TEST BANK
Introductory Mental Health Nursing
Cynthia A. Kincheloe
5th Edition
,Table of Contents
Chapter 01 Mental Health and Mental Illness 1
Chapter 02 The Delivery of Mental Health Care 14
Chapter 03 Theories of Development 24
Chapter 04 Treatment of Mental Illness 37
Chapter 05 Establishing and Maintaining a Therapeutic Relationship 47
Chapter 06 Dynamics of Anger, Violence, and Crises 56
Chapter 07 Communication in Mental Health Nursing 66
Chapter 08 The Nursing Process in Mental Health Nursing 76
Chapter 09 Anxiety Disorders 85
Chapter 10 Mood Disorders 95
Chapter 11 Psychotic Disorders 105
Chapter 12 Personality Disorders 115
Chapter 13 Somatic Symptom and Related Disorders 125
Chapter 14 Dissociative Disorders 136
Chapter 15 Substance Use and Addiction 150
Chapter 16 Eating Disorders 164
Chapter 17 Mental Health Issues Related to Gender and Sexuality 173
Chapter 18 Disorders and Issues of Children and Adolescents 183
Chapter 19 Disorders and Issues of the Older Adult 195
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
Chapter 1, Mental Health and Mental Illness
1. The nurse is evaluating a client's ability to engage in adaptive coping strategies. Which
client statement supports the nurse's belief that the client is successfully managing the stress
of a recent divorce?
A. “Loving someone is no guarantee that they will love you back.”
B. “I know now that we were never really meant to be together.”
C. “It's not my fault I loved someone who was incapable of being faithful.”
D. “I'm a lovable person who has control over my own happiness.”
ANS: C
Rationale: In most situations, the sense of control an individual feels over a particular
stressor determines how they think about or perceive it. Reframing is a way of restructuring
our thinking about a stressful event into one that is less disturbing and over which we can
have some control such as the belief that one is lovable and in control. The remaining
options state feelings that deflect the hurt felt or that provide a rationale for the divorce.
PTS: 1 REF: Page and Header: 7, Promoting Adaptive Coping Strategies
OBJ: 4 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
2. When working with a client who is grieving, which nursing action best demonstrates an
understanding of the grieving process and the most effective means of facilitating the
client's ability to bring about closure and display hope for the future?
A. Using open-ended questioning techniques when communicating with the client
who is currently in the grieving process
B. Devoting time each meeting to discussing the feelings the client has described in
daily journal entries
C. Sharing with the grieving client that the client's grief is demonstrated in very
specific and personal ways that are unique to the person alone
D. Assuring the client that while the grieving process has identifiable stages, there is
no specific timetable for moving through these stages
ANS: B
Rationale: Interventions that assist individuals with the grieving process should encourage
openness and honesty about their feelings, while encouraging expressions of hope for the
future and reinvestment in life interests. Journaling, that encourages the expression of
grief-related feelings, has proven to be an effective intervention in this process and can help
bring closure. Open-ended questioning focuses on effective information gathering especially
related to the assessment of the grieving client. It is true that the grieving process is an
experience that is unique to each individual and not bound by specific timetables; sharing
this information with the client does not facilitate the expression of feelings so necessary to
the successful management of acute grief.
PTS: 1 REF: Page and Header: 15, Coping With Grief and Loss
OBJ: 11 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
______________________________________________________________________________________________
1|Page
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply NOT: Multiple Choice
3. When considering the various aspects of stress, which client statement would the nurse
interpret as accurately describing eustress?
A. “I often feel stressed by the end of a very hectic shift.”
B. “When I'm really stressed, I usually get a severe headache.”
C. “I generally do my best work when I feel some stress.”
D. “When you become a nurse, you become familiar with stress.”
ANS: C
Rationale: Eustress is positive and motivating, as shown by one's confidence in the ability to
master a challenge or stressor as reflected by the statement of doing one’s best work when
feeling some stress. Stress results when a threat or challenge to one's well-being requires the
person to adjust or adapt to the environment. Distress in response to a threat or challenge is
actually harmful to one's health. This is a negative stress and demands an exhausting type of
energy.
