TEST BANK
Psychiatric-Mental Health NURSING
By SHEILA L. VIDEBECK
9th Edition
Page 1
,Table of contents
UNIT 1 Current Theories and Practice
1. Foundations of Psychiatric–Mental Health NURSING
2. Neurobiologic Theories and Psychopharmacology
3. Psychosocial Theories and Therapy
4. Treatment Settings and Therapeutic Programs
UNIT 2 Building the Nurse–CLIENT Relationship
5. Therapeutic Relationships
6. Therapeutic Communication
7. CLIENT’s Response to Illness
8. Assessment
UNIT 3 Current Social and Emotional Concerns
9. Legal and Ethical Issues
10. Grief and Loss
11. Anger, Hostility, and Aggression
12. Abuse and Violence
UNIT 4 NURSING Practice for Psychiatric Disorders
13. Trauma and Stressor-Related Disorders
14. Anxiety and Anxiety Disorders
15. Obsessive–Compulsive and Related Disorders
16. Schizophrenia
17. Mood Disorders and Suicide
18. Personality Disorders
19. Addiction
20. Eating Disorders
21. Somatic Symptom Illnesses
22. Neurodevelopmental Disorders
23 Disruptive Behavior Disorders
24 Cognitive Disorders
Page 2
,Psychiatric Mental Health NURSING 9th Edition Test Bank
Chapter 1 Foundations of Psychiatric–Mental Health Nursing
1. The nurse is assessing the factors contributing to the well-being of a newly
admitted Client. Which of the following would the nurse identify as having
a positive impact on the individual's mental health?
A) Not needing others for companionship
B) The ability to effectively manage stress
C) A family history of mental illness
D) Striving for total self-
reliance
ANSWER: B
Feedback:
Individual factors influencing mental health include biologic makeup,
autonomy, independence, self-esteem, capacity for growth, vitality, ability to
find meaning in life, emotional resilience or hardiness, sense of belonging,
reality orientation, and coping or stress management abilities. Interpersonal
factors such as intimacy and a balance of separateness and connectedness are
both needed for good mental health, and therefore a healthy person would need
others for companionship. A family history of mental illness could relate to
the biologic makeup of an individual, which may have a negative impact on an
individual's mental health, as well as a negative impact on an individual's
interpersonal and social cultural factors of health. Total self-reliance is not
possible, and a positive social/cultural factor is access to adequate resources.
2. Which of the following statements about mental illness are true? Select all that apply.
A) Mental illness can cause significant distress, impaired functioning, or both.
B) Mental illness is only due to social/cultural factors.
C) Social/cultural factors that relate to mental illness include excessive
dependency on or withdrawal from relationships.
D) Individuals suffering from mental illness are usually able to cope
effectively with daily life.
E) Individuals suffering from mental illness may experience
dissatisfaction with relationships and self.
ANSWER: A, D, E
Feedback:
Mental illness can cause significant distress, impaired functioning, or both.
Mental illness may be related to individual, interpersonal, or social/cultural
factors. Excessive dependency on or withdrawal from relationships are
interpersonal factors that relate to mental illness. Individuals suffering from
mental illness can feel overwhelmed with daily life. Individuals suffering
from mental illness may experience dissatisfaction with relationships and self.
1
,3. Which of the following are true regarding mental health and mental illness?
A) Behavior that may be viewed as acceptable in one culture is
always unacceptable in other cultures.
B) It is easy to determine if a person is mentally healthy or mentally ill.
C) In most cases, mental health is a state of emotional, psychological, and
social wellness evidenced by satisfying interpersonal relationships,
effective behavior and coping, positive self-concept, and emotional
stability.
D) Persons who engage in fantasies are
mentally ill. ANSWER: C
Feedback:
What one society may view as acceptable and appropriate behavior, another
society may see that as maladaptive, and inappropriate. Mental health and
mental illness are difficult to define precisely. In most cases, mental health is
a state of emotional, psychological, and social wellness evidenced by
satisfying interpersonal relationships, effective behavior and coping, positive
self-concept, and emotional stability. Persons who engage in fantasiesmay be
mentally healthy, but the inability to distinguish reality from fantasyis an
individual factor that may contribute to mental illness.
4. A Client grieving the recent loss of her husband asks if she is becoming
mentally ill because she is so sad. The Nurse's best response would be,
A) You may have a temporary mental illness because you are experiencing
so much pain.
B) You are not mentally ill. This is an expected reaction to the loss
you have experienced.
