,2025 NCLEX Success Toolkit: Psychiatric
Nursing Concepts Based on Townsend &
Morgan’s 11th Edition
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).
Objectives
1. Which of the following best describes the primary
objective of studying stress adaptation in psychiatric
nursing?
A. To eliminate stress in patients
B. To understand patient responses and guide
interventions (Correct)
C. To diagnose all stress-related disorders
D. To prescribe medications for stress
Rationale: The main goal is to comprehend how patients
respond to stress so that nursing care can be tailored
effectively.
Subtopic: Objectives
2. An objective of the stress adaptation chapter is to help
students differentiate between stressors and stress
responses. Which example illustrates a stress response?
A. Loss of job
B. Elevated heart rate (Correct)
C. Financial difficulty
D. Moving to a new home
Rationale: A stress response is a physiological or
psychological reaction (e.g., tachycardia), whereas
stressors are events.
Subtopic: Objectives
,3. One stated objective is to identify factors influencing
stress perception. Which factor most directly affects
perception?
A. Weather conditions
B. Past experiences (Correct)
C. Time of day
D. Geographic location
Rationale: Personal history shapes how stressors are
appraised.
Subtopic: Objectives
4. Which objective emphasizes the nurse’s role in stress
adaptation?
A. To teach pharmacology
B. To implement coping strategies (Correct)
C. To perform laboratory tests
D. To manage hospital budgets
Rationale: Nurses assess stress and help patients use
coping methods.
Subtopic: Objectives
5. According to the chapter’s objectives, understanding
stress as a transaction aids in:
A. Preventing stress completely
B. Predicting exact patient behaviors
C. Tailoring interventions to individual perceptions
(Correct)
D. Standardizing care for all patients
, Rationale: Viewing stress as a person–environment
interaction highlights individual differences.
Subtopic: Objectives
6. An objective is to distinguish between eustress and
distress. Which scenario exemplifies eustress?
A. Uncontrollable anxiety
B. Excitement before graduation (Correct)
C. Overwhelming grief
D. Chronic worry
Rationale: Eustress is positive stress that motivates or
energizes.
Subtopic: Objectives
7. Which objective focuses on the role of appraisal in stress
adaptation?
A. Defining neurotransmitter functions
B. Explaining primary and secondary appraisal (Correct)
C. Listing relaxation techniques
D. Classifying personality disorders
Rationale: Appraisal processes are key in determining
stress.
Subtopic: Objectives
8. One objective is to describe physiological responses to
stress. Which hormone is released by the adrenal
medulla?
A. Cortisol
B. Epinephrine (Correct)
, C. Aldosterone
D. Insulin
Rationale: The adrenal medulla secretes catecholamines
(epinephrine, norepinephrine).
Subtopic: Objectives
9. According to the chapter objectives, stress management
includes:
A. Ignoring stressors
B. Enhancing coping resources (Correct)
C. Eliminating all stressors
D. Standardizing response for everyone
Rationale: Management focuses on boosting coping rather
than removing all stress.
Subtopic: Objectives
Stress as a Biological Response
10. The General Adaptation Syndrome’s second stage is:
A. Alarm reaction
B. Resistance (Correct)
C. Exhaustion
D. Recovery
Rationale: GAS: alarm → resistance → exhaustion.
Subtopic: Stress as a Biological Response
11. Which physiological system is primarily activated
during the alarm reaction?
, A. Parasympathetic nervous system
B. Sympathetic–adrenal–medullary axis (Correct)
C. Gastrointestinal system
D. Immune system
Rationale: The SAM axis triggers fight-or-flight responses.
Subtopic: Stress as a Biological Response
12. Cortisol release in stress adaptation is regulated by:
A. Hypothalamic–pituitary–adrenal axis (Correct)
B. Renin–angiotensin system
C. Gastrointestinal hormones
D. Pancreatic feedback
Rationale: The HPA axis controls cortisol secretion.
Subtopic: Stress as a Biological Response
13. Which change is characteristic of the exhaustion
stage?
A. Heightened alertness
B. Decreased immunity (Correct)
C. Elevated energy
D. Improved performance
Rationale: Prolonged stress exhausts adaptive resources,
lowering immunity.
Subtopic: Stress as a Biological Response
14. Homeostasis refers to:
A. Maximum stress tolerance
B. Constant internal environment (Correct)
C. Rapid heart rate
, D. Chronic fatigue
Rationale: Homeostasis is the body’s effort to maintain
stable internal conditions.