PTS: 1 REF: Page and Header: 7, Defining Stress
OBJ: 5 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1 KEY: Integrated Process: Communication and Documentation
BLM: Cognitive Level: Analyze NOT: Multiple Choice
4. Which client statement supports the nurse's suspicions that a client being treated for chronic
depression is experiencing severe emotional distress produced by external circumstances?
A. “My professional life is ruined because my boss never recognizes my worth and
value.”
B. “My doctor told me that I have to manage my stress or risk having a heart attack.”
C. “I have been depressed ever since I was diagnosed with leukemia.”
D. “I'm never comfortable when I know that I have to fly for my work.”
ANS: A
Rationale: It is important to recognize that many times people view external circumstances
as the cause of their stress such as in the case of the client's perception of the boss's
viewpoint. The remaining options demonstrate internal or self-perceptions and viewpoints.
PTS: 1
REF: Page and Header: 9, Contributing Factors to Stress and Anxiety
OBJ: 6 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
5. A young adult student recently failed a major exam. While talking with the student, the
nurse determines that the student is using reframing to cope with the resulting anxiety based
on which student statement?
A. “That course is taught again next semester; if I fail, I'll take it over then.”
B. “I've decided to transfer to another section that's taught by an easier teacher.”
C. “That exam wasn't really that important. I'll do better on the next one.”
D. “I've arranged to join a study group so I'll do better on the next exam.”
______________________________________________________________________________________________
2|Page
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
ANS: D
Rationale: Reframing is a way of restructuring our thinking about a stressful event into one
that is less disturbing and over which we can have some control such as deciding on a plan
to improve on their next exam grade. Reframing does not involve minimization,
transference, or denial of the problem.
PTS: 1 REF: Page and Header: 7, Promoting Adaptive Coping Strategies
OBJ: 4 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
6. A college student who is very anxious about auditioning for the school's famous chorale
comes to the health center for assistance. During the interview, the student reveals using
various coping strategies. Which strategy would the nurse recognize as being maladaptive?
A. Arranging for private voice lessons
B. Practicing the songs used in the audition
C. Repeatedly telling friends it's okay to fail
D. Singing with a group of friends who are also auditioning
ANS: C
Rationale: Maladaptive and dysfunctional strategies usually do not result in a positive
outcome. The individual who does not attempt to reduce the anxiety or solve the problem is
considered to have dysfunctional coping in response to the stressor and the emotional
response. In this scenario, the student does not attempt to reduce the anxiety of auditioning
but rather decides that failing will be acceptable. The other options demonstrate some
positive action directed toward preparing for the audition and so reducing anxiety.
PTS: 1 REF: Page and Header: 6, Coping Strategies
OBJ: 4 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply NOT: Multiple Choice
7. A nurse assisting a client in dealing with the grief associated with the death of a loved one.
Which intervention would the nurse do first?
A. Use open-ended questions to explore the client's feelings about grief and encourage
communication.
B. Engage in self-reflection regarding personal beliefs and values associated with
death and dying
C. Help the client identify the members of the client's support system and the
importance of their assistance.
D. Assist the client in creating a letter to the deceased in order to facilitate closure for
the relationship.
ANS: B
______________________________________________________________________________________________
3|Page
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
Rationale: To deal effectively with the client experiencing grief, the nurse must face the
reality of their own mortality and the concept of death. While all the remaining options are
appropriate interventions, the process must begin with the nurse working toward an
understanding of their personal grief beliefs and the ability to provide unbiased support to
the client.
PTS: 1 REF: Page and Header: 15, Coping With Grief and Loss
OBJ: 11 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1 KEY: Integrated Process: Caring
BLM: Cognitive Level: Apply NOT: Multiple Choice
8. The nurse suspects a client is demonstrating signs of dysfunctional grief. Which question
would the nurse most likely use to help confirm this suspicion?