C) Were you generally dissatisfied with your relationship before your
husband's death?î
D) Try not to worry about that right now. You never know what the future
brings.î ANSWER: B
Feedback:
Mental illness includes general dissatisfaction with self, ineffective
relationships, ineffective coping, and lack of personal growth. Additionally
the behavior must not be culturally expected. Acute grief reactions are
expected and therefore not considered mental illness. False reassurance or
over analysis does not accurately address the CLIENT's concerns.
2
,5. The NURSEconsults the DSM forwhich of the following purposes?
A) To devise a plan of care for a newly admitted CLIENT
B) To predict the CLIENT's prognosis of treatment outcomes
C) To document the appropriate diagnostic code in the CLIENT's medical record
D) To serve as a guide for CLIENT
assessment ANSWER: D
Feedback:
The DSM provides standard nomenclature, presents defining characteristics,
and identifies underlying causes of mental disorders. It does not provide
care plans or prognostic outcomes of treatment. Diagnosis of mental illness
is not within the generalist RN's scope of practice, so documenting the code in
the medical record wouldbe inappropriate.
6. Which would be a reason for a student NURSE to use the DSM?
A) Identifying the medical diagnosis
B) Treat CLIENTs
C) Evaluate treatments
D) Understand the reason for the admissionand the nature of
psychiatric illnesses. ANSWER: D
Feedback:
Although student NURSEs do not use the DSM to diagnose CLIENTs,
they will find it a helpful resource to understand the reason for the
admission and to begin building knowledge about the nature of psychiatric
illnesses. Identifying the medical diagnosis, treating, and evaluating
treatments are not a part of the NURSING process.
7. The legislation enacted in 1963 was largely responsibleforwhich of the
following shifts in care for the mentally ill?
A) The widespread use of community-based services
B) The advancement in pharmacotherapies
C) Increased access to hospitalization
D) Improved rights for CLIENTs in long-term
institutional careANSWER: A
Feedback:
The Community Mental Health Centers Construction Act of 1963
accomplished the release of individuals from long-term stays in state
institutions, the decrease in admissions to hospitals, and the
development of community-based services as an alternative to hospital
care.
3
, 8. Which one of the following is a result of federal legislation?
A) Making it easier to commit people formental health treatment against their will.
B) Making it more difficult to commit people for mental health treatment
against their will.
C) State mental institutions being the primary source of care formentally ill persons.
D) Improved care for mentally ill
persons. ANSWER: B
Feedback:
Commitment laws changed in the early 1970s, making it more difficult to
commit people for mental health treatment against their will.
Deinstitutionalization accomplished the release of individuals from long-
term stays in state institutions. Deinstitutionalization also had negative
effects in that some mentally ill persons are subjected to the revolving door
effect, which may limit careformentally ill persons.
9. The goal of the 1963 Community Mental Health Centers Act was to
A) ensurepatients' rights for the mentally ill.
B) deinstitutionalize state hospitals.
C) provide funds to build hospitals with psychiatric units.
D) treat people with mental illness in a humane
fashion. ANSWER: B
Feedback:
The 1963 Community Mental Health Centers Act intimated the movement
toward treating those with mental illness in a less restrictive environment.
This legislation resulted in the shift of CLIENTs with mental illness from large
state institutions to carebased in the community. Answer choices A, C, and D
were not purposes of the 1963 Community Mental Health CentersAct.
10. The creation of asylumsduring the 1800swasmeant to
A) improve treatment of mental disorders.
B) providefood and shelter for the mentally ill.
C) punish people with mental illness who were believed to be possessed.
D) remove dangerous people with mentalillness from the
community. ANSWER: B
Feedback:
The asylum was meant to be a safehaven with food, shelter, and humane
treatment for the mentally ill. Asylums were not used to improve treatment of
mental disorders or topunish mentally ill people who were believed to be
possessed. The asylum was not created to remove the dangerously mentally ill
from the community.
4
,11. The major problems with large state institutions are: Select all that apply.
A) attendants were accused of abusing the residents.
B) stigma associated with residence in an insane asylum.
C) CLIENTs were geographically isolated from family and community.
D) increasing financial costs to individual
residents. ANSWER: A, C
Feedback:
CLIENTs were often far removed from the local community, family, and
friends because state institutions were usually in rural or remote settings.
Choices B and D were not major problems associated with large state
instructions.
12. A significant change in the treatment of people with mental illness
occurred in the 1950s when
A) community support services were established.
B) legislation dramatically changed civil commitment procedures.
C) the Patient's Bill of Rights was enacted.
