"Comprehensive Test Bank for Psychiatric-
Mental Health Nursing, 9th Edition by Sheila L.
Videbeck (2025) – Chapter-by-Chapter Practice
Questions and Answers for Enhanced Exam
Preparation"
,
,UNIT 1:Current Theories And Practice
Introduction to Psychiatric and Mental Health Nursing
Signs <<<Detailed Answer>>>clinicians' observations and objective
findings
Symptoms <<<Detailed Answer>>>subjective experiences described by
the patient
Mental Health Definition <<<Detailed Answer>>>A state of well-being
where individuals realize their abilities, cope with normal life stresses, and
contribute to the community.
Mental Illness Definition <<<Detailed Answer>>>Psychiatric disorders
with definable diagnoses marked by significant dysfunction in mental
functioning.
DSM-5 vs. Nursing Diagnosis <<<Detailed Answer>>>DSM-5 categorizes
mental disorders; nursing diagnosis focuses on human responses.
Roles of PMH Nurses <<<Detailed Answer>>>Includes assessment,
therapy, education, crisis intervention, and promoting therapeutic
environment (milieu therapy).
Milieu Therapy <<<Detailed Answer>>>A controlled environment that
promotes healing through structure, routine, and therapeutic interaction.
Multidisciplinary Team <<<Detailed Answer>>>Collaboration among
nurses, psychiatrists, social workers, and others to deliver holistic mental
health care.
Community Health Centers Act of 1963 <<<Detailed
Answer>>>Promoted deinstitutionalization and created community-based
services.
,Partial vs. Traditional Inpatient Hospitalization <<<Detailed
Answer>>>Partial provides structured treatment during the day; inpatient
offers 24-hour care.
Homelessness in Mental Illness <<<Detailed Answer>>>Many lack
consistent treatment or support, leading to increased vulnerability and
repeated hospitalizations.
Revolving Door Phenomenon <<<Detailed Answer>>>High readmission
rates due to short inpatient stays and poor outpatient follow-up.
ED Boarding <<<Detailed Answer>>>Patients with psychiatric issues
remain in ER due to lack of beds, leading to poor outcomes and increased
staff strain.
Therapeutic Relationship <<<Detailed Answer>>>Nurse uses self-
awareness and communication to foster growth.
Empathy vs. Sympathy <<<Detailed Answer>>>Empathy fosters trust by
understanding and validating feelings; sympathy can create distance or
minimize experiences.
Verbal & Nonverbal Communication <<<Detailed Answer>>>Effective use
enhances trust. Examples: active listening, open posture, eye contact.
Enhancers vs. Blockers <<<Detailed Answer>>>Open-ended questions
and reflecting are helpful; giving advice or changing topics obstructs
therapeutic dialogue.
Boundaries, Transference, Countertransference <<<Detailed
Answer>>>Nurse maintains professional roles; awareness prevents harm
or blurred relationships.
Cultural Competence <<<Detailed Answer>>>Understanding cultural
beliefs improves care and reduces misunderstandings.
Freud (Id, Ego, Superego) <<<Detailed Answer>>>Explains behavior as
influenced by unconscious conflict; basis for insight therapy.
,Defense Mechanisms <<<Detailed Answer>>>Unconscious coping
strategies (e.g., denial, projection) used to reduce anxiety.
Erikson's Psychosocial Stages <<<Detailed Answer>>>Describes
psychosocial challenges across the lifespan; guides developmental
assessments.
Sullivan's Interpersonal Theory <<<Detailed Answer>>>Focus on
interpersonal relationships to reduce anxiety and improve functioning.
Peplau's Nursing Theory <<<Detailed Answer>>>Foundation for
therapeutic nurse-client relationship: orientation, working, and termination
phases.
Group Therapy & Phases <<<Detailed Answer>>>Open vs. closed
groups. Stages: forming, storming, norming, performing, adjourning.
Ethical Principles <<<Detailed Answer>>>Autonomy, beneficence,
nonmaleficence, fidelity, veracity, justice—core to ethical nursing practice.
