Test Bank For Davis Advantage for Townsends Essentials of
Psychiatric Mental Health Nursing 9th Edition Karyn Morgan
Chapters 1-32 , 9781719645768 , All Chapters with Answers
and Rationals
As a last resort, an agitated, physically aggressive client is placed in four-point restraints. The client
yells, "I'll sue you for assault and battery!" The unit manager determines that the nurses are protected
under which condition?
1) The client is voluntarily committed and poses a danger to others on the unit.
2) The client is voluntarily committed and has a history of being a danger to others.
3) The client is involuntarily committed because of a history of violent
behavior.
4) The client is involuntarily committed and is refusing treatment. - ANSWER: As a threat to others,
the client can be restrained despite objections and voluntary commitment.
A history of being a danger to others does not indicate a current, imminent threat; therefore, the
client has the right to the least restrictive treatment alternative and restraints cannot be legally
applied.
A history of violent behavior does not indicate a current, imminent threat; therefore, the client has
the right to the least restrictive treatment alternative and restraints cannot be legally applied.
Treatment refusal is a client's right that can be lost if the client poses an imminent danger to self or
others or has been deemed incompetent and assigned a guardian. Neither of these situations exists;
therefore, the client has the right to the least restrictive treatment alternative and restraints cannot
be legally applied.
Oliver has been referred by his boss to the employee assistance program because of difficulties that
have arisen in his relationships with coworkers. During the nurse's intake assessment, which of the
following statements by Oliver are consistent with a diagnosis of paranoid personality disorder?
Select all that apply.
1) "I work very hard at my job."
2) "I stay away from my co-workers because they'd love to see me fail."
3) "I would have my boss' job if administration promoted people fairly."
4) "I set a trap in my office so I can tell if my coworkers have opened my file cabinets."
5) "I feel bad for my boss, he's been so stressed this last year." - ANSWER: Feedback 1: This is a
neutral statement that neither supports nor negates a diagnosis of paranoid personality disorder.
Significant statements would be those that convey inappropriate mistrust of others.
Feedback 2: This statement is a generalization of mistrust for all his coworkers and an assumption
that they intend to harm him in some way. This statement is consistent with paranoid personality
disorder.
Feedback 3: The sense that the individual would be more successful if not for unfair treatment is a
symptom of paranoid personality disorder.
Feedback 4: Testing others' honesty because of a pervasive fear that they can't betrusted is
symptomatic of paranoid personality disorder.
Feedback 5: Typically people with paranoid personality disorders have a hard exterior and are
insensitive to the feelings of others, so this statement is not consistent with the disorder.
,For the past 3 days, a student has skipped classes, cried constantly, and experienced panic attacks.
She is now exhibiting difficulty with short-term memory. What crucial information should the nurse
initially obtain prior to planning interventions for this student?
1) The student's description of the precipitating stressor
2) The student's usual ability to cope with stress
3) The student's available support system
4) The student's access to community resources - ANSWER: 1. It is important to assess the
precipitating stressor that led to the student's behavioral symptoms. This information will be crucial
when planning client care.
After the nurse assesses the precipitating stressor, assessing the student's usual ability to cope with
stress could be beneficial.
After the nurse assesses the precipitating stressor, assessing the student's available support system
could be beneficial.
After the nurse assesses the precipitating stressor, assessing the student's access to community
resources could be beneficial.
The nurse is assessing a client for side effects of electroconvulsive therapy (ECT). Which side effects
are common and to be expected?
1) Temporary disorientation
2) Enduring memory loss
3) Residual seizure disorder
4) Cardiovascular complications - ANSWER: Temporary memory loss and confusion are common side
effects of ECT.
Permanent, or enduring, memory loss is not considered a common side effect of ECT.
Residual seizure disorder is not considered a common side effect of ECT.
Cardiovascular complications are not considered common side effects of ECT.