D) psychotropic drugs became available for
use. ANSWER: D
Feedback:
The development of psychotropic drugs, or drugs used to treat mental illness,
beganin the 1950s. Answer choices A, B, and C did not occur in the 1950s.
13. Beforethe period of the enlightenment, treatment of the mentally ill included
A) creating large institutions to provide custodial care.
B) focusing on religious education to improve their souls.
C) placing the mentally ill on display for the public's amusement.
D) providing a safe refuge or haven offering
protection. ANSWER: C
Feedback:
In 1775, visitors at St. Mary's of Bethlehem were charged a fee for viewing
and ridiculing the mentally ill, who were seen as animals, less than human.
Custodial care was not often provided as persons who were considered
harmless were allowed to wander in the countryside or live in rural
communities, and more dangerous lunatics were imprisoned, chained, and
starved. In early Christian times, primitive beliefs and superstitions were
strong. The mentally ill were viewed as evil or possessed. Priests performed
exorcisms to rid evil spirits, and in the colonies, witch hunts were conducted
with offenders burned at the stake. It was not until the period of
enlightenment when persons who were mentally ill were offered asylum as a
safe refuge or haven offering protection at institutions.
5
, 14. The first training of NURSEsItoIworkIwithIpersons with mental illness
was inI1882 Iin which state?
A) California
B) Illinois
C) Massachusetts
D) New
York
ANSWER: C
Feedback:
The first training for NURSEs to work with persons with mental illness was in
1882 at McLean Hospital in Belmont, Massachusetts.
15. What is meant by the term revolving door effect in mental health care?
A) An overall reduction in incidence of severe mental illness
B) Shorter and more frequent hospital stays for persons with severe and
persistent mental illness
C) Flexible treatment settings for mentally ill
D) Most effective and least expensive treatment
settings ANSWER: B
Feedback:
The revolving door effect refers to shorter, but more frequent, hospital stays.
CLIENTs are quickly discharged into the community where services are
not adequate; without adequate community services, CLIENTs become
acutely ill and require rehospitalization.The revolving door effect does not
refer to flexible treatmentsettings for mentally ill. Even though
hospitalization is more expensive than outpatient treatment, if utilized
appropriately could result in stabilization and less need for emergency
department visits and/or rehospitalization. The revolving door effect does not
relate to the incidence of severe mental illness.
6
Psychiatric-Mental Health NURSING
By SHEILA L. VIDEBECK
9th Edition
Page 1
,Table of contents
UNIT 1 Current Theories and Practice
1. Foundations of Psychiatric–Mental Health NURSING
2. Neurobiologic Theories and Psychopharmacology
3. Psychosocial Theories and Therapy
4. Treatment Settings and Therapeutic Programs
UNIT 2 Building the Nurse–CLIENT Relationship
5. Therapeutic Relationships
6. Therapeutic Communication
7. CLIENT’s Response to Illness
8. Assessment
UNIT 3 Current Social and Emotional Concerns
9. Legal and Ethical Issues
10. Grief and Loss
11. Anger, Hostility, and Aggression
12. Abuse and Violence
UNIT 4 NURSING Practice for Psychiatric Disorders
13. Trauma and Stressor-Related Disorders
14. Anxiety and Anxiety Disorders
15. Obsessive–Compulsive and Related Disorders
16. Schizophrenia
17. Mood Disorders and Suicide
18. Personality Disorders
19. Addiction
20. Eating Disorders
21. Somatic Symptom Illnesses
22. Neurodevelopmental Disorders
23 Disruptive Behavior Disorders
24 Cognitive Disorders
Page 2
,Psychiatric Mental Health NURSING 9th Edition Test Bank
Chapter 1 Foundations of Psychiatric–Mental Health Nursing
1. The nurse is assessing the factors contributing to the well-being of a newly
admitted Client. Which of the following would the nurse identify as having
a positive impact on the individual's mental health?
A) Not needing others for companionship
B) The ability to effectively manage stress
C) A family history of mental illness
D) Striving for total self-
reliance
ANSWER: B
Feedback:
Individual factors influencing mental health include biologic makeup,
autonomy, independence, self-esteem, capacity for growth, vitality, ability to
find meaning in life, emotional resilience or hardiness, sense of belonging,
reality orientation, and coping or stress management abilities. Interpersonal
factors such as intimacy and a balance of separateness and connectedness are
both needed for good mental health, and therefore a healthy person would need
others for companionship. A family history of mental illness could relate to
the biologic makeup of an individual, which may have a negative impact on an
individual's mental health, as well as a negative impact on an individual's
interpersonal and social cultural factors of health. Total self-reliance is not
possible, and a positive social/cultural factor is access to adequate resources.
