Chapter 01: Mental Health and Mental Illness
Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition
MULTIPLE CHOICE
1. A citizen at a community health fair asks the nurse, “What is the most prevalent mental disorder in the
United States?” Select the nurse’s correct response. a. Schizophrenia
b. Bipolar disorder
c. Dissociative fugue
d. Alzheimer’s disease
ANS: D
The 12-month prevalence for Alzheimer’s disease is 10% for persons older than 65% and 50% for
persons older than 85. The prevalence of schizophrenia is 1.1% per year. The prevalence of bipolar
disorder is 2.6%. Dissociative fugue is a rare disorder.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-33 (Table 1-1) TOP: Nursing Process: Implementation MSC: Client
Needs: Health Promotion and Maintenance
2. In the majority culture of the United States, which individual has the greatest risk to be labeled
mentally ill? One who
a. describes hearing God’s voice speaking.
b. is usually pessimistic but strives to meet personal goals.
c. is wealthy and gives away $20 bills to needy individuals.
d. always has an optimistic viewpoint about life and having own needs met.
ANS: A
The question asks about risk. Hearing voices is generally associated with mental illness, but in charismatic
religious groups, hearing the voice of God or a prophet is a desirable event.
Cultural norms vary, which makes it more difficult to make an accurate diagnosis. The individuals
described in the other options are less likely to be labeled mentally ill.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 1-3, 4
TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
3. A patient’s relationships are intense and unstable. The patient initially idealizes the significant other
and then devalues him or her, resulting in frequent feelings of emptiness. This patient will benefit from
interventions to develop which aspect of mental health? a. Effectiveness in work
b. Communication skills
c. Productive activities
d. Fulfilling relationships
ANS: D
The information given centers on relationships with others that are described as intense and unstable. The
relationships of mentally healthy individuals are stable, satisfying, and socially
1
, integrated. Data are not present to describe work effectiveness, communication skills, or activities.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-32 (Figure 1-1) TOP: Nursing Process: Planning MSC: Client
Needs: Psychosocial Integrity
4. Which belief will best support a nurse’s efforts to provide patient advocacy during a
multidisciplinary patient care planning session?
a. All mental illnesses are culturally determined.
b. Schizophrenia and bipolar disorder are cross-cultural disorders.
c. Symptoms of mental disorders are unchanged from culture to culture.
d. Assessment findings in mental illness reflect a person’s cultural patterns.
ANS: D
Symptoms must be understood in terms of a person’s cultural background. A nurse who understands
that a patient’s symptoms are influenced by culture will be able to advocate for the patient to a
greater degree than a nurse who believes that culture is of little relevance. The distracters are untrue
statements.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-27
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial
Integrity
5. A nurse is part of a multidisciplinary team working with groups of depressed patients. One group of
patients receives supportive interventions and antidepressant medication. The other group receives
only medication. The team measures outcomes for each group. Which type of study is evident?
a. Incidence
b. Prevalence
c. Comorbidity
d. Clinical epidemiology
ANS: D
Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if
there is no treatment and the problem is left to run its course) of an illness, studies of diagnostic
screening tests, and observational and experimental studies of interventions used to treat people with
the illness or symptoms. Prevalence refers to numbers of new cases.
Comorbidity refers to having more than one mental disorder at a time. Incidence refers to the number
of new cases of mental disorders in a healthy population within a given period. See related audience
response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-17 TOP:
Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
2
,6. The spouse of a patient diagnosed with schizophrenia says, “I don’t understand how events from
childhood have anything to do with this disabling illness.” Which response by the nurse will best help
the spouse understand the cause of this disorder?
a. “Psychological stress is the basis of most mental disorders.”
b. “This illness results from developmental factors rather than stress.”
c. “Research shows that this condition more likely has a biological basis.”
d. “It must be frustrating for you that your spouse is sick so much of the time.”
ANS: C
Many of the most prevalent and disabling mental disorders have strong biological influences. Genetics
are only one part of biological factors. Empathy does not address increasing the spouse’s level of
knowledge about the cause of the disorder. The other distracters are not established facts.
PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-5, 6
TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
7. A category 5 tornado occurred in a community of 400 people. Many homes and businesses were
destroyed. In the 2 years following the disaster, 140 individuals were diagnosed with posttraumatic
stress disorder (PTSD). Which term best applies to these newly diagnosed cases?
a. Prevalence
b. Comorbidity
c. Incidence
d. Parity
ANS: C
Incidence refers to the number of new cases of mental disorders in a healthy population within a given
period of time. Prevalence describes the total number of cases, new and existing, in a given population
during a specific period of time, regardless of when they became ill. Parity refers to equivalence, and
legislation required insurers that provide mental health coverage to offer annual and lifetime benefits
at the same level provided for medical–surgical coverage.