Voluntary vs. Involuntary Commitment <<<Detailed Answer>>>Voluntary
= patient consents; Involuntary = court-ordered if danger to self/others.
Client Rights: Restraints & Seclusion <<<Detailed Answer>>>Used only
when necessary for safety. Requires documentation and constant
monitoring.
Duty to Warn <<<Detailed Answer>>>Legal obligation to inform potential
victims of threats. Overrides confidentiality when safety is at risk.
Malpractice Prevention <<<Detailed Answer>>>Maintain documentation,
follow protocols, act within scope of practice.
Insanity Defense <<<Detailed Answer>>>Based on M'Naghten Rule:
patient unable to understand wrongfulness or control actions.
Neurotransmitters <<<Detailed Answer>>>Dopamine: ↑ = schizophrenia,
↓ = Parkinson's. Serotonin: mood, sleep, ↓ = depression. GABA: ↓ =
anxiety. Norepinephrine: fight/flight, mood. Acetylcholine: memory,
learning.
,Brain Structures <<<Detailed Answer>>>Cerebral cortex (thoughts),
limbic system (emotions), hippocampus (memory), hypothalamus
(hormones).
Imaging Techniques <<<Detailed Answer>>>CT & MRI (structure), PET
& SPECT (function). Help visualize abnormalities in psychiatric conditions.
Psychoneuroimmunology <<<Detailed Answer>>>Links stress and
immune function. Chronic stress affects neurotransmitters and increases
vulnerability to mental illness.
Endocrine Involvement <<<Detailed Answer>>>Hormone imbalances
(e.g., cortisol, thyroid) can mimic or worsen psychiatric symptoms.
SSRIs <<<Detailed Answer>>>Fluoxetine, Paroxetine, Sertraline,
Citalopram. Inhibit serotonin reuptake. Treat depression, anxiety, OCD.
Side effects: GI upset, sexual dysfunction, insomnia.
Tricyclics (TCAs) <<<Detailed Answer>>>Amitriptyline, Nortriptyline,
Imipramine. Block reuptake of serotonin and norepinephrine. Side effects:
sedation, arrhythmias, anticholinergic effects.
MAOIs <<<Detailed Answer>>>Phenelzine, Tranylcypromine. Prevent
breakdown of monoamines. Risk of hypertensive crisis with tyramine foods
(aged cheese, wine).
Lithium <<<Detailed Answer>>>Mood stabilizer for bipolar disorder.
Monitor levels (0.6-1.2 mEq/L). Toxicity: tremors, GI distress, confusion.
Maintain consistent salt/water intake.
2nd Gen Antipsychotics <<<Detailed Answer>>>Risperidone,
Olanzapine, Clozapine. Treat schizophrenia. Fewer EPS than 1st gen.
Monitor WBC with Clozapine.
EPS Medications <<<Detailed Answer>>>Benztropine (Cogentin),
Diphenhydramine (Benadryl). Used to manage EPS: dystonia, akathisia,
pseudoparkinsonism.
,Serotonin Syndrome <<<Detailed Answer>>>Life-threatening. Symptoms:
agitation, confusion, tachycardia, hyperthermia. Caused by combining
serotonergic drugs.
Benzodiazepines <<<Detailed Answer>>>Lorazepam, Diazepam,
Alprazolam. Enhance GABA. Used for anxiety, alcohol withdrawal. Risk of
dependence, CNS depression.
Stimulants <<<Detailed Answer>>>Methylphenidate, Amphetamines.
Treat ADHD. Monitor for weight loss, insomnia, abuse.
Herbal Interactions <<<Detailed Answer>>>St. John's Wort can increase
serotonin (risk of serotonin syndrome). Ginkgo ↑ bleeding risk with
anticoagulants.
Syndrome <<<Detailed Answer>>>group of signs and symptoms that
occur together as a recognizable condition that may be less than specific
than a clear-cut disorder or disease
Intellect <<<Detailed Answer>>>includes consciousness, memory,
orientation, perception, attention and concentration, thought process,
insight, knowledge judgment, and intelligence.