A. “How would you define grief?”
B. “What gives your life meaning?”
C. “Have you ever thought about hurting yourself?”
D. “When did you first notice the feelings of grief?”
ANS: B
Rationale: Dysfunctional grief is a failure to complete the grieving process and cope
successfully with a loss. If the person experiences a prolonged and intensified reaction, life
may become meaningless and a mere existence centered on longing for that which is lost.
While the assessment should attempt to identify when the symptoms began and how the
client views their condition, this information will not necessarily support a diagnosis of
dysfunctional grief. Assessing for suicidal ideations is appropriate for clients experiencing a
variety of mental health disorders.
PTS: 1 REF: Page and Header: 13, Types of Grief
OBJ: 8 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply NOT: Multiple Choice
9. While gathering information from a client who has experienced a loss, the client states,
“I’ve been doing okay, but I still have periods of grief from time to time, especially around
the time of our anniversary, knowing that we’ll never get to celebrate our 50th.” The nurse
interprets this statement as reflecting which condition?
A. Dysfunctional grief
B. Chronic sorrow
C. Unresolved grief
D. Conventional grief
ANS: B
______________________________________________________________________________________________
4|Page
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
Rationale: A person’s response to a loss is uniquely personal and is dependent on the
person’s level of development, past experiences with loss and grief as well as past and
present coping strategies. The client’s statement reflects chronic sorrow, which is seen in a
situation where the grief resurfaces at times, but never fully goes away. Dysfunctional grief
is a failure to complete the grieving process and cope successfully with a loss. If the person
experiences a prolonged and intensified reaction, life may become meaningless and a mere
existence centered on longing for that which is lost. Unresolved grief describes situations
when the grief process is incomplete, and life is burdened with maladaptive symptoms
continuing months after the loss has occurred. Conventional grief is primarily associated
with the grief that is experienced following a loss.
PTS: 1 REF: Page and Header: 13, Types of Grief
OBJ: 8 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply NOT: Multiple Choice
10. A client is telling the nurse about a recent stressful experience. Which client statement
would the nurse interpret as indicating the client experienced the fight-or- flight response?
A. “When I feel stressed, I get this surge of energy.”
B. “I find it difficult to make decisions when I'm stressed.”
C. “I can't remember a time when I didn't feel stressed.”
D. “I can't seem to relax even after the stress is gone.”
ANS: A
Rationale: The fight-or-flight response is a reaction to an immediate threat (acute stress) in
which there is a surge of adrenalin into the bloodstream. It is referred to in this way because
it provides the energy or instant strength to either fight or run away from an acute danger or
threat. This type of response can occur in situations where there is a sense of imminent
danger and the response is usually reversed to a relaxation mode once the danger is past.
Poor concentration is characteristic of a moderate level of anxiety. Chronic stress occurs
when the situation is ongoing or continuous.
PTS: 1 REF: Page and Header: 8, Defining Stress
OBJ: 5 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
11. A client recently diagnosed with a terminal illness appears to be denying the finality of the
condition. The client's adult child expresses concern. Which response by the nurse would be
most effective in explaining the therapeutic value of denial?
A. “Denial allows your parent time to prepare for their death.”
B. “Denial is a natural response to bad news and is expected.”
C. “The first stage of the healthy grief process is denial.”
D. “Your parent will soon move into the anger stage of the process.”
ANS: A
______________________________________________________________________________________________
5|Page
, ______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
Rationale: The first stage of grief is shock, disbelief, and denial that the event is happening.
Denial allows an adjustment period in which to gather coping strategies for the grieving
work ahead. While the remaining options are true, none explain the positive purpose of
denial associated with the grief process.
PTS: 1 REF: Page and Header: 14, Stages of Grief
OBJ: Apply NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1 KEY: Integrated Process: Caring
BLM: Cognitive Level: 9 NOT: Multiple Choice
12. The nurse determines that a client understands the concept of being mentally healthy based
on which client statement?