2. Which of the following statements about mental illness are true? Select all that apply.
A) Mental illness can cause significant distress, impaired functioning, or both.
B) Mental illness is only due to social/cultural factors.
C) Social/cultural factors that relate to mental illness include excessive
dependency on or withdrawal from relationships.
D) Individuals suffering from mental illness are usually able to cope
effectively with daily life.
E) Individuals suffering from mental illness may experience
dissatisfaction with relationships and self.
ANSWER: A, D, E
Feedback:
Mental illness can cause significant distress, impaired functioning, or both.
Mental illness may be related to individual, interpersonal, or social/cultural
factors. Excessive dependency on or withdrawal from relationships are
interpersonal factors that relate to mental illness. Individuals suffering from
mental illness can feel overwhelmed with daily life. Individuals suffering
from mental illness may experience dissatisfaction with relationships and self.
1
,3. Which of the following are true regarding mental health and mental illness?
A) Behavior that may be viewed as acceptable in one culture is
always unacceptable in other cultures.
B) It is easy to determine if a person is mentally healthy or mentally ill.
C) In most cases, mental health is a state of emotional, psychological, and
social wellness evidenced by satisfying interpersonal relationships,
effective behavior and coping, positive self-concept, and emotional
stability.
D) Persons who engage in fantasies are
mentally ill. ANSWER: C
Feedback:
What one society may view as acceptable and appropriate behavior, another
society may see that as maladaptive, and inappropriate. Mental health and
mental illness are difficult to define precisely. In most cases, mental health is
a state of emotional, psychological, and social wellness evidenced by
satisfying interpersonal relationships, effective behavior and coping, positive
self-concept, and emotional stability. Persons who engage in fantasiesmay be
mentally healthy, but the inability to distinguish reality from fantasyis an
individual factor that may contribute to mental illness.
4. A Client grieving the recent loss of her husband asks if she is becoming
mentally ill because she is so sad. The Nurse's best response would be,
A) You may have a temporary mental illness because you are experiencing
so much pain.
B) You are not mentally ill. This is an expected reaction to the loss
you have experienced.
C) Were you generally dissatisfied with your relationship before your
husband's death?î
D) Try not to worry about that right now. You never know what the future
brings.î ANSWER: B
Feedback:
Mental illness includes general dissatisfaction with self, ineffective
relationships, ineffective coping, and lack of personal growth. Additionally
the behavior must not be culturally expected. Acute grief reactions are
expected and therefore not considered mental illness. False reassurance or
over analysis does not accurately address the CLIENT's concerns.
2
,5. The NURSEconsults the DSM forwhich of the following purposes?
A) To devise a plan of care for a newly admitted CLIENT
B) To predict the CLIENT's prognosis of treatment outcomes
C) To document the appropriate diagnostic code in the CLIENT's medical record
D) To serve as a guide for CLIENT
assessment ANSWER: D
Feedback:
The DSM provides standard nomenclature, presents defining characteristics,
and identifies underlying causes of mental disorders. It does not provide
care plans or prognostic outcomes of treatment. Diagnosis of mental illness
is not within the generalist RN's scope of practice, so documenting the code in
the medical record wouldbe inappropriate.
6. Which would be a reason for a student NURSE to use the DSM?
A) Identifying the medical diagnosis
B) Treat CLIENTs
C) Evaluate treatments
D) Understand the reason for the admissionand the nature of
psychiatric illnesses. ANSWER: D
Feedback:
Although student NURSEs do not use the DSM to diagnose CLIENTs,
they will find it a helpful resource to understand the reason for the
admission and to begin building knowledge about the nature of psychiatric
illnesses. Identifying the medical diagnosis, treating, and evaluating
treatments are not a part of the NURSING process.
7. The legislation enacted in 1963 was largely responsibleforwhich of the
following shifts in care for the mentally ill?
A) The widespread use of community-based services
B) The advancement in pharmacotherapies
C) Increased access to hospitalization
D) Improved rights for CLIENTs in long-term
institutional careANSWER: A
Feedback:
The Community Mental Health Centers Construction Act of 1963
accomplished the release of individuals from long-term stays in state
institutions, the decrease in admissions to hospitals, and the
development of community-based services as an alternative to hospital
care.
3
, 8. Which one of the following is a result of federal legislation?
A) Making it easier to commit people formental health treatment against their will.
B) Making it more difficult to commit people for mental health treatment
against their will.