Emotions <<<Detailed Answer>>>the inner feeling of experiences of the
individual.
Behavior <<<Detailed Answer>>>the conduct of the individual
Consciousness <<<Detailed Answer>>>A state of awareness
Apperception <<<Detailed Answer>>>perception modified by one's own
emotions and thoughts.
Sensorium <<<Detailed Answer>>>state of cognitive functioning of the
special senses.
Disturbances of consciousness <<<Detailed Answer>>>Are most often
associated with brain pathology.
, Disorientation <<<Detailed Answer>>>Disturbance of orientation in time,
place and person.
Clouding of consciousness <<<Detailed Answer>>>Incomplete clear-
mindedness with disturbances in perception and attitudes.
Stupor <<<Detailed Answer>>>Lack of reaction to and unawareness of
surroundings.
Delirium <<<Detailed Answer>>>Bewildered, restless, confused,
disoriented reaction associated with fear and hallucinations.
Coma <<<Detailed Answer>>>Profound degree of unconsciousness.
Coma vigil <<<Detailed Answer>>>Coma in which the patient appears to
be a sleep but ready to be aroused also known as a kinetic mutism.
Twilight state <<<Detailed Answer>>>Disturbed consciousness with
hallucinations.
Dreamlike state <<<Detailed Answer>>>Often used as a synonym for
complex partial seizure or psychomotor epilepsy.
Somnolence <<<Detailed Answer>>>Abnormal drowsiness.
Disturbances of Attention <<<Detailed Answer>>>the amount of effort
exerted in focusing on certain portion of an experience; ability to sustain a
focus on one activity; ability to concentrate.
Distractibility <<<Detailed Answer>>>Inability to concentrate attention,
attention drawn to unimportant or irrelevant external stimuli.
Selective inattention <<<Detailed Answer>>>Blocking out only those
things that generate anxiety.
Hyper vigilance <<<Detailed Answer>>>Excessive attention and focus on
all internal and external stimuli, usually secondary to delusional or paranoid
states.
Mental Health Nursing, 9th Edition by Sheila L.
Videbeck (2025) – Chapter-by-Chapter Practice
Questions and Answers for Enhanced Exam
Preparation"
,
,UNIT 1:Current Theories And Practice
Introduction to Psychiatric and Mental Health Nursing
Signs <<<Detailed Answer>>>clinicians' observations and objective
findings
Symptoms <<<Detailed Answer>>>subjective experiences described by
the patient
Mental Health Definition <<<Detailed Answer>>>A state of well-being
where individuals realize their abilities, cope with normal life stresses, and
contribute to the community.
Mental Illness Definition <<<Detailed Answer>>>Psychiatric disorders
with definable diagnoses marked by significant dysfunction in mental
functioning.
DSM-5 vs. Nursing Diagnosis <<<Detailed Answer>>>DSM-5 categorizes
mental disorders; nursing diagnosis focuses on human responses.
Roles of PMH Nurses <<<Detailed Answer>>>Includes assessment,
therapy, education, crisis intervention, and promoting therapeutic
environment (milieu therapy).
Milieu Therapy <<<Detailed Answer>>>A controlled environment that
promotes healing through structure, routine, and therapeutic interaction.
Multidisciplinary Team <<<Detailed Answer>>>Collaboration among
nurses, psychiatrists, social workers, and others to deliver holistic mental
health care.
Community Health Centers Act of 1963 <<<Detailed
Answer>>>Promoted deinstitutionalization and created community-based
services.
,Partial vs. Traditional Inpatient Hospitalization <<<Detailed
Answer>>>Partial provides structured treatment during the day; inpatient
offers 24-hour care.
Homelessness in Mental Illness <<<Detailed Answer>>>Many lack
consistent treatment or support, leading to increased vulnerability and
repeated hospitalizations.
Revolving Door Phenomenon <<<Detailed Answer>>>High readmission
rates due to short inpatient stays and poor outpatient follow-up.
