Chapter 01: Mental Health and Mental Illness
f f f f f f
Halter:Varcarolis’FoundationsofPsychiatric-MentalHealth Nursing:AClinical
f f f f f f f f
Approach, 9th Edition
f f f
MULTIPLE CHOICE f
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
f f f f f f f f f f f f
a. Conducting a mental health assessment. f f f f
b. Prescribing psychotropic medication. f f
c. Establishing a therapeutic relationship. f f f
d. Individualizing a nursing care plan. f f f f
ANS: B f
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and
f f f f f f f f f f f
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
f f f f f f f f f f f f f
prepared at the basic level is permitted to perform mental health assessments, establish
f f f f f f f f f f f f f
relationships, and provide individualized care planning.
f f f f f f
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
f f f f f
TOP: Nursing Process: Implementation
f MSC: Client Needs: Safe, Effective Care Environment f f f f f f f f
2. Anursing student expresses concerns that mental health nurses “lose all their clinical nursing
f f f f f f f f f f f f f
skills.” Select the best response by the mental health nurse.
f f f f f f f f f f
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to- f f f f f f f f f
f client ratios must be better because of the nature of the clients’ problems.”
f f f f f f f f f f f f
b. “Psychiatric nurses use complex communication skills as well as critical thinking to f f f f f f f f f f f
f solve multidimensional problems. I am challenged by those situations.”
f f f f f f f f
c. “That’s a misconception. Psychiatric nurses frequently use high technology
f f f f f f f f
f monitoring equipment and manage complex intravenous therapies.” f f f f f f
d. “Psychiatric nurses do not have to deal with as much pain and suffering as f f f f f f f f f f f f f
f medical–surgical nurses do. That appeals to me.” f f f f f f
ANS: B f
The practice of psychiatric nursing requires a different set of skills than medical–surgical nursing,
f f f f f f f f f f f f f
though there is substantial overlap. Psychiatric nurses must be able to help clients with medical as
f f f f f f f f f f f f f f f f
well as mental health problems, reflecting the holistic perspective these nurses must have. Nurse–
f f f f f f f f f f f f f f
client ratios and workloads in psychiatric settings have increased, just like other specialties.
f f f f f f f f f f f f
Psychiatric nursing involves clinical practice, not just documentation.
f f f f f f f f
Psychosocial pain and suffering are as real as physical pain and suffering. f f f f f f f f f f f
PTS: 1 DIF: Cognitive Level: Apply (Application)
f f f f f
TOP: Nursing Process: Implementation
f MSC: Client Needs: Safe, Effective Care Environment f f f f f f f f
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with
f f f f f f f f f f f f f f
fmental illness, a group of nurses write letters to their elected representatives in opposition to the
f f f f f f f f f f f f f f f
flegislation. Which role have the nurses fulfilled? f f f f f f
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice f
, ANS: C f
An advocate defends or asserts another’s cause, particularly when the other person lacks the
f f f f f f f f f f f f f
ability to do that for self. Examples of individual advocacy include helping clients understand
f f f f f f f f f f f f f f
their rights or make decisions. On a community scale, advocacy includes political activity, public
f f f f f f f f f f f f f f
speaking, and publication in the interest of improving the human condition. Since funding is
f f f f f f f f f f f f f f
necessary to deliver quality programming for persons with mental illness, the letter- writing
f f f f f f f f f f f f f
campaign advocates for that cause on behalf of clients who are unable to articulate their own
f f f f f f f f f f f f f f f f
needs.
f
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
f f f f f
TOP: Nursing Process: Evaluation f MSC: Client Needs: Safe, Effective Care Environment f f f f f f f f
4. Afamily has a long history of conflicted relationships among the members. Which family
f f f f f f f f f f f f f
fmember’s comment best reflects a mentally healthy perspective? f f f f f f f
a. “I’ve made mistakes but everyone else in this family has also.”
f f f f f f f f f f
b. “I remember joy and mutual respect from our early years together.”
f f f f f f f f f f
c. “I will make some changes in my behavior for the good of the family.”
f f f f f f f f f f f f f
d. “It’s best for me to move away from my family. Things will never change.”
f f f f f f f f f f f f f
ANS: C f
The correct response demonstrates the best evidence of a healthy recognition of the importance
f f f f f f f f f f f f f
of relationships. Mental health includes rational thinking, communication skills, learning,
f f f f f f f f f f
emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may be healthy,
f f f f f f f f f f f f f f
but the correct response shows a higher level of mental health. The other incorrect responses show
f f f f f f f f f f f f f f f f
blaming and avoidance.