A. “I try to eliminate stress from my life.”
B. “If I'm physically healthy, I'll be mentally healthy.”
C. “Mental health is dependent on one's early childhood experience.”
D. “I make every effort to balance work, play, and my relationships.”
ANS: D
Rationale: Mental health involves the components of emotional, psychological, and social
well-being; the balance between the individual’s cognitive, behavioral, and emotional states;
and the individual’s ability to handle stress and adversity, relate to others, emote (express)
their feelings, and make healthy choices. It is not possible or even desirable to eliminate
stress from one's life. One can be mentally healthy but be considered physically unhealthy.
While being cared for and supported effectively during childhood can have an impact on
mental health, there are other factors that must be considered.
PTS: 1 REF: Page and Header: 2, Mental Health OBJ: 1
NAT: Client Needs: Psychosocial Integrity TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
13. A client is observed pacing back and forth in the room. When the nurse attempts to gather
more information from the client about the behavior, the client responds, “I don't know why
but I'm really feeling uneasy.” This response most likely reflects which situation?
A. Stress
B. Anxiety
C. Distress
D. Grief
ANS: B
Rationale: Anxiety is defined as a feeling of apprehension, uneasiness, or uncertainty that
occurs in response to a real or perceived threat whose source is not known. It is an automatic
and unconscious biologic response to a stressor that cannot be controlled by our conscious
minds. Stress, on the other hand, is the condition that results when a threat or challenge to
one's well-being requires the person to adjust or adapt to the environment. Distress is
negative stress in response to a threat or challenge that exhausts and drains energy from the
individual. Grief is defined as the emotional process of coping with a loss.
PTS: 1 REF: Page and Header: 8, Defining Anxiety
OBJ: 5 NAT: Client Needs: Psychosocial Integrity
______________________________________________________________________________________________
6|Page
Introductory Mental Health Nursing
Cynthia A. Kincheloe
5th Edition
,Table of Contents
Chapter 01 Mental Health and Mental Illness 1
Chapter 02 The Delivery of Mental Health Care 14
Chapter 03 Theories of Development 24
Chapter 04 Treatment of Mental Illness 37
Chapter 05 Establishing and Maintaining a Therapeutic Relationship 47
Chapter 06 Dynamics of Anger, Violence, and Crises 56
Chapter 07 Communication in Mental Health Nursing 66
Chapter 08 The Nursing Process in Mental Health Nursing 76
Chapter 09 Anxiety Disorders 85
Chapter 10 Mood Disorders 95
Chapter 11 Psychotic Disorders 105
Chapter 12 Personality Disorders 115
Chapter 13 Somatic Symptom and Related Disorders 125
Chapter 14 Dissociative Disorders 136
Chapter 15 Substance Use and Addiction 150
Chapter 16 Eating Disorders 164
Chapter 17 Mental Health Issues Related to Gender and Sexuality 173
Chapter 18 Disorders and Issues of Children and Adolescents 183
Chapter 19 Disorders and Issues of the Older Adult 195
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
Chapter 1, Mental Health and Mental Illness
1. The nurse is evaluating a client's ability to engage in adaptive coping strategies. Which
client statement supports the nurse's belief that the client is successfully managing the stress
of a recent divorce?
A. “Loving someone is no guarantee that they will love you back.”
B. “I know now that we were never really meant to be together.”
C. “It's not my fault I loved someone who was incapable of being faithful.”
D. “I'm a lovable person who has control over my own happiness.”
ANS: C
Rationale: In most situations, the sense of control an individual feels over a particular
stressor determines how they think about or perceive it. Reframing is a way of restructuring
our thinking about a stressful event into one that is less disturbing and over which we can
have some control such as the belief that one is lovable and in control. The remaining
options state feelings that deflect the hurt felt or that provide a rationale for the divorce.
