1. Which outcome, focused on recovery, would be expected in the plan of care for a pa ent living in the
community and diagnosed with serious and persistent mental illness? Within 3 months, the pa ent will:
a. deny suicidal idea on.
b. report a sense of well-being.
c. take medica ons as prescribed.
d. a end clinic appointments on me. - Report a sense of well-being
2. A pa ent is hospitalized for depression and suicidal idea on a er their spouse asks for a divorce.
Select the nurse's most caring comment.
a. "Let's discuss some means of coping other than suicide when you have these feelings."
b. "I understand why you're so depressed. When I got divorced, I was devastated too."
c. "You should forget about your marriage and move on with your life."
d. "How did you get so depressed that hospitaliza on was necessary?" - ANS: A
The nurse's communica on should evidence caring and a commitment to work with the pa ent. This
commitment lets the pa ent know the nurse will help. Probing and advice are not helpful or therapeu c
interven ons.
3. In the shi -change report, an off-going nurse cri cizes a pa ent who wears heavy makeup. Which
comment by the nurse who receives the report best demonstrates advocacy?
a. "This is a psychiatric hospital. Craziness is what we are all about."
b. "Let's all show acceptance of this pa ent by wearing lots of makeup too."
c. "Your comments are inconsiderate and inappropriate. Keep the report objec ve."
d. "Our pa ents need our help to learn behaviors that will help them get along in society." - ANS: D
Accep ng pa ents' needs for self-expression and seeking to teach skills that will contribute to their well-
being demonstrate respect and are important parts of advocacy. The on-coming nurse needs to take
ac on to ensure that others are not prejudiced against the pa ent. Humor can be appropriate within the
privacy of a shi report but not at the expense of respect for pa ents. Judging the off-going nurse in a
cri cal way will create conflict. Nurses must show compassion for each other.
,4. A nurse assesses a newly admi ed pa ent diagnosed with major depressive disorder. Which
statement is an example of "a ending"?
a. "We all have stress in life. Being in a psychiatric hospital isn't the end of the world."
b. "Tell me why you felt you had to be hospitalized to receive treatment for your depression."
c. "You will feel be er a er we get some an depressant medica on started for you."
d. "I'd like to sit with you a while so you may feel more comfortable talking with me." - ANS: D
A ending is a technique that demonstrates the nurse's commitment to the rela onship and reduces
feelings of isola on. This technique shows respect for the pa ent and demonstrates caring.
Generaliza ons, probing, and false reassurances are non-therapeu c.
5. A pa ent shows the nurse an ar cle from the Internet about a health problem. Which characteris c of
the web site's address most alerts the nurse that the site may have biased and prejudiced informa on?
a. Address ends in ".org."
b. Address ends in ".com."
c. Address ends in ".gov."
d. Address ends in ".net." - ANS: B
Financial influences on a site are a clue that the informa on may be biased. ".com" at the end of the
address indicates that the site is a commercial one. ".gov" indicates that the site is maintained by a
government en ty. ".org" indicates that the site is nonproprietary; the site may or may not have reliable
informa on, but it does not profit from its ac vi es. ".net" can have mul ple meanings.
6. A nurse says, "When I was in school, I learned to call upset pa ents by name to get their a en on;
however, I read a descrip ve research study that says that this approach does not work. I plan to stop
calling pa ents by name." Which statement is the best appraisal of this nurse's comment?
a. One descrip ve research study rarely provides enough evidence to change prac ce.
b. Staff nurses apply new research findings only with the help from clinical nurse specialists.
c. New research findings should be incorporated into clinical algorithms before using them in prac ce.
d. The nurse misinterpreted the results of the study. Classic tenets of prac ce do not change. - ANS: A
Descrip ve research findings provide evidence for prac ce but must be viewed in rela on to other
studies before prac ce changes. One study is not enough. Descrip ve studies are low on the hierarchy of
evidence. Clinical algorithms use flow charts to manage problems and do not specify one response to a
clinical problem. Classic tenets of prac ce should change as research findings provide evidence for
change.
