,Townsend & Morgan’s Psychiatric
Concepts Q&A Review | NCLEX-Ready for
2025
Includes High-Quality NCLEX-Style MCQs per Chapter with
100% Correct Answers and Concise Rationales
Table of Contents for Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based
Practice, 10th Edition by Townsend & Morgan:
I. Basic Concepts in Psychiatric–Mental Health Nursing
1. The Concept of Stress Adaptation
2. Mental Health and Mental Illness: Historical and Theoretical Concepts
II. Foundations for Psychiatric–Mental Health Nursing
3. Concepts of Psychobiology
4. Psychopharmacology
5. Ethical and Legal Issues
III. Therapeutic Approaches in Psychiatric Nursing Care
6. Relationship Development
7. Therapeutic Communication
8. The Nursing Process in Psychiatric–Mental Health Nursing
9. Therapeutic Groups
10. Intervention with Families
11. Milieu Therapy—The Therapeutic Community
12. Crisis Intervention
13. Assertiveness Training
14. Promoting Self-Esteem
, 15. Anger and Aggression Management
16. Suicide Prevention
17. Behavior Therapy
18. Cognitive Behavioral Therapy
19. Electroconvulsive Therapy
20. The Recovery Model
IV. Nursing Care of Patients with Alterations in Psychosocial Adaptation
21. Caring for Patients with Mental Illness and Substance Use Disorders in General Practice
Settings
22. Neurocognitive Disorders
23. Substance-Related and Addictive Disorders
24. Schizophrenia Spectrum and Other Psychotic Disorders
25. Depressive Disorders
26. Bipolar and Related Disorders
27. Anxiety, Obsessive-Compulsive, and Related Disorders
28. Trauma and Stressor-Related Disorders
29. Somatic Symptom and Dissociative Disorders
30. Eating Disorders
31. Personality Disorders
V. Psychiatric/Mental Health Nursing of Special Populations
32. Children and Adolescents
33. The Aging Individual
34. Survivors of Abuse or Neglect
35. Community Mental Health Nursing
36. The Bereaved Individual
37. Military Families
38. Appendices & Additional Resources
, A. Answers to Chapter Review and Clinical Judgment Questions
B. Examples of Answers to Communication Exercises
C. Mental Status Assessment
Glossary
Index
eBook Bonus Chapters
38. Theoretical Models of Personality Development
39. Cultural and Spiritual Concepts Relevant to Psychiatric Mental Health Nursing
40. Complementary and Psychosocial Therapies
41. Relaxation Therapy
42. Issues Related to Human Sexuality and Gender Dysphoria
43. Forensic Nursing
,Chapter 1 – The Concept of Stress Adaptation (10th ed.,
Townsend & Morgan).
Subtopic: Objectives (7 questions)
1. Which goal of Chapter 1 emphasizes the nurse’s role in
assessing a patient’s adaptive coping resources?
A. To define homeostasis
B. To identify stressors and assess coping mechanisms ✔
C. To describe psychopharmacological interventions
D. To explain family systems theory
Rationale: One of the stated objectives is to identify
stressors and evaluate coping resources, aligning nursing
assessment with stress adaptation.
Subtopic: Objectives
2. An objective of this chapter is to distinguish between
eustress and distress. Which statement correctly defines
eustress?
A. Stress that overwhelms coping abilities
B. Stress that is perceived as positive or motivating ✔
C. Stress that originates from external events
D. Stress resulting in maladaptive responses
Rationale: Eustress refers to positive stress that can
motivate growth or achievement.
Subtopic: Objectives
,3. One objective is to describe the physiological stress
response. Which system is primarily responsible for the
“fight-or-flight” reaction?
A. Parasympathetic nervous system
B. Hypothalamic-pituitary-gonadal axis
C. Sympathetic-adrenomedullary system ✔
D. Renin-angiotensin-aldosterone system
Rationale: The sympathetic-adrenomedullary axis releases
catecholamines triggering fight-or-flight.