f f f
PTS: 1 DIF: Cognitive Level:Analyze (Analysis)
f f f f f
TOP: Nursing Process:Assessment f MSC: Client Needs: Psychosocial Integrity f f f f f f
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
f f f f f f f f f f f f f
fillness?
a. reporting occasional sleeplessness and anxiety. f f f f
b. reporting a consistently sad, discouraged, and hopeless mood. f f f f f f f
c. being able to describe the difference between “as if” and “for real.”
f f f f f f f f f f f
d. experiencing difficulty making a decision about whether to change jobs. f f f f f f f f f
ANS: B f
The correct response describes a mood alteration, which reflects mental illness. The distracters
f f f f f f f f f f f f
describe behaviors that are mentally healthy or within the usual scope of human experience.
f f f f f f f f f f f f f f
PTS: 1 DIF: Cognitive Level: Apply (Application)
f f f f f
TOP: Nursing Process:Assessment f MSC: Client Needs: Psychosocial Integrity f f f f f f
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
f f f f f f f f f f f
achieved for an adult client?
f f f f f
a. being willing to work towards achieving ideals and meeting demands.
f f f f f f f f f
b. behaving without considering the consequences of personal actions. f f f f f f f
c. aggressively meeting personal needs without considering the rights of others. f f f f f f f f f
d. seeking help from others to avoid assuming responsibility for major areas of own
f f f f f f f f f f f f
life. f
, ANS: A f
Mental health is a state of well-being in which individuals reach their own potential, cope with
f f f f f f f f f f f f f f f
the normal stresses of life, work productively, and contribute to the community. Mental health
f f f f f f f f f f f f f f
provides people with the capacity for rational thinking, communication skills, learning,
f f f f f f f f f f f
emotional growth, resilience, and self-esteem. The correct response describes an adaptive,
f f f f f f f f f f f
healthy behavior. The distracters describe maladaptive behaviors.
f f f f f f f
PTS: 1 f DIF: Cognitive Level: Apply (Application)
f f f f
TOP: Nursing Process: Evaluation
f MSC: Client Needs: Psychosocial Integrity f f f f f f
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. Which
f f f f f f f f f f f f f
resource should the nurse consult to determine criteria used to establish this diagnosis?
f f f f f f f f f f f f f
a. International Statistical Classification of Diseases and Related Health Problems f f f f f f f f
f (ICD-10)
b. TheANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
f f f f f f f f f
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) f f f f f f f
d. Abehavioral health reference manual
f f f f
ANS: C f
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline for
f f f f f f f f f f f f f f f f
diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a
f f f f f f f f f f f f
psychiatric illness.
f f
PTS: 1 f DIF: Cognitive Level: Understand (Comprehension)
f f f f
TOP: Nursing Process:Assessment
f MSC: Client Needs: Safe, Effective Care Environment
f f f f f f f f
8. Anurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
f f f f f f f f f f f f f f
fwould have the most complete information?
f f f f f
a. Nursing Outcomes Classification (NOC) f f f
b. DSM-V
c. TheANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
f f f f f f f f f
d. ICD-10
ANS: B f
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official
f f f f f f f f f f f f f
guideline for diagnosing psychiatric disorders. The other references are good resources but do not
f f f f f f f f f f f f f f
define the diagnostic criteria.
f f f f
PTS: 1 f DIF: Cognitive Level: Understand (Comprehension)
f f f f
TOP: Nursing Process: Implementation
f MSC: Client Needs: Safe, Effective Care Environment
f f f f f f f f
9. Which individual behavior demonstrates resilience?
f f f f
a. Repress stressors associated with a divorce. f f f f f
b. Continuing to grieve the death of a spouse for 5 years. f f f f f f f f f f
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire. f f f f f f f f f f f f f f f
d. Taking a temporary job to maintain financial stability after loss of a permanent job.
f f f f f f f f f f f f f
ANS: D f
, Resilience is closely associated with the process of adapting and helps people facing tragedies,
f f f f f f f f f f f f f
loss, trauma, and severe stress. It is the ability and capacity for people to secure the resources they
f f f f f f f f f f f f f f f f f f
need to support their well-being. Repression and protracted grief are unhealthy. Living in a
f f f f f f f f f f f f f f
shelter for 2 years shows a failure to move forward after a tragedy. See related audience response
f f f f f f f f f f f f f f f f f
question.
f
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
f f f f f
TOP: Nursing Process:Assessment fMSC: Client Needs: Psychosocial Integrity f f f f f f
10. The relationship of the NorthAmerican Nursing DiagnosisAssociation (NANDA) is to
f f f f f f f f f f f
f clinical judgment as Nursing Interventions Classification (NIC) is to what?
f f f f f f f f f
a. client outcomes. f
b. nursing actions. f
c. diagnosis.
d. symptoms.