ED Boarding <<<Detailed Answer>>>Patients with psychiatric issues
remain in ER due to lack of beds, leading to poor outcomes and increased
staff strain.
Therapeutic Relationship <<<Detailed Answer>>>Nurse uses self-
awareness and communication to foster growth.
Empathy vs. Sympathy <<<Detailed Answer>>>Empathy fosters trust by
understanding and validating feelings; sympathy can create distance or
minimize experiences.
Verbal & Nonverbal Communication <<<Detailed Answer>>>Effective use
enhances trust. Examples: active listening, open posture, eye contact.
Enhancers vs. Blockers <<<Detailed Answer>>>Open-ended questions
and reflecting are helpful; giving advice or changing topics obstructs
therapeutic dialogue.
Boundaries, Transference, Countertransference <<<Detailed
Answer>>>Nurse maintains professional roles; awareness prevents harm
or blurred relationships.
Cultural Competence <<<Detailed Answer>>>Understanding cultural
beliefs improves care and reduces misunderstandings.
Freud (Id, Ego, Superego) <<<Detailed Answer>>>Explains behavior as
influenced by unconscious conflict; basis for insight therapy.
,Defense Mechanisms <<<Detailed Answer>>>Unconscious coping
strategies (e.g., denial, projection) used to reduce anxiety.
Erikson's Psychosocial Stages <<<Detailed Answer>>>Describes
psychosocial challenges across the lifespan; guides developmental
assessments.
Sullivan's Interpersonal Theory <<<Detailed Answer>>>Focus on
interpersonal relationships to reduce anxiety and improve functioning.
Peplau's Nursing Theory <<<Detailed Answer>>>Foundation for
therapeutic nurse-client relationship: orientation, working, and termination
phases.
Group Therapy & Phases <<<Detailed Answer>>>Open vs. closed
groups. Stages: forming, storming, norming, performing, adjourning.
Ethical Principles <<<Detailed Answer>>>Autonomy, beneficence,
nonmaleficence, fidelity, veracity, justice—core to ethical nursing practice.
Voluntary vs. Involuntary Commitment <<<Detailed Answer>>>Voluntary
= patient consents; Involuntary = court-ordered if danger to self/others.
Client Rights: Restraints & Seclusion <<<Detailed Answer>>>Used only
when necessary for safety. Requires documentation and constant
monitoring.
Duty to Warn <<<Detailed Answer>>>Legal obligation to inform potential
victims of threats. Overrides confidentiality when safety is at risk.
Malpractice Prevention <<<Detailed Answer>>>Maintain documentation,
follow protocols, act within scope of practice.
Insanity Defense <<<Detailed Answer>>>Based on M'Naghten Rule:
patient unable to understand wrongfulness or control actions.
Neurotransmitters <<<Detailed Answer>>>Dopamine: ↑ = schizophrenia,
↓ = Parkinson's. Serotonin: mood, sleep, ↓ = depression. GABA: ↓ =
anxiety. Norepinephrine: fight/flight, mood. Acetylcholine: memory,
learning.
,Brain Structures <<<Detailed Answer>>>Cerebral cortex (thoughts),
limbic system (emotions), hippocampus (memory), hypothalamus
(hormones).
Imaging Techniques <<<Detailed Answer>>>CT & MRI (structure), PET
& SPECT (function). Help visualize abnormalities in psychiatric conditions.
Psychoneuroimmunology <<<Detailed Answer>>>Links stress and
immune function. Chronic stress affects neurotransmitters and increases
vulnerability to mental illness.
Endocrine Involvement <<<Detailed Answer>>>Hormone imbalances
(e.g., cortisol, thyroid) can mimic or worsen psychiatric symptoms.
SSRIs <<<Detailed Answer>>>Fluoxetine, Paroxetine, Sertraline,
Citalopram. Inhibit serotonin reuptake. Treat depression, anxiety, OCD.
Side effects: GI upset, sexual dysfunction, insomnia.
Tricyclics (TCAs) <<<Detailed Answer>>>Amitriptyline, Nortriptyline,
Imipramine. Block reuptake of serotonin and norepinephrine. Side effects:
sedation, arrhythmias, anticholinergic effects.