In evaluating learning, the nurse asked the client to answer the following statement: "When used in
combination with anxiolytic medication, alcohol leads to _____________ effects and caffeine leads to
_______________ effects."
1) Increased; increased
2) Increased; decreased
3) Decreased; decreased
4) Decreased; increased - ANSWER: 2.
Anxiolytic medications work through depression of certain CNS functions. Alcohol, which is a CNS
depressant, would increase/potentiate their effects. Caffeine, which is a CNS stimulant, would
decrease/inhibit their effects.
The disorder that is characterized by the presence of multiple motor tics and one or more vocal tics is
called ____________. - ANSWER: Tourette's disorder
Tourette's disorder is characterized by motor tics and vocal tics not attributable to a substance or
other medical condition. Pharmacotherapy is not recommended except in very severe cases.
Psychosocial therapies such as behavior therapy, individual counseling, and family therapy have been
identified as beneficial.
Disruption in identity and disruption in memory that are rooted in psychological traumas are
examples of dissociative responses. Psychodynamic theory would describe these responses in which
of the following ways?
1) An ego defense in the face of overwhelming anxiety
2) A cognitive distortion
3) A learned behavior
, 4) Factitious - ANSWER: Psychodynamic theory views dissociative responses as defense mechanisms
used by the ego to protect oneself from overwhelming anxiety.
Cognitive distortions are negative thinking patterns that, according to cognitive theorists, contribute
to illness.
Learning theorists suggest that responses are learned through reinforcement in families and society.
Factitious disorder is conscious, intentional feigning of symptoms. Dissociative responses are not
conscious or intentional efforts.
Walt is admitted to the forensic psychiatry unit after assaulting a store clerk for waiting on another
customer before him. He says the store clerk deserved to be hit "for being an idiot." He has previously
been diagnosed with antisocial personality disorder and his current nursing diagnosis is defensive
coping. Which of the following are recommended approaches in intervention for this diagnosis?
Select all that apply.
1) Explain the rules of the unit and consequences for violation of the rules.
2) Offer special privileges to facilitate a bond of trust.
3) Use a matter-of-fact approach in communication.4) Provide positive feedback and rewards for
acceptable behavior.
5) Repeatedly reinforce that antisocial people are a danger to society. - ANSWER: Feedback 1: Since
clients with this disorder do not self-impose limits on maladaptive behavior, clear communication of
rules and consequences is essential.
Feedback 2: Offering special privileges sends the message that the nurse-client relationship is open to
manipulation rather than being based on clear expectations. This is inappropriate and negatively
reinforces this client's manipulative behaviors.
Feedback 3: Clear, concrete, matter-of-fact communication is essential to minimize the opportunity
for misinterpretation or manipulation by the client.
Feedback 4: Positive reinforcement and privileges associated with acceptable behavior encourage
repetition of desirable behavior.
Feedback 5: A recommended approach in communication with this population is to focus on the
behavior, not the person, as being unacceptable.
Jennifer is a 25-year-old woman of average height and weight who reports to the mental health clinic
with complaints that she has been unable to go to work for the last 2 weeks because she can't get her
"appearance right." She reports that she repetitively checks the mirror and has to redo her make-up
every 5 or 10 minutes. Jennifer is most likely experiencing which of these disorders?
1) Social anxiety disorder
2) Panic disorder
3) Eating disorder
4) Body dysmorphic disorder - ANSWER: 4) Body Dysmorphic disorder
Repetitive mirror-checking and excessive grooming R/T perception of flawed appearance that
interferes with social, occupational, or other areas of functioning are symptoms of body dysmorphic
disorder.Social anxiety disorder is excessive fear of situations in which the person might do something
embarrassing or be evaluated negatively by others.
Panic disorder is characterized by unpredictable attacks of intense fear or sense of impending doom,
accompanied by somatic symptoms.Although individuals with eating disorders may have a
preoccupation with their appearance, there is no evidence of this disorder in the scenario.
