,
,
,
,18. Place in order the Kübler Ross stages of grief from 1-5. (Enter the number of each step in the
proper sequence, using comma and space format, such as: 1, 2, 3, 4.)
1. Bargaining
2. Denial
3. Acceptance
4. Depression
5. Anger
,Chapter 1: Mental Health and Mental Illness
Answer Section
MULTIPLE CHOICE
1. ANS: 4
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Discuss cultural elements that influence attitudes toward mental health and mental
illness.
Page: 9
Heading: Grief
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Grief and Loss
Difficulty: Moderate
Feedback
1 The client’s behaviors are to be expected in a time of grief.
2 The client’s behaviors are appropriate. It is quite normal for an individual to
function normally but to experience periods of sadness after the loss of a pet.
3 It is expected in mosNt cUuR
ltuSrI
esNtG
oTexBp.
erCieOnM
ce occasional feelings of sadness
following a loss, yet not experience an alteration in normal day-to-day activities
4 The nurse should assess that the client’s daily functioning is not impaired. The
client who experiences feelings of sadness after the loss of a pet is responding
within normal expectations.
PTS: 1 CON: Grief and Loss
2. ANS: 2
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Define mental health and mental illness.
Page: 4
Heading: Mental Illness
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress
Difficulty: Easy
Feedback
1 The client with a mental illness would have symptoms that reflect the DSM-5.
2 The nurse should determine that the client is at risk for mental illness when
responses to stress are maladaptive and interfere with daily functioning. The
DSM-5 indicates that in order to be diagnosed with a mental illness, daily
, functioning must be significantly impaired.
3 The client’s ability to communicate distress would be considered a positive
attribute.
4 The use of defense mechanisms does not indicate that the client is at risk for
mental illness.
PTS: 1 CON: Stress
3. ANS: 2
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Discuss the concepts of anxiety and grief as physiological responses to stress
Page:
Heading: Stages of Grief
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Grief and Loss
Difficulty: Moderate
Feedback
1 This statement demonstrates anger.
2 The client is asking God for a longer life in exchange for ceasing drugs, which
demonstrates bargaining.
3 This client is in the aN
ccUeR
ptS
anIcN
eGstT
agBe.oC
f tOhM
e grief process
4 This client is in the denial stage of the grief process
PTS: 1 CON: Grief and Loss
4. ANS: 4
Chapter: Chapter 1, Mental Health and Mental Illness
Objective:
Page:
Heading: Anxiety
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Analysis (Analyzing)
Concept: Stress
Difficulty: Moderate
Feedback
1 Mild anxiety is not typically symptomatic for an individual.
2 An individual with moderate anxiety has difficulty focusing and may be more
restless.
3 Severe anxiety influences attention and can cause physical symptoms such as
headaches and insomnia as well as emotional symptoms such as confusion and
dread.
4 Panic anxiety leads to inability to focus, hallucinations, delusions, wild or
, desperate behavior, feeling of terror, fear of “going crazy” or losing control,
emotional exhaustion, and physical exhaustion.
PTS: 1 CON: Stress
5. ANS: 1
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 7
Heading: Physical and Psychological Responses to Stress > Mild Anxiety
Cognitive Level: Application [Applying]
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Concept: Stress
Difficulty: Moderate
Feedback
1 The nurse should determine that defense mechanisms could be appropriate
during times of stress.
2 Defense mechanisms are not maladaptive attempts of the ego to manage anxiety.
3 Defense mechanisms are a normal part of coping with stress. They are not used
by individuals with weak ego integrity. They should not be discouraged and not
completely eliminated.
4 Defense mechanismsNaUreRnSoI rm
NaGl T
anBd.aC
reOuMsed by all individuals in some way
during times of stress; they do not cause disintegration of the ego.
PTS: 1 CON: Stress
6. ANS: 3
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 9
Heading: Physical and Psychological Responses to Stress > Severe Anxiety
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
1 This statement disregards the client’s statement and is not therapeutic to the
client.
2 This statement does not address the client’s statement and may anger the client
further.
3 The nurse should attempt to educate the client on the negative effects of
excessive stress on medical conditions.
, 4 It is not appropriate to skip physiological and psychosocial questions, as this
would lead to an inaccurate assessment.