MAOIs <<<Detailed Answer>>>Phenelzine, Tranylcypromine. Prevent
breakdown of monoamines. Risk of hypertensive crisis with tyramine foods
(aged cheese, wine).
Lithium <<<Detailed Answer>>>Mood stabilizer for bipolar disorder.
Monitor levels (0.6-1.2 mEq/L). Toxicity: tremors, GI distress, confusion.
Maintain consistent salt/water intake.
2nd Gen Antipsychotics <<<Detailed Answer>>>Risperidone,
Olanzapine, Clozapine. Treat schizophrenia. Fewer EPS than 1st gen.
Monitor WBC with Clozapine.
EPS Medications <<<Detailed Answer>>>Benztropine (Cogentin),
Diphenhydramine (Benadryl). Used to manage EPS: dystonia, akathisia,
pseudoparkinsonism.
,Serotonin Syndrome <<<Detailed Answer>>>Life-threatening. Symptoms:
agitation, confusion, tachycardia, hyperthermia. Caused by combining
serotonergic drugs.
Benzodiazepines <<<Detailed Answer>>>Lorazepam, Diazepam,
Alprazolam. Enhance GABA. Used for anxiety, alcohol withdrawal. Risk of
dependence, CNS depression.
Stimulants <<<Detailed Answer>>>Methylphenidate, Amphetamines.
Treat ADHD. Monitor for weight loss, insomnia, abuse.
Herbal Interactions <<<Detailed Answer>>>St. John's Wort can increase
serotonin (risk of serotonin syndrome). Ginkgo ↑ bleeding risk with
anticoagulants.
Syndrome <<<Detailed Answer>>>group of signs and symptoms that
occur together as a recognizable condition that may be less than specific
than a clear-cut disorder or disease
Intellect <<<Detailed Answer>>>includes consciousness, memory,
orientation, perception, attention and concentration, thought process,
insight, knowledge judgment, and intelligence.
Emotions <<<Detailed Answer>>>the inner feeling of experiences of the
individual.
Behavior <<<Detailed Answer>>>the conduct of the individual
Consciousness <<<Detailed Answer>>>A state of awareness
Apperception <<<Detailed Answer>>>perception modified by one's own
emotions and thoughts.
Sensorium <<<Detailed Answer>>>state of cognitive functioning of the
special senses.
Disturbances of consciousness <<<Detailed Answer>>>Are most often
associated with brain pathology.
, Disorientation <<<Detailed Answer>>>Disturbance of orientation in time,
place and person.
Clouding of consciousness <<<Detailed Answer>>>Incomplete clear-
mindedness with disturbances in perception and attitudes.
Stupor <<<Detailed Answer>>>Lack of reaction to and unawareness of
surroundings.
Delirium <<<Detailed Answer>>>Bewildered, restless, confused,
disoriented reaction associated with fear and hallucinations.
Coma <<<Detailed Answer>>>Profound degree of unconsciousness.
Coma vigil <<<Detailed Answer>>>Coma in which the patient appears to
be a sleep but ready to be aroused also known as a kinetic mutism.
Twilight state <<<Detailed Answer>>>Disturbed consciousness with
hallucinations.
Dreamlike state <<<Detailed Answer>>>Often used as a synonym for
complex partial seizure or psychomotor epilepsy.
Somnolence <<<Detailed Answer>>>Abnormal drowsiness.
Disturbances of Attention <<<Detailed Answer>>>the amount of effort
exerted in focusing on certain portion of an experience; ability to sustain a
focus on one activity; ability to concentrate.
Distractibility <<<Detailed Answer>>>Inability to concentrate attention,
attention drawn to unimportant or irrelevant external stimuli.
Selective inattention <<<Detailed Answer>>>Blocking out only those
things that generate anxiety.
Hyper vigilance <<<Detailed Answer>>>Excessive attention and focus on
all internal and external stimuli, usually secondary to delusional or paranoid
states.