Subtopic: Objectives
4. The chapter aims to explain transactional models of
stress. Who is the main theorist associated with this
model?
A. Hans Selye
B. Richard Lazarus ✔
C. Walter Cannon
D. Florence Nightingale
Rationale: Lazarus developed the cognitive-transactional
model emphasizing appraisal and coping.
Subtopic: Objectives
5. Which objective aligns with teaching stress-management
techniques to patients?
A. Describe environmental stressors
B. Explain the stages of General Adaptation Syndrome
C. Demonstrate stress-management interventions ✔
D. Compare acute and chronic stress
, Rationale: An explicit objective is to demonstrate
evidence-based stress-management strategies.
Subtopic: Objectives
6. An objective is to differentiate types of stress. Which of
the following is NOT one of those types?
A. Acute stress
B. Chronic stress
C. Episodic acute stress
D. Residual stress ✔
Rationale: Residual stress is not a standard category; the
chapter lists acute, episodic acute, and chronic.
Subtopic: Objectives
7. Which objective emphasizes the nurse’s understanding of
stress at a population level?
A. To teach individual relaxation techniques
B. To explore community and cultural stressors ✔
C. To prescribe anxiolytics
D. To measure individual cortisol levels
Rationale: Recognizing community and cultural stress
contexts addresses population-level understanding.
Subtopic: Objectives
Subtopic: Stress as a Biological Response (7 questions)
8. Which hormone is released first during the alarm
reaction stage of stress?
, A. Cortisol
B. Epinephrine ✔
C. Thyroxine
D. Insulin
Rationale: Epinephrine is rapidly secreted by the adrenal
medulla in the initial alarm phase.
Subtopic: Stress as a Biological Response
9. What effect does prolonged cortisol elevation have on
the immune system?
A. Enhanced antibody production
B. Suppressed inflammatory response ✔
C. Increased leukocyte proliferation
D. Improved wound healing
Rationale: Chronically high cortisol suppresses
inflammation and immune function.
Subtopic: Stress as a Biological Response
10. During the resistance stage of the General
Adaptation Syndrome, the body:
A. Collapses under stress
B. Returns to pre-stressor baseline
C. Attempts to adapt and cope ✔
D. Initiates the exhaustion phase
Rationale: In resistance, physiological defenses continue
while the body attempts adaptation.
Subtopic: Stress as a Biological Response
,11. Which statement best describes allostasis?
A. Maintenance of a fixed internal environment
B. Dynamic process of achieving stability through change
✔
C. Immediate fight-or-flight reaction
D. Passive return to homeostasis
Rationale: Allostasis refers to active regulatory processes
to maintain stability amid stressors.
Subtopic: Stress as a Biological Response
12. Activation of the HPA axis results in the release of
which hormone from the anterior pituitary?
A. Antidiuretic hormone
B. Adrenocorticotropic hormone (ACTH) ✔
C. Growth hormone
D. Oxytocin
Rationale: CRH from the hypothalamus triggers ACTH
release, stimulating cortisol secretion.
Subtopic: Stress as a Biological Response
13. Which cellular structure is most directly affected by
oxidative stress?
A. Mitochondria ✔
B. Ribosomes
C. Golgi apparatus
D. Nucleus
Rationale: Oxidative stress damages mitochondrial
, membranes and function.
Subtopic: Stress as a Biological Response
14. Heart rate variability (HRV) is considered a
physiologic marker of:
A. Fluid balance
B. Autonomic flexibility ✔
C. Renal perfusion
D. Nutritional status
Rationale: HRV reflects adaptability of the autonomic
nervous system under stress.
Subtopic: Stress as a Biological Response
Subtopic: Stress as an Environmental Event (7 questions)
15. An environmental stressor is best defined as:
A. A physiological change due to stress
B. A person’s appraisal of a situation
C. An external demand requiring adaptation ✔
D. A coping strategy
Rationale: Environmental event stressors are external
demands that challenge homeostasis.
Subtopic: Stress as an Environmental Event
16. Which of the following is a situational
environmental stressor?