PTS: 1 CON: Stress
7. ANS: 3
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 7
Heading: Table 1-1 Ego Defense Mechanisms > Displacement
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Stress
Difficulty: Difficult
Feedback
1 Confronting others is not a behavior consistent with displacement.
2 Leaving the facility is not a behavior consistent with displacement.
3 The nurse should expect that the client using the defense mechanism of
displacement would criticize nursing care after being confronted by the
health-care provider.
4 This approach exemplifies intellectualization rather than displacement.
PTS: Stress
1 CON:
8. ANS: 3
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 7
Heading: Table 1-1 Ego Defense Mechanisms > Reaction Formation
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
1 Displacement refers to transferring feelings from one target to another.
2 Projection refers to the attribution of unacceptable feelings or behaviors to
another person.
3 The nurse should identify that the boy is using reaction formation as a defense
mechanism. Reaction formation is the attempt to prevent undesirable thoughts
from being expressed by expressing opposite thoughts or behaviors.
4 Sublimation refers to channeling unacceptable drives or impulses into more
constructive, acceptable activities.
, PTS: 1 CON: Stress
9. ANS: 2
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 6
Heading: Physical and Physiological Responses to Stress > Anxiety
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
Feedback
1 The client with psychosis is unaware that his or her behavior is maladaptive.
2 The nurse should understand that the client with psychosis experiences little
distress owing to his or her lack of awareness of reality.
3 The client with psychosis is unaware he or she has a psychological problem.
4 The client experiencing psychosis has a lack of awareness of reality.
PTS: 1 CON: Stress
10. ANS: 4
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physioNloUgR
icS
alIrN
esG
poTnBse.sCtoOsMtress.
Page: 7
Heading: Table 1-1 Ego Defense Mechanisms > Denial
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Addiction and Behaviors
Difficulty: Easy
Feedback
1 This behavior does not indicate denial.
2 Yelling at family members does not indicate denial.
3 Burning dinner on purpose is not an action that indicates denial.
4 The client’s statement “I don’t drink too much!” alerts the nurse to the use of the
defense mechanism of denial. The client is refusing to acknowledge the
existence of a real situation and the feelings associated with it.
PTS: 1 CON: Addiction and Behaviors
11. ANS: 3
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Discuss the concepts of anxiety and grief as psychological responses to stress.
Page: 10
Heading: Stages of Grief
,
,
,18. Place in order the Kübler Ross stages of grief from 1-5. (Enter the number of each step in the
proper sequence, using comma and space format, such as: 1, 2, 3, 4.)
1. Bargaining
2. Denial
3. Acceptance
4. Depression
5. Anger
,Chapter 1: Mental Health and Mental Illness
Answer Section
MULTIPLE CHOICE
1. ANS: 4
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Discuss cultural elements that influence attitudes toward mental health and mental
illness.
Page: 9
Heading: Grief
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Grief and Loss
Difficulty: Moderate
Feedback
1 The client’s behaviors are to be expected in a time of grief.
2 The client’s behaviors are appropriate. It is quite normal for an individual to
function normally but to experience periods of sadness after the loss of a pet.
3 It is expected in mosNt cUuR
ltuSrI
esNtG
oTexBp.
erCieOnM
ce occasional feelings of sadness
following a loss, yet not experience an alteration in normal day-to-day activities
4 The nurse should assess that the client’s daily functioning is not impaired. The
client who experiences feelings of sadness after the loss of a pet is responding
within normal expectations.
PTS: 1 CON: Grief and Loss
2. ANS: 2
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Define mental health and mental illness.
Page: 4
Heading: Mental Illness
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress
Difficulty: Easy
Feedback
1 The client with a mental illness would have symptoms that reflect the DSM-5.
2 The nurse should determine that the client is at risk for mental illness when
responses to stress are maladaptive and interfere with daily functioning. The
DSM-5 indicates that in order to be diagnosed with a mental illness, daily
, functioning must be significantly impaired.
3 The client’s ability to communicate distress would be considered a positive
attribute.
4 The use of defense mechanisms does not indicate that the client is at risk for
mental illness.
PTS: 1 CON: Stress
3. ANS: 2
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Discuss the concepts of anxiety and grief as physiological responses to stress
Page:
Heading: Stages of Grief
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Grief and Loss
Difficulty: Moderate
Feedback
1 This statement demonstrates anger.
2 The client is asking God for a longer life in exchange for ceasing drugs, which
demonstrates bargaining.
