electricity if I tell a lie."
d. "The instruments will know if my skin temperature changes." - CORRECT ANSWER C
A patient has told the nurse that she knows she is going to lose her job, which scares her because she needs to work to pay
her bills. Which nursing response reflects the positive stress response of problem solving?
a. "What are your plans to find a new job?"
b. "Can you call your parents to support you during this time?"
c. "Is it possible that this job loss is an opportunity to find a beerpaying job?"
d. "I'm sure everything will turn out just fine." - CORRECT ANSWER A
The nurse is caring for four patients. Which patient would be at highest risk for psychosocial compromise? The patient
who has experienced:
a. The death of a friend
b. A divorce
c. A recent job layoff d. The death of a spouse - CORRECT ANSWER D
Resilience, the capacity to rebound from stressors via adaptive coping, is associated with positive mental health. Your
friend has just been laid off from his job. Which of the following responses on your part would most likely contribute to
his enhanced resilience?
a. Using your connections to set up an interview with your employer
b. Connecting him with a friend of the family who owns his own business
c. Supporting him in arranging, preparing for, and completing multiple interviews
d. Helping him to understand that the layoff resulted from troubles in the economy and is not his fault - CORRECT
ANSWER C
Which of the following situations best supports the diathesis- stress model of mental illness development?
a. The rate of suicide increases during times of national disaster and despair.
b. A woman feels mildly anxious when asked to speak to a large group of people.
c. A man with no prior mental health problems experiences sadness after his divorce.
d. A man develops schizophrenia, but his identical twin remains free of mental illness. - CORRECT ANSWER D
Of the following statements about mental illness, identify all correct ones:
a. About 20% of Canadians experience a mental disorder during their lifetime.
b. Mental disorders and diagnoses occur very consistently across cultures.
c. Most serious mental illnesses are psychological rather than biological in nature.
d. The Mental Health Commission of Canada's report Changing Directions, Changing Lives outlines the mental health
strategy for Canada. - CORRECT ANSWER A,D
Jane is a 32-year-old mother of four. She is active with her family and in her community despite having a diagnosis of
severe anxiety.
,a. Optimal mental health with mental illness
b. Optimal mental health without mental illness
c. Poor mental health with mental illness
d. Poor mental health without mental illness - CORRECT ANSWER A
Which of the following actions represent the primary focus of psychiatric nursing for a basic-level registered nurse?
Select all that apply.
a. Determining a patient's diagnosis according to the DSM-5
b. Ordering diagnostic tests such as EEGs or MRI scans
c. Identifying how a patient is coping with a symptom such as hallucinations
d. Guiding a patient to learn and use a variety of stressmanagement techniques e. Helping a patient without personal
transportation find a way to his or her treatment appointments
f. Collecting petition signatures seeking the removal of stigmatizing images on television - CORRECT
ANSWER C,D,E,F
Asylum care of people with mental illness in Canada began in which year?
a. 1620
b. 1932
c. 1845
d. 1798 - CORRECT ANSWER C
The Weir Report was considered influential in which of the following areas?
a. Asylum reform
b. Nursing education curriculum reform
c. Deinstitutionalization
d. The establishment of the registered psychiatric nurse designation - CORRECT ANSWER B
Psychiatric mental health nursing in the community seing was influenced by which of the following factors?
a. The Weir Report
b. Deinstitutionalization
c. The registered psychiatric nurse designation
d. The increased medicalization of psychiatry - CORRECT ANSWER B
A friend recognizes that his depression has returned and tells you he is suicidal and concerned he will harm himself. He is
afraid that if he seeks help he will be involuntarily admied to a psychiatric hospital, an idea that terrifies him. Which of
the following responses best meets his immediate care needs?
a. Provide emotional support and encourage him to contact his family.
b. Express your concern for his safety, normalize psychiatric treatment as equal to treatment of any physical condition,
and offer to accompany and support him through assessment at a nearby emergency department.
c. Contact the police or a provincial/territorial magistrate to initiate involuntary assessment.
d. Assist him to obtain an outpatient counselling appointment at an area community mental health centre, and call him
frequently to ensure that he is safe until this appointment occurs. - CORRECT ANSWER B
You are about to interview a newly admied patient on your inpatient mental health unit. This is his first experience with
psychiatric treatment. Which of the following interventions would be appropriate for this patient? Select all that apply.
a. Discuss outpatient care options for after discharge.
b. Anticipate and address possible increased anxiety and shame.
c. Ensure that the individual understands his rights as a patient on your unit.
d. Assess the patient for physical health needs that may have been overlooked.