A. Genetic predisposition
B. Earthquake ✔
Concepts Q&A Review | NCLEX-Ready for
2025
Includes High-Quality NCLEX-Style MCQs per Chapter with
100% Correct Answers and Concise Rationales
Table of Contents for Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based
Practice, 10th Edition by Townsend & Morgan:
I. Basic Concepts in Psychiatric–Mental Health Nursing
1. The Concept of Stress Adaptation
2. Mental Health and Mental Illness: Historical and Theoretical Concepts
II. Foundations for Psychiatric–Mental Health Nursing
3. Concepts of Psychobiology
4. Psychopharmacology
5. Ethical and Legal Issues
III. Therapeutic Approaches in Psychiatric Nursing Care
6. Relationship Development
7. Therapeutic Communication
8. The Nursing Process in Psychiatric–Mental Health Nursing
9. Therapeutic Groups
10. Intervention with Families
11. Milieu Therapy—The Therapeutic Community
12. Crisis Intervention
13. Assertiveness Training
14. Promoting Self-Esteem
, 15. Anger and Aggression Management
16. Suicide Prevention
17. Behavior Therapy
18. Cognitive Behavioral Therapy
19. Electroconvulsive Therapy
20. The Recovery Model
IV. Nursing Care of Patients with Alterations in Psychosocial Adaptation
21. Caring for Patients with Mental Illness and Substance Use Disorders in General Practice
Settings
22. Neurocognitive Disorders
23. Substance-Related and Addictive Disorders
24. Schizophrenia Spectrum and Other Psychotic Disorders
25. Depressive Disorders
26. Bipolar and Related Disorders
27. Anxiety, Obsessive-Compulsive, and Related Disorders
28. Trauma and Stressor-Related Disorders
29. Somatic Symptom and Dissociative Disorders
30. Eating Disorders
31. Personality Disorders
V. Psychiatric/Mental Health Nursing of Special Populations
32. Children and Adolescents
33. The Aging Individual
34. Survivors of Abuse or Neglect
35. Community Mental Health Nursing
36. The Bereaved Individual
37. Military Families
38. Appendices & Additional Resources
, A. Answers to Chapter Review and Clinical Judgment Questions
B. Examples of Answers to Communication Exercises
C. Mental Status Assessment
Glossary
Index
eBook Bonus Chapters
38. Theoretical Models of Personality Development
39. Cultural and Spiritual Concepts Relevant to Psychiatric Mental Health Nursing
40. Complementary and Psychosocial Therapies
41. Relaxation Therapy
42. Issues Related to Human Sexuality and Gender Dysphoria
43. Forensic Nursing
,Chapter 1 – The Concept of Stress Adaptation (10th ed.,
Townsend & Morgan).
Subtopic: Objectives (7 questions)
1. Which goal of Chapter 1 emphasizes the nurse’s role in
assessing a patient’s adaptive coping resources?
A. To define homeostasis
B. To identify stressors and assess coping mechanisms ✔
C. To describe psychopharmacological interventions
D. To explain family systems theory
Rationale: One of the stated objectives is to identify
stressors and evaluate coping resources, aligning nursing
assessment with stress adaptation.
Subtopic: Objectives
2. An objective of this chapter is to distinguish between
eustress and distress. Which statement correctly defines
eustress?
A. Stress that overwhelms coping abilities
B. Stress that is perceived as positive or motivating ✔
C. Stress that originates from external events
D. Stress resulting in maladaptive responses
Rationale: Eustress refers to positive stress that can
motivate growth or achievement.
Subtopic: Objectives
,3. One objective is to describe the physiological stress
response. Which system is primarily responsible for the
“fight-or-flight” reaction?
A. Parasympathetic nervous system
B. Hypothalamic-pituitary-gonadal axis
C. Sympathetic-adrenomedullary system ✔
D. Renin-angiotensin-aldosterone system
Rationale: The sympathetic-adrenomedullary axis releases
catecholamines triggering fight-or-flight.
Subtopic: Objectives
4. The chapter aims to explain transactional models of
stress. Who is the main theorist associated with this
model?