PTS: 1 REF: Page and Header: 7, Promoting Adaptive Coping Strategies
OBJ: 4 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
2. When working with a client who is grieving, which nursing action best demonstrates an
understanding of the grieving process and the most effective means of facilitating the
client's ability to bring about closure and display hope for the future?
A. Using open-ended questioning techniques when communicating with the client
who is currently in the grieving process
B. Devoting time each meeting to discussing the feelings the client has described in
daily journal entries
C. Sharing with the grieving client that the client's grief is demonstrated in very
specific and personal ways that are unique to the person alone
D. Assuring the client that while the grieving process has identifiable stages, there is
no specific timetable for moving through these stages
ANS: B
Rationale: Interventions that assist individuals with the grieving process should encourage
openness and honesty about their feelings, while encouraging expressions of hope for the
future and reinvestment in life interests. Journaling, that encourages the expression of
grief-related feelings, has proven to be an effective intervention in this process and can help
bring closure. Open-ended questioning focuses on effective information gathering especially
related to the assessment of the grieving client. It is true that the grieving process is an
experience that is unique to each individual and not bound by specific timetables; sharing
this information with the client does not facilitate the expression of feelings so necessary to
the successful management of acute grief.
PTS: 1 REF: Page and Header: 15, Coping With Grief and Loss
OBJ: 11 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
______________________________________________________________________________________________
1|Page
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply NOT: Multiple Choice
3. When considering the various aspects of stress, which client statement would the nurse
interpret as accurately describing eustress?
A. “I often feel stressed by the end of a very hectic shift.”
B. “When I'm really stressed, I usually get a severe headache.”
C. “I generally do my best work when I feel some stress.”
D. “When you become a nurse, you become familiar with stress.”
ANS: C
Rationale: Eustress is positive and motivating, as shown by one's confidence in the ability to
master a challenge or stressor as reflected by the statement of doing one’s best work when
feeling some stress. Stress results when a threat or challenge to one's well-being requires the
person to adjust or adapt to the environment. Distress in response to a threat or challenge is
actually harmful to one's health. This is a negative stress and demands an exhausting type of
energy.
PTS: 1 REF: Page and Header: 7, Defining Stress
OBJ: 5 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1 KEY: Integrated Process: Communication and Documentation
BLM: Cognitive Level: Analyze NOT: Multiple Choice
4. Which client statement supports the nurse's suspicions that a client being treated for chronic
depression is experiencing severe emotional distress produced by external circumstances?
A. “My professional life is ruined because my boss never recognizes my worth and
value.”
B. “My doctor told me that I have to manage my stress or risk having a heart attack.”
C. “I have been depressed ever since I was diagnosed with leukemia.”
D. “I'm never comfortable when I know that I have to fly for my work.”
ANS: A
Rationale: It is important to recognize that many times people view external circumstances
as the cause of their stress such as in the case of the client's perception of the boss's
viewpoint. The remaining options demonstrate internal or self-perceptions and viewpoints.
PTS: 1
REF: Page and Header: 9, Contributing Factors to Stress and Anxiety
OBJ: 6 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
5. A young adult student recently failed a major exam. While talking with the student, the
nurse determines that the student is using reframing to cope with the resulting anxiety based
on which student statement?
A. “That course is taught again next semester; if I fail, I'll take it over then.”
B. “I've decided to transfer to another section that's taught by an easier teacher.”
C. “That exam wasn't really that important. I'll do better on the next one.”
D. “I've arranged to join a study group so I'll do better on the next exam.”
______________________________________________________________________________________________
2|Page
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
ANS: D
Rationale: Reframing is a way of restructuring our thinking about a stressful event into one
that is less disturbing and over which we can have some control such as deciding on a plan
to improve on their next exam grade. Reframing does not involve minimization,
transference, or denial of the problem.
PTS: 1 REF: Page and Header: 7, Promoting Adaptive Coping Strategies
OBJ: 4 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
6. A college student who is very anxious about auditioning for the school's famous chorale
comes to the health center for assistance. During the interview, the student reveals using
various coping strategies. Which strategy would the nurse recognize as being maladaptive?