e. Carefully check all clothing and possessions for potentially dangerous items - CORRECT ANSWER B,C,D,E
Which of the following nursing actions are appropriate in maintaining a safe therapeutic inpatient milieu? Select all that
apply.
a. Interact frequently with both individuals and groups on the unit.
b. Ensure that none of the unit fixtures can be used for suicide by hanging.
c. Initiate and support group interactions via therapeutic groups and activities.
d. Stock the unit with standard hospital beds and other sturdy hospital furnishings.
e. Provide and encourage opportunities to practise social and other life skills.
f. Collaborate with housekeeping to provide a safe, pleasant environment. - CORRECT ANSWER A,B,C,E,F
, A patient becomes agitated and hostile, threatening to smash a chair into the nurses' station door. Which of the following
responses would be most appropriate for the student nurse to make?
a. Maintain a safe distance, and aempt to de-escalate the patient verbally.
b. When the response team arrives, assist in physically restraining the patient.
c. Assist in promptly moving other patients to a safe distance or separate location.
d. Meet with the patient immediately after the crisis to help him process what happened. - CORRECT ANSWER C
A student is considering a career in mental health nursing. Which of the following statements accurately reflects the role
and expectations of mental health nurses in acute care seings?
a. The primary role of the nurse is to monitor the patients from the nurses' station.
b. Psychiatric patients rarely need medical care, so nurses do not need medical nursing skills.
c. The close relationships developed with patients can lead to later romantic relationships.
d. Mental health nursing requires a high degree of interpersonal comfort and therapeutic skill. - CORRECT
ANSWER D
You are a community mental health nurse meeting with a patient who has just been discharged from the hospital, where
he had received psychiatric care for the first time. Which of the following activities would you expect to undertake in
your role as the nurse on the treatment team caring for this patient?
a. Take medications to the patient's home each day and administer them.
b. Solve day-to-day problems for the patient to minimize his exposure to stress. c. Refer the patient to counsellors or other
providers when he indicates a need to talk with someone.
d. Take a ride on the local bus system with the patient to help him learn routes and schedules. - CORRECT
ANSWER D
Mrs. Chan, a patient at the community mental health centre, tends to stop taking her medications at intervals, usually
leading to decompensation. Which of the following interventions would most likely improve her adherence to her
medications?
a. Help Mrs. Chan understand her illness and allow her to share in decisions about her care.
b. Advise Mrs. Chan that if she stops her medications, her doctor will hospitalize her.
c. Arrange for Mrs. Chan to receive daily home care so her use of medications is monitored.
d. Discourage Mrs. Chan from focusing on adverse effects and other excuses for stopping her pills. - CORRECT
ANSWER A
The nurse is working with a patient who lacks the ability to problem-solve and seeks ways to self-satisfy without regard
for others. Which system of the patient's personality is most pronounced?
a. Id
b. Ego
c. Conscience (superego)
d. Ego ideal (superego) - CORRECT ANSWER A
Which behaviour, seen in a 30-year-old patient, would alert the nurse to the fact that the patient is not in his appropriate
developmental stage according to Erikson?
a. States he is happily married
b. Frequently asks to call his brother "just to check in"
c. Looks forward to visits from a co-worker
d. Says, "I'm still trying to find myself." - CORRECT ANSWER D
A patient has difficulty siing still and listening to others during group therapy. The therapist plans to use operant
conditioning as a form of behavioural modification to assist the patient. Which action would the nurse expect to see in
group therapy?
a. The therapist will act as a role model for the patient by siing still and listening. b. The patient will receive a token from
the therapist for each session in which she sits still and listens.
c. The patient will be required to sit in solitude for 30 minutes after each session in which she does not sit still or listen.
d. The therapist will ask that the patient to sit still and listen for only 2 minutes at a time to begin with and will increase
the time incrementally until the patient can sit and listen for 10 minutes at a time. - CORRECT ANSWER B
The nurse is planning care for a patient with anxiety who will be admied to the unit shortly. Which nursing action is most
important?
a. Consider ways to assist the patient to feel valued during his stay on the unit.
b. Choose a roommate for the patient so that a friendship can develop.
c. Identify a room where the patient will have comfortable surroundings, and order a balanced meal plan.