A. Hans Selye
B. Richard Lazarus ✔
C. Walter Cannon
D. Florence Nightingale
Rationale: Lazarus developed the cognitive-transactional
model emphasizing appraisal and coping.
Subtopic: Objectives
5. Which objective aligns with teaching stress-management
techniques to patients?
A. Describe environmental stressors
B. Explain the stages of General Adaptation Syndrome
C. Demonstrate stress-management interventions ✔
D. Compare acute and chronic stress
, Rationale: An explicit objective is to demonstrate
evidence-based stress-management strategies.
Subtopic: Objectives
6. An objective is to differentiate types of stress. Which of
the following is NOT one of those types?
A. Acute stress
B. Chronic stress
C. Episodic acute stress
D. Residual stress ✔
Rationale: Residual stress is not a standard category; the
chapter lists acute, episodic acute, and chronic.
Subtopic: Objectives
7. Which objective emphasizes the nurse’s understanding of
stress at a population level?
A. To teach individual relaxation techniques
B. To explore community and cultural stressors ✔
C. To prescribe anxiolytics
D. To measure individual cortisol levels
Rationale: Recognizing community and cultural stress
contexts addresses population-level understanding.
Subtopic: Objectives
Subtopic: Stress as a Biological Response (7 questions)
8. Which hormone is released first during the alarm
reaction stage of stress?
, A. Cortisol
B. Epinephrine ✔
C. Thyroxine
D. Insulin
Rationale: Epinephrine is rapidly secreted by the adrenal
medulla in the initial alarm phase.
Subtopic: Stress as a Biological Response
9. What effect does prolonged cortisol elevation have on
the immune system?
A. Enhanced antibody production
B. Suppressed inflammatory response ✔
C. Increased leukocyte proliferation
D. Improved wound healing
Rationale: Chronically high cortisol suppresses
inflammation and immune function.
Subtopic: Stress as a Biological Response
10. During the resistance stage of the General
Adaptation Syndrome, the body:
A. Collapses under stress
B. Returns to pre-stressor baseline
C. Attempts to adapt and cope ✔
D. Initiates the exhaustion phase
Rationale: In resistance, physiological defenses continue
while the body attempts adaptation.
Subtopic: Stress as a Biological Response
,11. Which statement best describes allostasis?
A. Maintenance of a fixed internal environment
B. Dynamic process of achieving stability through change
✔
C. Immediate fight-or-flight reaction
D. Passive return to homeostasis
Rationale: Allostasis refers to active regulatory processes
to maintain stability amid stressors.
Subtopic: Stress as a Biological Response
12. Activation of the HPA axis results in the release of
which hormone from the anterior pituitary?
A. Antidiuretic hormone
B. Adrenocorticotropic hormone (ACTH) ✔
C. Growth hormone
D. Oxytocin
Rationale: CRH from the hypothalamus triggers ACTH
release, stimulating cortisol secretion.
Subtopic: Stress as a Biological Response
13. Which cellular structure is most directly affected by
oxidative stress?
A. Mitochondria ✔
B. Ribosomes
C. Golgi apparatus
D. Nucleus
Rationale: Oxidative stress damages mitochondrial
, membranes and function.
Subtopic: Stress as a Biological Response
14. Heart rate variability (HRV) is considered a
physiologic marker of:
A. Fluid balance
B. Autonomic flexibility ✔
C. Renal perfusion
D. Nutritional status
Rationale: HRV reflects adaptability of the autonomic
nervous system under stress.
Subtopic: Stress as a Biological Response
Subtopic: Stress as an Environmental Event (7 questions)
15. An environmental stressor is best defined as:
A. A physiological change due to stress
B. A person’s appraisal of a situation
C. An external demand requiring adaptation ✔
D. A coping strategy
Rationale: Environmental event stressors are external
demands that challenge homeostasis.
Subtopic: Stress as an Environmental Event
16. Which of the following is a situational
environmental stressor?
A. Genetic predisposition
B. Earthquake ✔