Schizophrenia is best characterized as
A. split personality.
B. multiple personalities.
C. ambivalent personality.
D. deteriorating personality. - ANSWER: D.
Psychiatric Mental Health Nursing 9th Edition Karyn Morgan
Chapters 1-32 , 9781719645768 , All Chapters with Answers
and Rationals
As a last resort, an agitated, physically aggressive client is placed in four-point restraints. The client
yells, "I'll sue you for assault and battery!" The unit manager determines that the nurses are protected
under which condition?
1) The client is voluntarily committed and poses a danger to others on the unit.
2) The client is voluntarily committed and has a history of being a danger to others.
3) The client is involuntarily committed because of a history of violent
behavior.
4) The client is involuntarily committed and is refusing treatment. - ANSWER: As a threat to others,
the client can be restrained despite objections and voluntary commitment.
A history of being a danger to others does not indicate a current, imminent threat; therefore, the
client has the right to the least restrictive treatment alternative and restraints cannot be legally
applied.
A history of violent behavior does not indicate a current, imminent threat; therefore, the client has
the right to the least restrictive treatment alternative and restraints cannot be legally applied.
Treatment refusal is a client's right that can be lost if the client poses an imminent danger to self or
others or has been deemed incompetent and assigned a guardian. Neither of these situations exists;
therefore, the client has the right to the least restrictive treatment alternative and restraints cannot
be legally applied.
Oliver has been referred by his boss to the employee assistance program because of difficulties that
have arisen in his relationships with coworkers. During the nurse's intake assessment, which of the
following statements by Oliver are consistent with a diagnosis of paranoid personality disorder?
Select all that apply.
1) "I work very hard at my job."
2) "I stay away from my co-workers because they'd love to see me fail."
3) "I would have my boss' job if administration promoted people fairly."
4) "I set a trap in my office so I can tell if my coworkers have opened my file cabinets."
5) "I feel bad for my boss, he's been so stressed this last year." - ANSWER: Feedback 1: This is a
neutral statement that neither supports nor negates a diagnosis of paranoid personality disorder.
Significant statements would be those that convey inappropriate mistrust of others.
Feedback 2: This statement is a generalization of mistrust for all his coworkers and an assumption
that they intend to harm him in some way. This statement is consistent with paranoid personality
disorder.
Feedback 3: The sense that the individual would be more successful if not for unfair treatment is a
symptom of paranoid personality disorder.
Feedback 4: Testing others' honesty because of a pervasive fear that they can't betrusted is
symptomatic of paranoid personality disorder.
Feedback 5: Typically people with paranoid personality disorders have a hard exterior and are
insensitive to the feelings of others, so this statement is not consistent with the disorder.
,For the past 3 days, a student has skipped classes, cried constantly, and experienced panic attacks.
She is now exhibiting difficulty with short-term memory. What crucial information should the nurse
initially obtain prior to planning interventions for this student?
1) The student's description of the precipitating stressor
2) The student's usual ability to cope with stress
3) The student's available support system
4) The student's access to community resources - ANSWER: 1. It is important to assess the
precipitating stressor that led to the student's behavioral symptoms. This information will be crucial
when planning client care.
After the nurse assesses the precipitating stressor, assessing the student's usual ability to cope with
stress could be beneficial.
After the nurse assesses the precipitating stressor, assessing the student's available support system
could be beneficial.
After the nurse assesses the precipitating stressor, assessing the student's access to community
resources could be beneficial.
The nurse is assessing a client for side effects of electroconvulsive therapy (ECT). Which side effects
are common and to be expected?
1) Temporary disorientation
2) Enduring memory loss
3) Residual seizure disorder
4) Cardiovascular complications - ANSWER: Temporary memory loss and confusion are common side
effects of ECT.
Permanent, or enduring, memory loss is not considered a common side effect of ECT.
Residual seizure disorder is not considered a common side effect of ECT.
Cardiovascular complications are not considered common side effects of ECT.