ANS: B f
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis
f f f f f f f f f
Association, identifies diagnostic statements regarding human responses to actual or potential
f f f f f f f f f f f
health problems. These statements represent clinical judgments. NIC (Nursing Interventions
f f f f f f f f f f
Classification) identifies actions provided by nurses that enhance client outcomes. Nursing care
f f f f f f f f f f f f
activities may be direct or indirect.
f f f f f f
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
f f f f f
TOP: Nursing Process: Evaluation fMSC: Client Needs: Safe, Effective Care Environment f f f f f f f f
11. An adult says, “Most of the time I’m happy and feel good about myself. I have learned that
f f f f f f f f f f f f f f f f f
f what I get out of something is proportional to the effort I put into it.” Which number on this
f f f f f f f f f f f f f f f f f f
f mental health continuum should the nurse select? f f f f f f
MentalIllness MentalHealth 1 f f f f
f2345f f f
a. 1
b. 2 f f
c. 3
d. 4 f f
e. 5
ANS: E f
The adult is generally happy and has an adequate self-concept. The statement indicates the adult is
f f f f f f f f f f f f f f f
reality-oriented, works effectively, and has control over own behavior. Mental health does not
f f f f f f f f f f f f f
mean that a person is always happy.
f f f f f f f
PTS: 1 DIF: Cognitive Level: Apply (Application)
f f f f f
TOP: Nursing Process:Assessment fMSC: Client Needs: Psychosocial Integrity f f f f f f
12. Which disorder is an example of a culture-bound syndrome?
f f f f f f f f
a. Epilepsy
b. Schizophrenia
c. Running amok f
d. Major depressive disorder f f
f f f f f f
Halter:Varcarolis’FoundationsofPsychiatric-MentalHealth Nursing:AClinical
f f f f f f f f
Approach, 9th Edition
f f f
MULTIPLE CHOICE f
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
f f f f f f f f f f f f
a. Conducting a mental health assessment. f f f f
b. Prescribing psychotropic medication. f f
c. Establishing a therapeutic relationship. f f f
d. Individualizing a nursing care plan. f f f f
ANS: B f
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and
f f f f f f f f f f f
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
f f f f f f f f f f f f f
prepared at the basic level is permitted to perform mental health assessments, establish
f f f f f f f f f f f f f
relationships, and provide individualized care planning.
f f f f f f
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
f f f f f
TOP: Nursing Process: Implementation
f MSC: Client Needs: Safe, Effective Care Environment f f f f f f f f
2. Anursing student expresses concerns that mental health nurses “lose all their clinical nursing
f f f f f f f f f f f f f
skills.” Select the best response by the mental health nurse.
f f f f f f f f f f
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to- f f f f f f f f f
f client ratios must be better because of the nature of the clients’ problems.”
f f f f f f f f f f f f
b. “Psychiatric nurses use complex communication skills as well as critical thinking to f f f f f f f f f f f
f solve multidimensional problems. I am challenged by those situations.”
f f f f f f f f
c. “That’s a misconception. Psychiatric nurses frequently use high technology
f f f f f f f f
f monitoring equipment and manage complex intravenous therapies.” f f f f f f
d. “Psychiatric nurses do not have to deal with as much pain and suffering as f f f f f f f f f f f f f
f medical–surgical nurses do. That appeals to me.” f f f f f f
ANS: B f
The practice of psychiatric nursing requires a different set of skills than medical–surgical nursing,
f f f f f f f f f f f f f
though there is substantial overlap. Psychiatric nurses must be able to help clients with medical as
f f f f f f f f f f f f f f f f
well as mental health problems, reflecting the holistic perspective these nurses must have. Nurse–
f f f f f f f f f f f f f f
client ratios and workloads in psychiatric settings have increased, just like other specialties.
f f f f f f f f f f f f
Psychiatric nursing involves clinical practice, not just documentation.