A. Arranging for private voice lessons
B. Practicing the songs used in the audition
C. Repeatedly telling friends it's okay to fail
D. Singing with a group of friends who are also auditioning
ANS: C
Rationale: Maladaptive and dysfunctional strategies usually do not result in a positive
outcome. The individual who does not attempt to reduce the anxiety or solve the problem is
considered to have dysfunctional coping in response to the stressor and the emotional
response. In this scenario, the student does not attempt to reduce the anxiety of auditioning
but rather decides that failing will be acceptable. The other options demonstrate some
positive action directed toward preparing for the audition and so reducing anxiety.
PTS: 1 REF: Page and Header: 6, Coping Strategies
OBJ: 4 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply NOT: Multiple Choice
7. A nurse assisting a client in dealing with the grief associated with the death of a loved one.
Which intervention would the nurse do first?
A. Use open-ended questions to explore the client's feelings about grief and encourage
communication.
B. Engage in self-reflection regarding personal beliefs and values associated with
death and dying
C. Help the client identify the members of the client's support system and the
importance of their assistance.
D. Assist the client in creating a letter to the deceased in order to facilitate closure for
the relationship.
ANS: B
______________________________________________________________________________________________
3|Page
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
Rationale: To deal effectively with the client experiencing grief, the nurse must face the
reality of their own mortality and the concept of death. While all the remaining options are
appropriate interventions, the process must begin with the nurse working toward an
understanding of their personal grief beliefs and the ability to provide unbiased support to
the client.
PTS: 1 REF: Page and Header: 15, Coping With Grief and Loss
OBJ: 11 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1 KEY: Integrated Process: Caring
BLM: Cognitive Level: Apply NOT: Multiple Choice
8. The nurse suspects a client is demonstrating signs of dysfunctional grief. Which question
would the nurse most likely use to help confirm this suspicion?
A. “How would you define grief?”
B. “What gives your life meaning?”
C. “Have you ever thought about hurting yourself?”
D. “When did you first notice the feelings of grief?”
ANS: B
Rationale: Dysfunctional grief is a failure to complete the grieving process and cope
successfully with a loss. If the person experiences a prolonged and intensified reaction, life
may become meaningless and a mere existence centered on longing for that which is lost.
While the assessment should attempt to identify when the symptoms began and how the
client views their condition, this information will not necessarily support a diagnosis of
dysfunctional grief. Assessing for suicidal ideations is appropriate for clients experiencing a
variety of mental health disorders.
PTS: 1 REF: Page and Header: 13, Types of Grief
OBJ: 8 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply NOT: Multiple Choice
9. While gathering information from a client who has experienced a loss, the client states,
“I’ve been doing okay, but I still have periods of grief from time to time, especially around
the time of our anniversary, knowing that we’ll never get to celebrate our 50th.” The nurse
interprets this statement as reflecting which condition?
A. Dysfunctional grief
B. Chronic sorrow
C. Unresolved grief
D. Conventional grief
ANS: B
______________________________________________________________________________________________
4|Page
,______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
Rationale: A person’s response to a loss is uniquely personal and is dependent on the
person’s level of development, past experiences with loss and grief as well as past and
present coping strategies. The client’s statement reflects chronic sorrow, which is seen in a
situation where the grief resurfaces at times, but never fully goes away. Dysfunctional grief
is a failure to complete the grieving process and cope successfully with a loss. If the person
experiences a prolonged and intensified reaction, life may become meaningless and a mere
existence centered on longing for that which is lost. Unresolved grief describes situations
when the grief process is incomplete, and life is burdened with maladaptive symptoms
continuing months after the loss has occurred. Conventional grief is primarily associated
with the grief that is experienced following a loss.
PTS: 1 REF: Page and Header: 13, Types of Grief
OBJ: 8 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply NOT: Multiple Choice
10. A client is telling the nurse about a recent stressful experience. Which client statement
would the nurse interpret as indicating the client experienced the fight-or- flight response?