3 This client is in the aN
ccUeR
ptS
anIcN
eGstT
agBe.oC
f tOhM
e grief process
4 This client is in the denial stage of the grief process
PTS: 1 CON: Grief and Loss
4. ANS: 4
Chapter: Chapter 1, Mental Health and Mental Illness
Objective:
Page:
Heading: Anxiety
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Analysis (Analyzing)
Concept: Stress
Difficulty: Moderate
Feedback
1 Mild anxiety is not typically symptomatic for an individual.
2 An individual with moderate anxiety has difficulty focusing and may be more
restless.
3 Severe anxiety influences attention and can cause physical symptoms such as
headaches and insomnia as well as emotional symptoms such as confusion and
dread.
4 Panic anxiety leads to inability to focus, hallucinations, delusions, wild or
, desperate behavior, feeling of terror, fear of “going crazy” or losing control,
emotional exhaustion, and physical exhaustion.
PTS: 1 CON: Stress
5. ANS: 1
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 7
Heading: Physical and Psychological Responses to Stress > Mild Anxiety
Cognitive Level: Application [Applying]
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Concept: Stress
Difficulty: Moderate
Feedback
1 The nurse should determine that defense mechanisms could be appropriate
during times of stress.
2 Defense mechanisms are not maladaptive attempts of the ego to manage anxiety.
3 Defense mechanisms are a normal part of coping with stress. They are not used
by individuals with weak ego integrity. They should not be discouraged and not
completely eliminated.
4 Defense mechanismsNaUreRnSoI rm
NaGl T
anBd.aC
reOuMsed by all individuals in some way
during times of stress; they do not cause disintegration of the ego.
PTS: 1 CON: Stress
6. ANS: 3
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 9
Heading: Physical and Psychological Responses to Stress > Severe Anxiety
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
1 This statement disregards the client’s statement and is not therapeutic to the
client.
2 This statement does not address the client’s statement and may anger the client
further.
3 The nurse should attempt to educate the client on the negative effects of
excessive stress on medical conditions.
, 4 It is not appropriate to skip physiological and psychosocial questions, as this
would lead to an inaccurate assessment.
PTS: 1 CON: Stress
7. ANS: 3
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 7
Heading: Table 1-1 Ego Defense Mechanisms > Displacement
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Stress
Difficulty: Difficult
Feedback
1 Confronting others is not a behavior consistent with displacement.
2 Leaving the facility is not a behavior consistent with displacement.
3 The nurse should expect that the client using the defense mechanism of
displacement would criticize nursing care after being confronted by the
health-care provider.
4 This approach exemplifies intellectualization rather than displacement.
PTS: Stress
1 CON:
8. ANS: 3
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 7
Heading: Table 1-1 Ego Defense Mechanisms > Reaction Formation
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
1 Displacement refers to transferring feelings from one target to another.
2 Projection refers to the attribution of unacceptable feelings or behaviors to
another person.
3 The nurse should identify that the boy is using reaction formation as a defense
mechanism. Reaction formation is the attempt to prevent undesirable thoughts
from being expressed by expressing opposite thoughts or behaviors.
4 Sublimation refers to channeling unacceptable drives or impulses into more
constructive, acceptable activities.
, PTS: 1 CON: Stress
9. ANS: 2
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physiological responses to stress.
Page: 6
Heading: Physical and Physiological Responses to Stress > Anxiety
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
Feedback
1 The client with psychosis is unaware that his or her behavior is maladaptive.
2 The nurse should understand that the client with psychosis experiences little
distress owing to his or her lack of awareness of reality.
3 The client with psychosis is unaware he or she has a psychological problem.
4 The client experiencing psychosis has a lack of awareness of reality.
PTS: 1 CON: Stress
10. ANS: 4
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Identify physioNloUgR
icS
alIrN
esG
poTnBse.sCtoOsMtress.
Page: 7
Heading: Table 1-1 Ego Defense Mechanisms > Denial
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Addiction and Behaviors
Difficulty: Easy
Feedback
1 This behavior does not indicate denial.
2 Yelling at family members does not indicate denial.
3 Burning dinner on purpose is not an action that indicates denial.
4 The client’s statement “I don’t drink too much!” alerts the nurse to the use of the
defense mechanism of denial. The client is refusing to acknowledge the
existence of a real situation and the feelings associated with it.
PTS: 1 CON: Addiction and Behaviors
11. ANS: 3
Chapter: Chapter 1, Mental Health and Mental Illness
Objective: Discuss the concepts of anxiety and grief as psychological responses to stress.
Page: 10
Heading: Stages of Grief