f f f f f f f f
Psychosocial pain and suffering are as real as physical pain and suffering. f f f f f f f f f f f
PTS: 1 DIF: Cognitive Level: Apply (Application)
f f f f f
TOP: Nursing Process: Implementation
f MSC: Client Needs: Safe, Effective Care Environment f f f f f f f f
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with
f f f f f f f f f f f f f f
fmental illness, a group of nurses write letters to their elected representatives in opposition to the
f f f f f f f f f f f f f f f
flegislation. Which role have the nurses fulfilled? f f f f f f
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice f
, ANS: C f
An advocate defends or asserts another’s cause, particularly when the other person lacks the
f f f f f f f f f f f f f
ability to do that for self. Examples of individual advocacy include helping clients understand
f f f f f f f f f f f f f f
their rights or make decisions. On a community scale, advocacy includes political activity, public
f f f f f f f f f f f f f f
speaking, and publication in the interest of improving the human condition. Since funding is
f f f f f f f f f f f f f f
necessary to deliver quality programming for persons with mental illness, the letter- writing
f f f f f f f f f f f f f
campaign advocates for that cause on behalf of clients who are unable to articulate their own
f f f f f f f f f f f f f f f f
needs.
f
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
f f f f f
TOP: Nursing Process: Evaluation f MSC: Client Needs: Safe, Effective Care Environment f f f f f f f f
4. Afamily has a long history of conflicted relationships among the members. Which family
f f f f f f f f f f f f f
fmember’s comment best reflects a mentally healthy perspective? f f f f f f f
a. “I’ve made mistakes but everyone else in this family has also.”
f f f f f f f f f f
b. “I remember joy and mutual respect from our early years together.”
f f f f f f f f f f
c. “I will make some changes in my behavior for the good of the family.”
f f f f f f f f f f f f f
d. “It’s best for me to move away from my family. Things will never change.”
f f f f f f f f f f f f f
ANS: C f
The correct response demonstrates the best evidence of a healthy recognition of the importance
f f f f f f f f f f f f f
of relationships. Mental health includes rational thinking, communication skills, learning,
f f f f f f f f f f
emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may be healthy,
f f f f f f f f f f f f f f
but the correct response shows a higher level of mental health. The other incorrect responses show
f f f f f f f f f f f f f f f f
blaming and avoidance.
f f f
PTS: 1 DIF: Cognitive Level:Analyze (Analysis)
f f f f f
TOP: Nursing Process:Assessment f MSC: Client Needs: Psychosocial Integrity f f f f f f
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
f f f f f f f f f f f f f
fillness?
a. reporting occasional sleeplessness and anxiety. f f f f
b. reporting a consistently sad, discouraged, and hopeless mood. f f f f f f f
c. being able to describe the difference between “as if” and “for real.”
f f f f f f f f f f f
d. experiencing difficulty making a decision about whether to change jobs. f f f f f f f f f
ANS: B f
The correct response describes a mood alteration, which reflects mental illness. The distracters
f f f f f f f f f f f f
describe behaviors that are mentally healthy or within the usual scope of human experience.
f f f f f f f f f f f f f f
PTS: 1 DIF: Cognitive Level: Apply (Application)
f f f f f
TOP: Nursing Process:Assessment f MSC: Client Needs: Psychosocial Integrity f f f f f f
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
f f f f f f f f f f f
achieved for an adult client?
f f f f f
a. being willing to work towards achieving ideals and meeting demands.
f f f f f f f f f
b. behaving without considering the consequences of personal actions. f f f f f f f
c. aggressively meeting personal needs without considering the rights of others. f f f f f f f f f
d. seeking help from others to avoid assuming responsibility for major areas of own
f f f f f f f f f f f f
life. f
, ANS: A f
Mental health is a state of well-being in which individuals reach their own potential, cope with
f f f f f f f f f f f f f f f
the normal stresses of life, work productively, and contribute to the community. Mental health
f f f f f f f f f f f f f f
provides people with the capacity for rational thinking, communication skills, learning,
f f f f f f f f f f f
emotional growth, resilience, and self-esteem. The correct response describes an adaptive,
f f f f f f f f f f f
healthy behavior. The distracters describe maladaptive behaviors.