In evaluating learning, the nurse asked the client to answer the following statement: "When used in
combination with anxiolytic medication, alcohol leads to _____________ effects and caffeine leads to
_______________ effects."
1) Increased; increased
2) Increased; decreased
3) Decreased; decreased
4) Decreased; increased - ANSWER: 2.
Anxiolytic medications work through depression of certain CNS functions. Alcohol, which is a CNS
depressant, would increase/potentiate their effects. Caffeine, which is a CNS stimulant, would
decrease/inhibit their effects.
The disorder that is characterized by the presence of multiple motor tics and one or more vocal tics is
called ____________. - ANSWER: Tourette's disorder
Tourette's disorder is characterized by motor tics and vocal tics not attributable to a substance or
other medical condition. Pharmacotherapy is not recommended except in very severe cases.
Psychosocial therapies such as behavior therapy, individual counseling, and family therapy have been
identified as beneficial.
Disruption in identity and disruption in memory that are rooted in psychological traumas are
examples of dissociative responses. Psychodynamic theory would describe these responses in which
of the following ways?
1) An ego defense in the face of overwhelming anxiety
2) A cognitive distortion
3) A learned behavior
, 4) Factitious - ANSWER: Psychodynamic theory views dissociative responses as defense mechanisms
used by the ego to protect oneself from overwhelming anxiety.
Cognitive distortions are negative thinking patterns that, according to cognitive theorists, contribute
to illness.
Learning theorists suggest that responses are learned through reinforcement in families and society.
Factitious disorder is conscious, intentional feigning of symptoms. Dissociative responses are not
conscious or intentional efforts.
Walt is admitted to the forensic psychiatry unit after assaulting a store clerk for waiting on another
customer before him. He says the store clerk deserved to be hit "for being an idiot." He has previously
been diagnosed with antisocial personality disorder and his current nursing diagnosis is defensive
coping. Which of the following are recommended approaches in intervention for this diagnosis?
Select all that apply.
1) Explain the rules of the unit and consequences for violation of the rules.
2) Offer special privileges to facilitate a bond of trust.
3) Use a matter-of-fact approach in communication.4) Provide positive feedback and rewards for
acceptable behavior.
5) Repeatedly reinforce that antisocial people are a danger to society. - ANSWER: Feedback 1: Since
clients with this disorder do not self-impose limits on maladaptive behavior, clear communication of
rules and consequences is essential.
Feedback 2: Offering special privileges sends the message that the nurse-client relationship is open to
manipulation rather than being based on clear expectations. This is inappropriate and negatively
reinforces this client's manipulative behaviors.
Feedback 3: Clear, concrete, matter-of-fact communication is essential to minimize the opportunity
for misinterpretation or manipulation by the client.
Feedback 4: Positive reinforcement and privileges associated with acceptable behavior encourage
repetition of desirable behavior.
Feedback 5: A recommended approach in communication with this population is to focus on the
behavior, not the person, as being unacceptable.
Jennifer is a 25-year-old woman of average height and weight who reports to the mental health clinic
with complaints that she has been unable to go to work for the last 2 weeks because she can't get her
"appearance right." She reports that she repetitively checks the mirror and has to redo her make-up
every 5 or 10 minutes. Jennifer is most likely experiencing which of these disorders?
1) Social anxiety disorder
2) Panic disorder
3) Eating disorder
4) Body dysmorphic disorder - ANSWER: 4) Body Dysmorphic disorder
Repetitive mirror-checking and excessive grooming R/T perception of flawed appearance that
interferes with social, occupational, or other areas of functioning are symptoms of body dysmorphic
disorder.Social anxiety disorder is excessive fear of situations in which the person might do something
embarrassing or be evaluated negatively by others.
Panic disorder is characterized by unpredictable attacks of intense fear or sense of impending doom,
accompanied by somatic symptoms.Although individuals with eating disorders may have a
preoccupation with their appearance, there is no evidence of this disorder in the scenario.
Schizophrenia is best characterized as
A. split personality.
B. multiple personalities.
C. ambivalent personality.
D. deteriorating personality. - ANSWER: D.