Questions and CORRECT Answers
The nurse is caring for a patient who is experiencing a crisis. Which symptoms would indicate that the patient is in the
stage of alarm?
a. Constricted pupils
b. Dry mouth
c. Decrease in heart rate
d. Sudden drop in blood pressure - CORRECT ANSWER B
If it is determined that a patient will benefit from guided imagery, what teaching should the nurse provide?
a. Focus on a visual object or sound.
b. Become acutely aware of your breathing paern.
c. Envision an image of a place that is peaceful.
d. Develop deep abdominal breathing. - CORRECT ANSWER C
A patient is going to undergo biofeedback. Which patient statement requires further teaching by the nurse?
a. "This will measure my muscle activity, heart rate, and blood pressure."
b. "It will help me recognize how my body responds to stress."
c. "I will feel a small shock of electricity if I tell a lie."
d. "The instruments will know if my skin temperature changes." - CORRECT ANSWER C
A patient has told the nurse that she knows she is going to lose her job, which scares her because she needs to work to pay
her bills. Which nursing response reflects the positive stress response of problem solving?
a. "What are your plans to find a new job?"
b. "Can you call your parents to support you during this time?"
c. "Is it possible that this job loss is an opportunity to find a beerpaying job?"
d. "I'm sure everything will turn out just fine." - CORRECT ANSWER A
The nurse is caring for four patients. Which patient would be at highest risk for psychosocial compromise? The patient
who has experienced:
a. The death of a friend
b. A divorce
c. A recent job layoff d. The death of a spouse - CORRECT ANSWER D
Resilience, the capacity to rebound from stressors via adaptive coping, is associated with positive mental health. Your
friend has just been laid off from his job. Which of the following responses on your part would most likely contribute to
his enhanced resilience?
a. Using your connections to set up an interview with your employer
b. Connecting him with a friend of the family who owns his own business
c. Supporting him in arranging, preparing for, and completing multiple interviews
d. Helping him to understand that the layoff resulted from troubles in the economy and is not his fault - CORRECT
ANSWER C
Which of the following situations best supports the diathesis- stress model of mental illness development?
a. The rate of suicide increases during times of national disaster and despair.
b. A woman feels mildly anxious when asked to speak to a large group of people.
c. A man with no prior mental health problems experiences sadness after his divorce.
d. A man develops schizophrenia, but his identical twin remains free of mental illness. - CORRECT ANSWER D
Of the following statements about mental illness, identify all correct ones:
a. About 20% of Canadians experience a mental disorder during their lifetime.
b. Mental disorders and diagnoses occur very consistently across cultures.
c. Most serious mental illnesses are psychological rather than biological in nature.
d. The Mental Health Commission of Canada's report Changing Directions, Changing Lives outlines the mental health
strategy for Canada. - CORRECT ANSWER A,D
Jane is a 32-year-old mother of four. She is active with her family and in her community despite having a diagnosis of
severe anxiety.
,a. Optimal mental health with mental illness
b. Optimal mental health without mental illness
c. Poor mental health with mental illness
d. Poor mental health without mental illness - CORRECT ANSWER A
Which of the following actions represent the primary focus of psychiatric nursing for a basic-level registered nurse?
Select all that apply.
a. Determining a patient's diagnosis according to the DSM-5
b. Ordering diagnostic tests such as EEGs or MRI scans
c. Identifying how a patient is coping with a symptom such as hallucinations
d. Guiding a patient to learn and use a variety of stressmanagement techniques e. Helping a patient without personal
transportation find a way to his or her treatment appointments
f. Collecting petition signatures seeking the removal of stigmatizing images on television - CORRECT
ANSWER C,D,E,F
Asylum care of people with mental illness in Canada began in which year?
a. 1620
b. 1932
c. 1845
d. 1798 - CORRECT ANSWER C
The Weir Report was considered influential in which of the following areas?
a. Asylum reform
b. Nursing education curriculum reform
c. Deinstitutionalization
d. The establishment of the registered psychiatric nurse designation - CORRECT ANSWER B
Psychiatric mental health nursing in the community seing was influenced by which of the following factors?
a. The Weir Report
b. Deinstitutionalization
c. The registered psychiatric nurse designation
d. The increased medicalization of psychiatry - CORRECT ANSWER B
A friend recognizes that his depression has returned and tells you he is suicidal and concerned he will harm himself. He is
afraid that if he seeks help he will be involuntarily admied to a psychiatric hospital, an idea that terrifies him. Which of
the following responses best meets his immediate care needs?
a. Provide emotional support and encourage him to contact his family.
b. Express your concern for his safety, normalize psychiatric treatment as equal to treatment of any physical condition,
and offer to accompany and support him through assessment at a nearby emergency department.
c. Contact the police or a provincial/territorial magistrate to initiate involuntary assessment.
d. Assist him to obtain an outpatient counselling appointment at an area community mental health centre, and call him
frequently to ensure that he is safe until this appointment occurs. - CORRECT ANSWER B
You are about to interview a newly admied patient on your inpatient mental health unit. This is his first experience with
psychiatric treatment. Which of the following interventions would be appropriate for this patient? Select all that apply.