f f f f f f f
PTS: 1 f DIF: Cognitive Level: Apply (Application)
f f f f
TOP: Nursing Process: Evaluation
f MSC: Client Needs: Psychosocial Integrity f f f f f f
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. Which
f f f f f f f f f f f f f
resource should the nurse consult to determine criteria used to establish this diagnosis?
f f f f f f f f f f f f f
a. International Statistical Classification of Diseases and Related Health Problems f f f f f f f f
f (ICD-10)
b. TheANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
f f f f f f f f f
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) f f f f f f f
d. Abehavioral health reference manual
f f f f
ANS: C f
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline for
f f f f f f f f f f f f f f f f
diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a
f f f f f f f f f f f f
psychiatric illness.
f f
PTS: 1 f DIF: Cognitive Level: Understand (Comprehension)
f f f f
TOP: Nursing Process:Assessment
f MSC: Client Needs: Safe, Effective Care Environment
f f f f f f f f
8. Anurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
f f f f f f f f f f f f f f
fwould have the most complete information?
f f f f f
a. Nursing Outcomes Classification (NOC) f f f
b. DSM-V
c. TheANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
f f f f f f f f f
d. ICD-10
ANS: B f
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official
f f f f f f f f f f f f f
guideline for diagnosing psychiatric disorders. The other references are good resources but do not
f f f f f f f f f f f f f f
define the diagnostic criteria.
f f f f
PTS: 1 f DIF: Cognitive Level: Understand (Comprehension)
f f f f
TOP: Nursing Process: Implementation
f MSC: Client Needs: Safe, Effective Care Environment
f f f f f f f f
9. Which individual behavior demonstrates resilience?
f f f f
a. Repress stressors associated with a divorce. f f f f f
b. Continuing to grieve the death of a spouse for 5 years. f f f f f f f f f f
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire. f f f f f f f f f f f f f f f
d. Taking a temporary job to maintain financial stability after loss of a permanent job.
f f f f f f f f f f f f f
ANS: D f
, Resilience is closely associated with the process of adapting and helps people facing tragedies,
f f f f f f f f f f f f f
loss, trauma, and severe stress. It is the ability and capacity for people to secure the resources they
f f f f f f f f f f f f f f f f f f
need to support their well-being. Repression and protracted grief are unhealthy. Living in a
f f f f f f f f f f f f f f
shelter for 2 years shows a failure to move forward after a tragedy. See related audience response
f f f f f f f f f f f f f f f f f
question.
f
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
f f f f f
TOP: Nursing Process:Assessment fMSC: Client Needs: Psychosocial Integrity f f f f f f
10. The relationship of the NorthAmerican Nursing DiagnosisAssociation (NANDA) is to
f f f f f f f f f f f
f clinical judgment as Nursing Interventions Classification (NIC) is to what?
f f f f f f f f f
a. client outcomes. f
b. nursing actions. f
c. diagnosis.
d. symptoms.
ANS: B f
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis
f f f f f f f f f
Association, identifies diagnostic statements regarding human responses to actual or potential
f f f f f f f f f f f
health problems. These statements represent clinical judgments. NIC (Nursing Interventions
f f f f f f f f f f
Classification) identifies actions provided by nurses that enhance client outcomes. Nursing care
f f f f f f f f f f f f
activities may be direct or indirect.
f f f f f f
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
f f f f f
TOP: Nursing Process: Evaluation fMSC: Client Needs: Safe, Effective Care Environment f f f f f f f f
11. An adult says, “Most of the time I’m happy and feel good about myself. I have learned that
f f f f f f f f f f f f f f f f f
f what I get out of something is proportional to the effort I put into it.” Which number on this
f f f f f f f f f f f f f f f f f f
f mental health continuum should the nurse select? f f f f f f
MentalIllness MentalHealth 1 f f f f
f2345f f f
a. 1
b. 2 f f
c. 3
d. 4 f f
e. 5
ANS: E f
The adult is generally happy and has an adequate self-concept. The statement indicates the adult is
f f f f f f f f f f f f f f f
reality-oriented, works effectively, and has control over own behavior. Mental health does not
f f f f f f f f f f f f f
mean that a person is always happy.
f f f f f f f
PTS: 1 DIF: Cognitive Level: Apply (Application)
f f f f f
TOP: Nursing Process:Assessment fMSC: Client Needs: Psychosocial Integrity f f f f f f
12. Which disorder is an example of a culture-bound syndrome?
f f f f f f f f
a. Epilepsy
b. Schizophrenia
c. Running amok f
d. Major depressive disorder f f