C) State mental institutions being the primary source of care formentally ill persons.
D) Improved care for mentally ill
persons. ANSWER: B
Feedback:
Commitment laws changed in the early 1970s, making it more difficult to
commit people for mental health treatment against their will.
Deinstitutionalization accomplished the release of individuals from long-
term stays in state institutions. Deinstitutionalization also had negative
effects in that some mentally ill persons are subjected to the revolving door
effect, which may limit careformentally ill persons.
9. The goal of the 1963 Community Mental Health Centers Act was to
A) ensurepatients' rights for the mentally ill.
B) deinstitutionalize state hospitals.
C) provide funds to build hospitals with psychiatric units.
D) treat people with mental illness in a humane
fashion. ANSWER: B
Feedback:
The 1963 Community Mental Health Centers Act intimated the movement
toward treating those with mental illness in a less restrictive environment.
This legislation resulted in the shift of CLIENTs with mental illness from large
state institutions to carebased in the community. Answer choices A, C, and D
were not purposes of the 1963 Community Mental Health CentersAct.
10. The creation of asylumsduring the 1800swasmeant to
A) improve treatment of mental disorders.
B) providefood and shelter for the mentally ill.
C) punish people with mental illness who were believed to be possessed.
D) remove dangerous people with mentalillness from the
community. ANSWER: B
Feedback:
The asylum was meant to be a safehaven with food, shelter, and humane
treatment for the mentally ill. Asylums were not used to improve treatment of
mental disorders or topunish mentally ill people who were believed to be
possessed. The asylum was not created to remove the dangerously mentally ill
from the community.
4
,11. The major problems with large state institutions are: Select all that apply.
A) attendants were accused of abusing the residents.
B) stigma associated with residence in an insane asylum.
C) CLIENTs were geographically isolated from family and community.
D) increasing financial costs to individual
residents. ANSWER: A, C
Feedback:
CLIENTs were often far removed from the local community, family, and
friends because state institutions were usually in rural or remote settings.
Choices B and D were not major problems associated with large state
instructions.
12. A significant change in the treatment of people with mental illness
occurred in the 1950s when
A) community support services were established.
B) legislation dramatically changed civil commitment procedures.
C) the Patient's Bill of Rights was enacted.
D) psychotropic drugs became available for
use. ANSWER: D
Feedback:
The development of psychotropic drugs, or drugs used to treat mental illness,
beganin the 1950s. Answer choices A, B, and C did not occur in the 1950s.
13. Beforethe period of the enlightenment, treatment of the mentally ill included
A) creating large institutions to provide custodial care.
B) focusing on religious education to improve their souls.
C) placing the mentally ill on display for the public's amusement.
D) providing a safe refuge or haven offering
protection. ANSWER: C
Feedback:
In 1775, visitors at St. Mary's of Bethlehem were charged a fee for viewing
and ridiculing the mentally ill, who were seen as animals, less than human.
Custodial care was not often provided as persons who were considered
harmless were allowed to wander in the countryside or live in rural
communities, and more dangerous lunatics were imprisoned, chained, and
starved. In early Christian times, primitive beliefs and superstitions were
strong. The mentally ill were viewed as evil or possessed. Priests performed
exorcisms to rid evil spirits, and in the colonies, witch hunts were conducted
with offenders burned at the stake. It was not until the period of
enlightenment when persons who were mentally ill were offered asylum as a
safe refuge or haven offering protection at institutions.
5
, 14. The first training of NURSEsItoIworkIwithIpersons with mental illness
was inI1882 Iin which state?
A) California
B) Illinois
C) Massachusetts
D) New
York
ANSWER: C
Feedback:
The first training for NURSEs to work with persons with mental illness was in
1882 at McLean Hospital in Belmont, Massachusetts.
15. What is meant by the term revolving door effect in mental health care?
A) An overall reduction in incidence of severe mental illness
B) Shorter and more frequent hospital stays for persons with severe and
persistent mental illness
C) Flexible treatment settings for mentally ill
D) Most effective and least expensive treatment
settings ANSWER: B
Feedback:
The revolving door effect refers to shorter, but more frequent, hospital stays.
CLIENTs are quickly discharged into the community where services are
not adequate; without adequate community services, CLIENTs become
acutely ill and require rehospitalization.The revolving door effect does not
refer to flexible treatmentsettings for mentally ill. Even though
hospitalization is more expensive than outpatient treatment, if utilized
appropriately could result in stabilization and less need for emergency
department visits and/or rehospitalization. The revolving door effect does not
relate to the incidence of severe mental illness.
6