a. Discuss outpatient care options for after discharge.
b. Anticipate and address possible increased anxiety and shame.
c. Ensure that the individual understands his rights as a patient on your unit.
d. Assess the patient for physical health needs that may have been overlooked.
e. Carefully check all clothing and possessions for potentially dangerous items - CORRECT ANSWER B,C,D,E
Which of the following nursing actions are appropriate in maintaining a safe therapeutic inpatient milieu? Select all that
apply.
a. Interact frequently with both individuals and groups on the unit.
b. Ensure that none of the unit fixtures can be used for suicide by hanging.
c. Initiate and support group interactions via therapeutic groups and activities.
d. Stock the unit with standard hospital beds and other sturdy hospital furnishings.
e. Provide and encourage opportunities to practise social and other life skills.
f. Collaborate with housekeeping to provide a safe, pleasant environment. - CORRECT ANSWER A,B,C,E,F
, A patient becomes agitated and hostile, threatening to smash a chair into the nurses' station door. Which of the following
responses would be most appropriate for the student nurse to make?
a. Maintain a safe distance, and aempt to de-escalate the patient verbally.
b. When the response team arrives, assist in physically restraining the patient.
c. Assist in promptly moving other patients to a safe distance or separate location.
d. Meet with the patient immediately after the crisis to help him process what happened. - CORRECT ANSWER C
A student is considering a career in mental health nursing. Which of the following statements accurately reflects the role
and expectations of mental health nurses in acute care seings?
a. The primary role of the nurse is to monitor the patients from the nurses' station.
b. Psychiatric patients rarely need medical care, so nurses do not need medical nursing skills.
c. The close relationships developed with patients can lead to later romantic relationships.
d. Mental health nursing requires a high degree of interpersonal comfort and therapeutic skill. - CORRECT
ANSWER D
You are a community mental health nurse meeting with a patient who has just been discharged from the hospital, where
he had received psychiatric care for the first time. Which of the following activities would you expect to undertake in
your role as the nurse on the treatment team caring for this patient?
a. Take medications to the patient's home each day and administer them.
b. Solve day-to-day problems for the patient to minimize his exposure to stress. c. Refer the patient to counsellors or other
providers when he indicates a need to talk with someone.
d. Take a ride on the local bus system with the patient to help him learn routes and schedules. - CORRECT
ANSWER D
Mrs. Chan, a patient at the community mental health centre, tends to stop taking her medications at intervals, usually
leading to decompensation. Which of the following interventions would most likely improve her adherence to her
medications?
a. Help Mrs. Chan understand her illness and allow her to share in decisions about her care.
b. Advise Mrs. Chan that if she stops her medications, her doctor will hospitalize her.
c. Arrange for Mrs. Chan to receive daily home care so her use of medications is monitored.
d. Discourage Mrs. Chan from focusing on adverse effects and other excuses for stopping her pills. - CORRECT
ANSWER A
The nurse is working with a patient who lacks the ability to problem-solve and seeks ways to self-satisfy without regard
for others. Which system of the patient's personality is most pronounced?
a. Id
b. Ego
c. Conscience (superego)
d. Ego ideal (superego) - CORRECT ANSWER A
Which behaviour, seen in a 30-year-old patient, would alert the nurse to the fact that the patient is not in his appropriate
developmental stage according to Erikson?
a. States he is happily married
b. Frequently asks to call his brother "just to check in"
c. Looks forward to visits from a co-worker
d. Says, "I'm still trying to find myself." - CORRECT ANSWER D
A patient has difficulty siing still and listening to others during group therapy. The therapist plans to use operant
conditioning as a form of behavioural modification to assist the patient. Which action would the nurse expect to see in
group therapy?
a. The therapist will act as a role model for the patient by siing still and listening. b. The patient will receive a token from
the therapist for each session in which she sits still and listens.
c. The patient will be required to sit in solitude for 30 minutes after each session in which she does not sit still or listen.
d. The therapist will ask that the patient to sit still and listen for only 2 minutes at a time to begin with and will increase
the time incrementally until the patient can sit and listen for 10 minutes at a time. - CORRECT ANSWER B
The nurse is planning care for a patient with anxiety who will be admied to the unit shortly. Which nursing action is most
important?
a. Consider ways to assist the patient to feel valued during his stay on the unit.
b. Choose a roommate for the patient so that a friendship can develop.
c. Identify a room where the patient will have comfortable surroundings, and order a balanced meal plan.