,7. Two nursing students discuss career plans a er gradua on. One student wants to enter psychiatric
nursing. The other student asks, "Why would you want to be a psychiatric nurse? All they do is talk. You
will lose your skills." Select the best response by the student interested in psychiatric nursing.
a. "Psychiatric nurses prac ce in safer environments than other special es. Nurse-to-pa ent ra os must
be be er because of the nature of pa ents' problems."
b. "Psychiatric nurses use complex communica on skills, as well as cri cal thinking, to solve
mul dimensional problems. I'm challenged by those situa ons."
c. "I think I will be good in the mental health field. I do not like clinical rota ons in school, so I do not
want to con nue them a er I graduate."
d. "Psychiatric nurses do not have to deal with as much pain and suffering as medical surgical nurses.
That appeals to me." - ANS: B
The prac ce of psychiatric nursing requires a different set of skills than medical surgical nursing,
although substan al overlap does exist. Psychiatric nurses must be able to help pa ents with medical
and mental health problems, reflec ng the holis c perspec ve these nurses must have. Nurse-pa ent
ra os and workloads in psychiatric se ngs have increased, similar to other special es. Psychiatric
nursing involves clinical prac ce, not simply documenta on. Psychosocial pain is real and can cause as
much suffering as physical pain.
8. Which research evidence would most influence a group of nurses to change their prac ce?
a. Expert commi ee report of recommenda ons for prac ce
b. Systema c review of randomized controlled trials
c. Nonexperimental descrip ve study
d. Cri cal pathway - ANS: B
Research findings are graded using a hierarchy of evidence. A systema c review of randomized
controlled trials is Level A and provides the strongest evidence for changing prac ce. Expert commi ee
recommenda ons and descrip ve studies lend less powerful and influen al evidence. A cri cal pathway
is not evidence; it incorporates research findings a er they have been analyzed.
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with mental
illnesses. A group of nurses write le ers to their elected representa ves in opposi on to the legisla on.
Which role have the nurses fulfilled?
a. Advocacy
b. A ending
, c. Recovery
d. Evidence-based prac ce - ANS: A
An advocate defends or asserts another's cause, par cularly when the other person lacks the ability to
do that for himself or herself. Examples of individual advocacy include helping pa ents understand their
rights or make decisions. On a community scale, advocacy includes poli cal ac vity, public speaking, and
publica on in the interest of improving the individuals with mental illness; the le er-wri ng campaign
advocates for that cause on behalf of pa ents who are unable to ar culate their own needs.
10. An informal group of pa ents discuss their percep ons of nursing care. Which comment best
indicates a pa ent's percep on that his or her nurse is caring?
a. "My nurse always asks me which type of juice I want to help me swallow my medica on."
b. "My nurse explained my treatment plan to me and asked for my ideas about how to make it be er."
c. "My nurse told me that if I take all the medicines the doctor prescribes I will get discharged soon."
d. "My nurse spends me listening to me talk about my problems. That helps me feel like I'm not alone."
- ANS: D
Caring evidences empathic understanding, as well as competency. It helps change pain and suffering into
a shared experience, crea ng a human connec on that alleviates feelings of isola on. The incorrect
op ons give examples of statements that demonstrate advocacy or giving advice.
11. A pa ent who immigrated to the United States from Honduras was diagnosed with schizophrenia.
The pa ent took an an psycho c medica on for 3 weeks but showed no improvement. Which resource
should the treatment team consult for informa on on more effec ve medica ons for this pa ent?
a. Clinical algorithm
b. Clinical pathway
c. Clinical prac ce guideline
d. Interna onal Sta s cal Classifica on of Diseases and Related Health Problems (ICD) - ANS: A
A clinical algorithm is a guideline that describes diagnos c and/or treatment approaches drawn from
large databases of informa on. These guidelines help the treatment team make decisions cognizant of
an individual pa ent's needs, such as ethnic origin, age, or gender. A clinical pathway is a map of
interven ons and treatments related to a specific disorder. Clinical prac ce guidelines summarize best
prac ces about specific health problems. The ICD classifies diseases.
