,GCN|NUR 256 Exam 1 | Mental Health Nursing |
1. A nurse is assessing a client who reports feeling overwhelmed but continues to work productively
and maintain social relationships. According to the mental health-illness continuum, how should the
nurse interpret this presentation?
A) The client is experiencing a mental illness that requires immediate hospitalization
B) The client demonstrates mental health despite experiencing temporary stress
C) The client is in the early stage of a psychotic disorder
D) The client is using maladaptive defense mechanisms to hide symptoms
Correct Answer: The client demonstrates mental health despite experiencing temporary stress
Rationale: Mental health is defined as the ability to recognize one's own potential, cope with normal
stress, work productively, and contribute to the community. Temporary stress does not equate to
mental illness; functioning remains intact. Hospitalization and psychosis are not indicated, and there
is no evidence of maladaptive defenses.
2. According to the diathesis-stress model, which factor most directly determines whether an
individual develops a mental disorder?
A) The presence of a single stressful life event
B) The interaction between biological predisposition and environmental stressors
C) The individual's socioeconomic status during childhood
D) The availability of social support systems
Correct Answer: The interaction between biological predisposition and environmental stressors
Rationale: The diathesis-stress model posits that mental disorders result from the interplay between a
biological vulnerability (diathesis) and triggering environmental stressors. Neither factor alone is
sufficient; the combination determines expression. Socioeconomic status and social support are
modifiers, not determinants.
3. A client who lost their job states, "I'm actually relieved—now I can finally focus on my art full-time."
The nurse recognizes this response as an example of which characteristic of resilience?
,A) Denial of negative emotions
B) Optimism and sense of mastery
C) Avoidance of reality
D) Regression to an earlier developmental stage
Correct Answer: Optimism and sense of mastery
Rationale: Resilience is characterized by optimism, a sense of mastery, and competence. Reframing a
loss as an opportunity reflects adaptive coping. Denial and avoidance are defense mechanisms that
distort reality, while regression involves returning to earlier behaviors.
4. A 6-year-old child constantly interrupts the nurse during a health teaching session. According to
Erikson's theory, which developmental task is this child actively negotiating?
A) Trust versus mistrust
B) Autonomy versus shame and doubt
C) Initiative versus guilt
D) Industry versus inferiority
Correct Answer: Initiative versus guilt
Rationale: Erikson's initiative versus guilt stage occurs from ages 3 to 6 years, during which children
assert themselves and explore their environment. Interrupting reflects initiative. Trust versus mistrust
occurs in infancy, autonomy versus shame in toddlerhood, and industry versus inferiority in school-
age children.
5. A nurse notices that a client consistently seeks approval from staff and becomes anxious when left
alone. According to Maslow's hierarchy, which level of need is primarily unmet for this client?
A) Physiological needs
B) Safety needs
C) Belonging and love needs
D) Esteem needs
, Correct Answer: Belonging and love needs
Rationale: Belonging and love needs include intimate relationships, love, affection, and a sense of
belonging. Seeking approval and anxiety when alone indicate unmet needs for connection.
Physiological needs relate to survival, safety to security, and esteem to confidence and value.
6. A client who lost a parent unexpectedly states, "I don't want to talk about it; I just need to keep
busy." The nurse recognizes this response as which level of anxiety?
A) Mild anxiety
B) Moderate anxiety
C) Severe anxiety
D) Panic-level anxiety
Correct Answer: Mild anxiety
Rationale: Mild anxiety is associated with heightened awareness and the use of coping mechanisms
such as keeping busy to manage discomfort. Moderate anxiety narrows the perceptual field, severe
anxiety causes significant dysfunction, and panic-level anxiety results in loss of control.
7. Which statement by a nurse demonstrates the use of the therapeutic communication technique of
reflection?
A) "Tell me more about what happened before you started feeling this way."
B) "You seem to be feeling frustrated with your treatment plan."
C) "I understand that this is a difficult time for you."
D) "What do you think would help you feel more comfortable?"
Correct Answer: "You seem to be feeling frustrated with your treatment plan."
Rationale: Reflection involves identifying and verbalizing the client's implied feelings or emotions. This
statement mirrors the client's affect. Option A is clarification, C is empathy, and D is a broad opening
—all therapeutic but not reflective.