Comorbidity refers to having more than one mental disorder at a time.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-16 TOP: Nursing Process: Planning/Outcomes Identification MSC:
Client Needs: Safe, Effective Care Environment
8. Which component of treatment of mental illness is specifically recognized by Quality and Safety
Education for Nurses (QSEN)? a. All genomes are unique.
b. Care is centered on the patient.
c. Healthy development is vital to mental health.
d. Recovery occurs on a continuum from illness to health.
ANS: B
3
, The key areas of care promoted by QSEN are patient-centered care, teamwork and collaboration,
evidence-based practice, quality improvement, safety, and informatics.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-14
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective
Care Environment
9. Select the best response for the nurse to a question from another health professional regarding the
difference between a diagnosis in DSM-V and a nursing diagnosis.
a. “There is no functional difference between the two. Both identify human disorders.”
b. “The DSM-V diagnosis disregards culture, whereas the nursing diagnosis takes culture into
account.”
c. “The DSM-V diagnosis describes causes of disorders whereas a nursing diagnosis does not explore
etiology.”
d. “The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis offers a
framework for identifying interventions for issues a patient is
experiencing.”
ANS: D
The medical diagnosis is concerned with the patient’s disease state, causes, and cures, whereas the
nursing diagnosis focuses on the patient’s response to stress and possible caring interventions. Both
tools consider culture. The DSM-V is multiaxial. Nursing diagnoses also consider potential problems.
PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 1-21 TOP:
Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
10. Which nursing intervention below is part of the scope of an advanced practice psychiatric/mental
health nurse rather than a basic level registered nurse? a. Coordination of care
b. Health teaching
c. Milieu therapy
d. Psychotherapy
ANS: D
Psychotherapy is part of the scope of practice of an advanced practice nurse. The distracters are
within a basic level registered nurse’s scope of practice.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 1-23, 35 (Table 1-2) TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
MULTIPLE RESPONSE
1. An experienced nurse says to a new graduate, “When you’ve practiced as long as I have, you
automatically know how to take care of patients experiencing psychosis.” Which factors should the new
graduate consider when analyzing this comment? (Select all that apply.) a. The
4
Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition
MULTIPLE CHOICE
1. A citizen at a community health fair asks the nurse, “What is the most prevalent mental disorder in the
United States?” Select the nurse’s correct response. a. Schizophrenia
b. Bipolar disorder
c. Dissociative fugue
d. Alzheimer’s disease
ANS: D
The 12-month prevalence for Alzheimer’s disease is 10% for persons older than 65% and 50% for
persons older than 85. The prevalence of schizophrenia is 1.1% per year. The prevalence of bipolar
disorder is 2.6%. Dissociative fugue is a rare disorder.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-33 (Table 1-1) TOP: Nursing Process: Implementation MSC: Client
Needs: Health Promotion and Maintenance
2. In the majority culture of the United States, which individual has the greatest risk to be labeled
mentally ill? One who
a. describes hearing God’s voice speaking.
b. is usually pessimistic but strives to meet personal goals.
c. is wealthy and gives away $20 bills to needy individuals.
d. always has an optimistic viewpoint about life and having own needs met.
ANS: A
The question asks about risk. Hearing voices is generally associated with mental illness, but in charismatic
religious groups, hearing the voice of God or a prophet is a desirable event.
Cultural norms vary, which makes it more difficult to make an accurate diagnosis. The individuals
described in the other options are less likely to be labeled mentally ill.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 1-3, 4
TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
3. A patient’s relationships are intense and unstable. The patient initially idealizes the significant other
and then devalues him or her, resulting in frequent feelings of emptiness. This patient will benefit from
interventions to develop which aspect of mental health? a. Effectiveness in work
b. Communication skills
c. Productive activities
d. Fulfilling relationships
ANS: D
The information given centers on relationships with others that are described as intense and unstable. The
relationships of mentally healthy individuals are stable, satisfying, and socially
1
, integrated. Data are not present to describe work effectiveness, communication skills, or activities.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-32 (Figure 1-1) TOP: Nursing Process: Planning MSC: Client
Needs: Psychosocial Integrity
4. Which belief will best support a nurse’s efforts to provide patient advocacy during a
multidisciplinary patient care planning session?
a. All mental illnesses are culturally determined.
b. Schizophrenia and bipolar disorder are cross-cultural disorders.
c. Symptoms of mental disorders are unchanged from culture to culture.
d. Assessment findings in mental illness reflect a person’s cultural patterns.