12. Which historical nursing leader helped focus prac ce to recognize the importance of science in
psychiatric nursing?
community and diagnosed with serious and persistent mental illness? Within 3 months, the pa ent will:
a. deny suicidal idea on.
b. report a sense of well-being.
c. take medica ons as prescribed.
d. a end clinic appointments on me. - Report a sense of well-being
2. A pa ent is hospitalized for depression and suicidal idea on a er their spouse asks for a divorce.
Select the nurse's most caring comment.
a. "Let's discuss some means of coping other than suicide when you have these feelings."
b. "I understand why you're so depressed. When I got divorced, I was devastated too."
c. "You should forget about your marriage and move on with your life."
d. "How did you get so depressed that hospitaliza on was necessary?" - ANS: A
The nurse's communica on should evidence caring and a commitment to work with the pa ent. This
commitment lets the pa ent know the nurse will help. Probing and advice are not helpful or therapeu c
interven ons.
3. In the shi -change report, an off-going nurse cri cizes a pa ent who wears heavy makeup. Which
comment by the nurse who receives the report best demonstrates advocacy?
a. "This is a psychiatric hospital. Craziness is what we are all about."
b. "Let's all show acceptance of this pa ent by wearing lots of makeup too."
c. "Your comments are inconsiderate and inappropriate. Keep the report objec ve."
d. "Our pa ents need our help to learn behaviors that will help them get along in society." - ANS: D
Accep ng pa ents' needs for self-expression and seeking to teach skills that will contribute to their well-
being demonstrate respect and are important parts of advocacy. The on-coming nurse needs to take
ac on to ensure that others are not prejudiced against the pa ent. Humor can be appropriate within the
privacy of a shi report but not at the expense of respect for pa ents. Judging the off-going nurse in a
cri cal way will create conflict. Nurses must show compassion for each other.
,4. A nurse assesses a newly admi ed pa ent diagnosed with major depressive disorder. Which
statement is an example of "a ending"?
a. "We all have stress in life. Being in a psychiatric hospital isn't the end of the world."
b. "Tell me why you felt you had to be hospitalized to receive treatment for your depression."
c. "You will feel be er a er we get some an depressant medica on started for you."
d. "I'd like to sit with you a while so you may feel more comfortable talking with me." - ANS: D
A ending is a technique that demonstrates the nurse's commitment to the rela onship and reduces
feelings of isola on. This technique shows respect for the pa ent and demonstrates caring.
Generaliza ons, probing, and false reassurances are non-therapeu c.
5. A pa ent shows the nurse an ar cle from the Internet about a health problem. Which characteris c of
the web site's address most alerts the nurse that the site may have biased and prejudiced informa on?
a. Address ends in ".org."
b. Address ends in ".com."
c. Address ends in ".gov."
d. Address ends in ".net." - ANS: B
Financial influences on a site are a clue that the informa on may be biased. ".com" at the end of the
address indicates that the site is a commercial one. ".gov" indicates that the site is maintained by a
government en ty. ".org" indicates that the site is nonproprietary; the site may or may not have reliable
informa on, but it does not profit from its ac vi es. ".net" can have mul ple meanings.
6. A nurse says, "When I was in school, I learned to call upset pa ents by name to get their a en on;
however, I read a descrip ve research study that says that this approach does not work. I plan to stop
calling pa ents by name." Which statement is the best appraisal of this nurse's comment?
a. One descrip ve research study rarely provides enough evidence to change prac ce.
b. Staff nurses apply new research findings only with the help from clinical nurse specialists.
c. New research findings should be incorporated into clinical algorithms before using them in prac ce.
d. The nurse misinterpreted the results of the study. Classic tenets of prac ce do not change. - ANS: A
Descrip ve research findings provide evidence for prac ce but must be viewed in rela on to other
studies before prac ce changes. One study is not enough. Descrip ve studies are low on the hierarchy of
evidence. Clinical algorithms use flow charts to manage problems and do not specify one response to a
clinical problem. Classic tenets of prac ce should change as research findings provide evidence for
change.
