Psychiatric Mental Health Nursing – 2025
Guide
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
1. Question: What is the primary purpose of defining the
concept of stress adaptation in psychiatric nursing?
o A. To identify pharmacologic interventions for stress
o B. To explain the stages of grief in response to loss
o C. To understand how individuals respond and adjust
to stressors
o D. To categorize mental illnesses based on severity
Correct Answer: C Rationale: The objectives focus on
understanding individuals’ responses and adjustments to
stressors, which is foundational for nursing interventions.
Subtopic: Objectives
2. Question: Which of the following is NOT an objective
outlined in Chapter 1 related to stress adaptation?
o A. Describe physiological responses to stress
o B. Identify coping strategies at the individual level
o C. Explain cultural variations in stress perception
o D. Outline the role of neurotransmitters in mood
regulation
Correct Answer: D Rationale: While neurotransmitters are
discussed, outlining their role in mood regulation is outside the
,specific objectives for stress adaptation in this chapter.
Subtopic: Objectives
3. Question: One of the chapter objectives is to differentiate
between stress as a biological response and stress as an
environmental event. Which skill best represents this
objective?
o A. Calculating medication dosages
o B. Comparing the fight-or-flight response to
situational triggers
o C. Evaluating patient lab results
o D. Documenting patient history
Correct Answer: B Rationale: Comparing physiological
responses (fight-or-flight) with environmental triggers
addresses that objective directly. Subtopic: Objectives
4. Question: The chapter aims to help nursing students
identify adaptive versus maladaptive coping. Which
outcome indicates successful achievement of this
objective?
o A. The student lists all DSM-5 diagnoses
o B. The student explains why avoidance is maladaptive
o C. The student memorizes all stages of stress
o D. The student prescribes coping interventions
without assessment
,Correct Answer: B Rationale: Explaining why avoidance is
maladaptive demonstrates understanding of adaptive versus
maladaptive coping. Subtopic: Objectives
5. Question: Which objective emphasizes the importance of
cultural context in stress adaptation?
o A. Define the endorphin response in the brain
o B. Describe how culture shapes stress perception
o C. Identify vital sign changes during stress
o D. List environmental stressors in urban settings
Correct Answer: B Rationale: Describing cultural influences
directly relates to how culture impacts stress perception.
Subtopic: Objectives
6. Question: A stated objective is to examine intervention
strategies. Which of the following exemplifies meeting
that objective?
o A. Identifying coping strategies such as relaxation
techniques
o B. Listing neurotransmitter pathways
o C. Outlining the history of psychiatric nursing
o D. Describing the structure of the limbic system
Correct Answer: A Rationale: Identifying practical coping
strategies reflects examining intervention strategies. Subtopic:
Objectives
, 7. Question: An objective involves discussing the role of the
autonomic nervous system. Which concept best matches
this?
o A. Environmental stimuli
o B. Sympathetic activation
o C. Cognitive appraisal
o D. Social support networks
Correct Answer: B Rationale: Sympathetic activation is a core
function of the autonomic nervous system in stress. Subtopic:
Objectives
8. Question: The chapter objectives include analyzing stress
management. Which outcome would show mastery of this
objective?
o A. Differentiating problem-focused and emotion-
focused coping
o B. Reciting defense mechanism definitions
o C. Describing the anatomy of the hypothalamus
o D. Identifying psychotropic medication classes
Correct Answer: A Rationale: Differentiating coping strategies
demonstrates analysis of stress management. Subtopic:
Objectives
Subtopic: Stress as a Biological Response
, 9. Question: Which hormone is primarily responsible for the
fight-or-flight response?
o A. Melatonin
o B. Cortisol
o C. Oxytocin
o D. Serotonin
Correct Answer: B Rationale: Cortisol is the main stress
hormone released by the adrenal cortex during the fight-or-
flight response. Subtopic: Stress as a Biological Response
10. Question: Activation of the sympathetic nervous
system leads to which of the following changes?
o A. Decreased heart rate
o B. Bronchoconstriction
o C. Pupillary dilation
o D. Increased gastrointestinal motility
Correct Answer: C Rationale: Sympathetic activation causes
pupillary dilation to improve vision in stress situations.
Subtopic: Stress as a Biological Response
11. Question: The hypothalamic-pituitary-adrenal (HPA)
axis involves all EXCEPT:
o A. Release of CRH from the hypothalamus
o B. Secretion of ACTH from the anterior pituitary
, o C. Direct peripheral nerve stimulation of the adrenal
cortex
o D. Production of cortisol by the adrenal glands
Correct Answer: C Rationale: The HPA axis does not include
direct nerve stimulation; it is hormone-mediated. Subtopic:
Stress as a Biological Response
12. Question: Prolonged stress can lead to
immunosuppression primarily due to:
o A. Increased endorphin release
o B. Elevated cortisol levels
o C. Enhanced lymphocyte proliferation
o D. Decreased sympathetic tone
Correct Answer: B Rationale: Chronically elevated cortisol
suppresses immune cell function. Subtopic: Stress as a
Biological Response
13. Question: Which neurotransmitter is most closely
associated with the feeling of euphoria that can follow
acute stress?
o A. GABA
o B. Dopamine
o C. Glutamate
o D. Acetylcholine