ANS: D
Symptoms must be understood in terms of a person’s cultural background. A nurse who understands
that a patient’s symptoms are influenced by culture will be able to advocate for the patient to a
greater degree than a nurse who believes that culture is of little relevance. The distracters are untrue
statements.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-27
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial
Integrity
5. A nurse is part of a multidisciplinary team working with groups of depressed patients. One group of
patients receives supportive interventions and antidepressant medication. The other group receives
only medication. The team measures outcomes for each group. Which type of study is evident?
a. Incidence
b. Prevalence
c. Comorbidity
d. Clinical epidemiology
ANS: D
Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if
there is no treatment and the problem is left to run its course) of an illness, studies of diagnostic
screening tests, and observational and experimental studies of interventions used to treat people with
the illness or symptoms. Prevalence refers to numbers of new cases.
Comorbidity refers to having more than one mental disorder at a time. Incidence refers to the number
of new cases of mental disorders in a healthy population within a given period. See related audience
response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-17 TOP:
Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
2
,6. The spouse of a patient diagnosed with schizophrenia says, “I don’t understand how events from
childhood have anything to do with this disabling illness.” Which response by the nurse will best help
the spouse understand the cause of this disorder?
a. “Psychological stress is the basis of most mental disorders.”
b. “This illness results from developmental factors rather than stress.”
c. “Research shows that this condition more likely has a biological basis.”
d. “It must be frustrating for you that your spouse is sick so much of the time.”
ANS: C
Many of the most prevalent and disabling mental disorders have strong biological influences. Genetics
are only one part of biological factors. Empathy does not address increasing the spouse’s level of
knowledge about the cause of the disorder. The other distracters are not established facts.
PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-5, 6
TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
7. A category 5 tornado occurred in a community of 400 people. Many homes and businesses were
destroyed. In the 2 years following the disaster, 140 individuals were diagnosed with posttraumatic
stress disorder (PTSD). Which term best applies to these newly diagnosed cases?
a. Prevalence
b. Comorbidity
c. Incidence
d. Parity
ANS: C
Incidence refers to the number of new cases of mental disorders in a healthy population within a given
period of time. Prevalence describes the total number of cases, new and existing, in a given population
during a specific period of time, regardless of when they became ill. Parity refers to equivalence, and
legislation required insurers that provide mental health coverage to offer annual and lifetime benefits
at the same level provided for medical–surgical coverage.
Comorbidity refers to having more than one mental disorder at a time.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-16 TOP: Nursing Process: Planning/Outcomes Identification MSC:
Client Needs: Safe, Effective Care Environment
8. Which component of treatment of mental illness is specifically recognized by Quality and Safety
Education for Nurses (QSEN)? a. All genomes are unique.
b. Care is centered on the patient.
c. Healthy development is vital to mental health.
d. Recovery occurs on a continuum from illness to health.
ANS: B
3
, The key areas of care promoted by QSEN are patient-centered care, teamwork and collaboration,
evidence-based practice, quality improvement, safety, and informatics.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-14
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective
Care Environment
9. Select the best response for the nurse to a question from another health professional regarding the
difference between a diagnosis in DSM-V and a nursing diagnosis.
a. “There is no functional difference between the two. Both identify human disorders.”
b. “The DSM-V diagnosis disregards culture, whereas the nursing diagnosis takes culture into
account.”
c. “The DSM-V diagnosis describes causes of disorders whereas a nursing diagnosis does not explore
etiology.”
d. “The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis offers a
framework for identifying interventions for issues a patient is
experiencing.”
ANS: D
The medical diagnosis is concerned with the patient’s disease state, causes, and cures, whereas the
nursing diagnosis focuses on the patient’s response to stress and possible caring interventions. Both
tools consider culture. The DSM-V is multiaxial. Nursing diagnoses also consider potential problems.
PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 1-21 TOP:
Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
10. Which nursing intervention below is part of the scope of an advanced practice psychiatric/mental
health nurse rather than a basic level registered nurse? a. Coordination of care
b. Health teaching
c. Milieu therapy
d. Psychotherapy
ANS: D
Psychotherapy is part of the scope of practice of an advanced practice nurse. The distracters are
within a basic level registered nurse’s scope of practice.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 1-23, 35 (Table 1-2) TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
MULTIPLE RESPONSE
1. An experienced nurse says to a new graduate, “When you’ve practiced as long as I have, you
automatically know how to take care of patients experiencing psychosis.” Which factors should the new
graduate consider when analyzing this comment? (Select all that apply.) a. The
4