1. A nurse is assessing a client who reports feeling overwhelmed but continues to work productively
and maintain social relationships. According to the mental health-illness continuum, how should the
nurse interpret this presentation?
A) The client is experiencing a mental illness that requires immediate hospitalization
B) The client demonstrates mental health despite experiencing temporary stress
C) The client is in the early stage of a psychotic disorder
D) The client is using maladaptive defense mechanisms to hide symptoms
Correct Answer: The client demonstrates mental health despite experiencing temporary stress
Rationale: Mental health is defined as the ability to recognize one's own potential, cope with normal
stress, work productively, and contribute to the community. Temporary stress does not equate to
mental illness; functioning remains intact. Hospitalization and psychosis are not indicated, and there
is no evidence of maladaptive defenses.
2. According to the diathesis-stress model, which factor most directly determines whether an
individual develops a mental disorder?
A) The presence of a single stressful life event
B) The interaction between biological predisposition and environmental stressors
C) The individual's socioeconomic status during childhood
D) The availability of social support systems
Correct Answer: The interaction between biological predisposition and environmental stressors
Rationale: The diathesis-stress model posits that mental disorders result from the interplay between a
biological vulnerability (diathesis) and triggering environmental stressors. Neither factor alone is
sufficient; the combination determines expression. Socioeconomic status and social support are
modifiers, not determinants.
3. A client who lost their job states, "I'm actually relieved—now I can finally focus on my art full-time."
The nurse recognizes this response as an example of which characteristic of resilience?
,A) Denial of negative emotions
B) Optimism and sense of mastery
C) Avoidance of reality
D) Regression to an earlier developmental stage
Correct Answer: Optimism and sense of mastery
Rationale: Resilience is characterized by optimism, a sense of mastery, and competence. Reframing a
loss as an opportunity reflects adaptive coping. Denial and avoidance are defense mechanisms that
distort reality, while regression involves returning to earlier behaviors.
4. A 6-year-old child constantly interrupts the nurse during a health teaching session. According to
Erikson's theory, which developmental task is this child actively negotiating?
A) Trust versus mistrust
B) Autonomy versus shame and doubt
C) Initiative versus guilt
D) Industry versus inferiority
Correct Answer: Initiative versus guilt
Rationale: Erikson's initiative versus guilt stage occurs from ages 3 to 6 years, during which children
assert themselves and explore their environment. Interrupting reflects initiative. Trust versus mistrust
occurs in infancy, autonomy versus shame in toddlerhood, and industry versus inferiority in school-
age children.
5. A nurse notices that a client consistently seeks approval from staff and becomes anxious when left
alone. According to Maslow's hierarchy, which level of need is primarily unmet for this client?
A) Physiological needs
B) Safety needs
C) Belonging and love needs
D) Esteem needs
, Correct Answer: Belonging and love needs
Rationale: Belonging and love needs include intimate relationships, love, affection, and a sense of
belonging. Seeking approval and anxiety when alone indicate unmet needs for connection.
Physiological needs relate to survival, safety to security, and esteem to confidence and value.
6. A client who lost a parent unexpectedly states, "I don't want to talk about it; I just need to keep
busy." The nurse recognizes this response as which level of anxiety?
A) Mild anxiety
B) Moderate anxiety
C) Severe anxiety
D) Panic-level anxiety
Correct Answer: Mild anxiety
Rationale: Mild anxiety is associated with heightened awareness and the use of coping mechanisms
such as keeping busy to manage discomfort. Moderate anxiety narrows the perceptual field, severe
anxiety causes significant dysfunction, and panic-level anxiety results in loss of control.
7. Which statement by a nurse demonstrates the use of the therapeutic communication technique of
reflection?
A) "Tell me more about what happened before you started feeling this way."
B) "You seem to be feeling frustrated with your treatment plan."
C) "I understand that this is a difficult time for you."
D) "What do you think would help you feel more comfortable?"
Correct Answer: "You seem to be feeling frustrated with your treatment plan."
Rationale: Reflection involves identifying and verbalizing the client's implied feelings or emotions. This
statement mirrors the client's affect. Option A is clarification, C is empathy, and D is a broad opening
—all therapeutic but not reflective.