A. “When I feel stressed, I get this surge of energy.”
B. “I find it difficult to make decisions when I'm stressed.”
C. “I can't remember a time when I didn't feel stressed.”
D. “I can't seem to relax even after the stress is gone.”
ANS: A
Rationale: The fight-or-flight response is a reaction to an immediate threat (acute stress) in
which there is a surge of adrenalin into the bloodstream. It is referred to in this way because
it provides the energy or instant strength to either fight or run away from an acute danger or
threat. This type of response can occur in situations where there is a sense of imminent
danger and the response is usually reversed to a relaxation mode once the danger is past.
Poor concentration is characteristic of a moderate level of anxiety. Chronic stress occurs
when the situation is ongoing or continuous.
PTS: 1 REF: Page and Header: 8, Defining Stress
OBJ: 5 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
11. A client recently diagnosed with a terminal illness appears to be denying the finality of the
condition. The client's adult child expresses concern. Which response by the nurse would be
most effective in explaining the therapeutic value of denial?
A. “Denial allows your parent time to prepare for their death.”
B. “Denial is a natural response to bad news and is expected.”
C. “The first stage of the healthy grief process is denial.”
D. “Your parent will soon move into the anger stage of the process.”
ANS: A
______________________________________________________________________________________________
5|Page
, ______________________________________________________________________________________________
Test Bank - Introductory Mental Health Nursing, 5th Edition (Kincheloe, 2024)
Rationale: The first stage of grief is shock, disbelief, and denial that the event is happening.
Denial allows an adjustment period in which to gather coping strategies for the grieving
work ahead. While the remaining options are true, none explain the positive purpose of
denial associated with the grief process.
PTS: 1 REF: Page and Header: 14, Stages of Grief
OBJ: Apply NAT: Client Needs: Psychosocial Integrity
TOP: Chapter: 1 KEY: Integrated Process: Caring
BLM: Cognitive Level: 9 NOT: Multiple Choice
12. The nurse determines that a client understands the concept of being mentally healthy based
on which client statement?
A. “I try to eliminate stress from my life.”
B. “If I'm physically healthy, I'll be mentally healthy.”
C. “Mental health is dependent on one's early childhood experience.”
D. “I make every effort to balance work, play, and my relationships.”
ANS: D
Rationale: Mental health involves the components of emotional, psychological, and social
well-being; the balance between the individual’s cognitive, behavioral, and emotional states;
and the individual’s ability to handle stress and adversity, relate to others, emote (express)
their feelings, and make healthy choices. It is not possible or even desirable to eliminate
stress from one's life. One can be mentally healthy but be considered physically unhealthy.
While being cared for and supported effectively during childhood can have an impact on
mental health, there are other factors that must be considered.
PTS: 1 REF: Page and Header: 2, Mental Health OBJ: 1
NAT: Client Needs: Psychosocial Integrity TOP: Chapter: 1
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
13. A client is observed pacing back and forth in the room. When the nurse attempts to gather
more information from the client about the behavior, the client responds, “I don't know why
but I'm really feeling uneasy.” This response most likely reflects which situation?
A. Stress
B. Anxiety
C. Distress
D. Grief
ANS: B
Rationale: Anxiety is defined as a feeling of apprehension, uneasiness, or uncertainty that
occurs in response to a real or perceived threat whose source is not known. It is an automatic
and unconscious biologic response to a stressor that cannot be controlled by our conscious
minds. Stress, on the other hand, is the condition that results when a threat or challenge to
one's well-being requires the person to adjust or adapt to the environment. Distress is
negative stress in response to a threat or challenge that exhausts and drains energy from the
individual. Grief is defined as the emotional process of coping with a loss.
PTS: 1 REF: Page and Header: 8, Defining Anxiety
OBJ: 5 NAT: Client Needs: Psychosocial Integrity
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