,7. Two nursing students discuss career plans a er gradua on. One student wants to enter psychiatric
nursing. The other student asks, "Why would you want to be a psychiatric nurse? All they do is talk. You
will lose your skills." Select the best response by the student interested in psychiatric nursing.
a. "Psychiatric nurses prac ce in safer environments than other special es. Nurse-to-pa ent ra os must
be be er because of the nature of pa ents' problems."
b. "Psychiatric nurses use complex communica on skills, as well as cri cal thinking, to solve
mul dimensional problems. I'm challenged by those situa ons."
c. "I think I will be good in the mental health field. I do not like clinical rota ons in school, so I do not
want to con nue them a er I graduate."
d. "Psychiatric nurses do not have to deal with as much pain and suffering as medical surgical nurses.
That appeals to me." - ANS: B
The prac ce of psychiatric nursing requires a different set of skills than medical surgical nursing,
although substan al overlap does exist. Psychiatric nurses must be able to help pa ents with medical
and mental health problems, reflec ng the holis c perspec ve these nurses must have. Nurse-pa ent
ra os and workloads in psychiatric se ngs have increased, similar to other special es. Psychiatric
nursing involves clinical prac ce, not simply documenta on. Psychosocial pain is real and can cause as
much suffering as physical pain.
8. Which research evidence would most influence a group of nurses to change their prac ce?
a. Expert commi ee report of recommenda ons for prac ce
b. Systema c review of randomized controlled trials
c. Nonexperimental descrip ve study
d. Cri cal pathway - ANS: B
Research findings are graded using a hierarchy of evidence. A systema c review of randomized
controlled trials is Level A and provides the strongest evidence for changing prac ce. Expert commi ee
recommenda ons and descrip ve studies lend less powerful and influen al evidence. A cri cal pathway
is not evidence; it incorporates research findings a er they have been analyzed.
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with mental
illnesses. A group of nurses write le ers to their elected representa ves in opposi on to the legisla on.
Which role have the nurses fulfilled?
a. Advocacy
b. A ending
, c. Recovery
d. Evidence-based prac ce - ANS: A
An advocate defends or asserts another's cause, par cularly when the other person lacks the ability to
do that for himself or herself. Examples of individual advocacy include helping pa ents understand their
rights or make decisions. On a community scale, advocacy includes poli cal ac vity, public speaking, and
publica on in the interest of improving the individuals with mental illness; the le er-wri ng campaign
advocates for that cause on behalf of pa ents who are unable to ar culate their own needs.
10. An informal group of pa ents discuss their percep ons of nursing care. Which comment best
indicates a pa ent's percep on that his or her nurse is caring?
a. "My nurse always asks me which type of juice I want to help me swallow my medica on."
b. "My nurse explained my treatment plan to me and asked for my ideas about how to make it be er."
c. "My nurse told me that if I take all the medicines the doctor prescribes I will get discharged soon."
d. "My nurse spends me listening to me talk about my problems. That helps me feel like I'm not alone."
- ANS: D
Caring evidences empathic understanding, as well as competency. It helps change pain and suffering into
a shared experience, crea ng a human connec on that alleviates feelings of isola on. The incorrect
op ons give examples of statements that demonstrate advocacy or giving advice.
11. A pa ent who immigrated to the United States from Honduras was diagnosed with schizophrenia.
The pa ent took an an psycho c medica on for 3 weeks but showed no improvement. Which resource
should the treatment team consult for informa on on more effec ve medica ons for this pa ent?
a. Clinical algorithm
b. Clinical pathway
c. Clinical prac ce guideline
d. Interna onal Sta s cal Classifica on of Diseases and Related Health Problems (ICD) - ANS: A
A clinical algorithm is a guideline that describes diagnos c and/or treatment approaches drawn from
large databases of informa on. These guidelines help the treatment team make decisions cognizant of
an individual pa ent's needs, such as ethnic origin, age, or gender. A clinical pathway is a map of
interven ons and treatments related to a specific disorder. Clinical prac ce guidelines summarize best
prac ces about specific health problems. The ICD classifies diseases.
12. Which historical nursing leader helped focus prac ce to recognize the importance of science in
psychiatric nursing?