Subtopic: Stress as a Biological Response
15. Which neurotransmitter increases during acute
stress?
A. Serotonin
B. GABA
C. Norepinephrine (Correct)
D. Adenosine
Rationale: Norepinephrine rises to facilitate alertness.
Subtopic: Stress as a Biological Response
16. A prolonged elevation of cortisol can lead to:
A. Improved memory
B. Muscle hypertrophy
C. Immunosuppression (Correct)
D. Decreased blood sugar
Rationale: Chronic cortisol impairs immune function and
increases glucose.
Subtopic: Stress as a Biological Response
17. What term describes the body’s initial, nonspecific
reaction to stress?
A. Adaptation
B. Alarm reaction (Correct)
C. Coping
D. Appraisal
Nursing Concepts Based on Townsend &
Morgan’s 11th Edition
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).
Objectives
1. Which of the following best describes the primary
objective of studying stress adaptation in psychiatric
nursing?
A. To eliminate stress in patients
B. To understand patient responses and guide
interventions (Correct)
C. To diagnose all stress-related disorders
D. To prescribe medications for stress
Rationale: The main goal is to comprehend how patients
respond to stress so that nursing care can be tailored
effectively.
Subtopic: Objectives
2. An objective of the stress adaptation chapter is to help
students differentiate between stressors and stress
responses. Which example illustrates a stress response?
A. Loss of job
B. Elevated heart rate (Correct)
C. Financial difficulty
D. Moving to a new home
Rationale: A stress response is a physiological or
psychological reaction (e.g., tachycardia), whereas
stressors are events.
Subtopic: Objectives
,3. One stated objective is to identify factors influencing
stress perception. Which factor most directly affects
perception?
A. Weather conditions
B. Past experiences (Correct)
C. Time of day
D. Geographic location
Rationale: Personal history shapes how stressors are
appraised.
Subtopic: Objectives
4. Which objective emphasizes the nurse’s role in stress
adaptation?
A. To teach pharmacology
B. To implement coping strategies (Correct)
C. To perform laboratory tests
D. To manage hospital budgets
Rationale: Nurses assess stress and help patients use
coping methods.
Subtopic: Objectives
5. According to the chapter’s objectives, understanding
stress as a transaction aids in:
A. Preventing stress completely
B. Predicting exact patient behaviors
C. Tailoring interventions to individual perceptions
(Correct)
D. Standardizing care for all patients
, Rationale: Viewing stress as a person–environment
interaction highlights individual differences.
Subtopic: Objectives
6. An objective is to distinguish between eustress and
distress. Which scenario exemplifies eustress?
A. Uncontrollable anxiety
B. Excitement before graduation (Correct)
C. Overwhelming grief
D. Chronic worry
Rationale: Eustress is positive stress that motivates or
energizes.
Subtopic: Objectives
7. Which objective focuses on the role of appraisal in stress
adaptation?
A. Defining neurotransmitter functions
B. Explaining primary and secondary appraisal (Correct)
C. Listing relaxation techniques
D. Classifying personality disorders
Rationale: Appraisal processes are key in determining
stress.
Subtopic: Objectives
8. One objective is to describe physiological responses to
stress. Which hormone is released by the adrenal
medulla?
A. Cortisol
B. Epinephrine (Correct)
, C. Aldosterone
D. Insulin
Rationale: The adrenal medulla secretes catecholamines
(epinephrine, norepinephrine).
Subtopic: Objectives
9. According to the chapter objectives, stress management
includes:
A. Ignoring stressors
B. Enhancing coping resources (Correct)
C. Eliminating all stressors
D. Standardizing response for everyone
Rationale: Management focuses on boosting coping rather
than removing all stress.
Subtopic: Objectives
Stress as a Biological Response
10. The General Adaptation Syndrome’s second stage is:
A. Alarm reaction
B. Resistance (Correct)
C. Exhaustion
D. Recovery
Rationale: GAS: alarm → resistance → exhaustion.
Subtopic: Stress as a Biological Response
11. Which physiological system is primarily activated
during the alarm reaction?
, A. Parasympathetic nervous system
B. Sympathetic–adrenal–medullary axis (Correct)
C. Gastrointestinal system
D. Immune system
Rationale: The SAM axis triggers fight-or-flight responses.
Subtopic: Stress as a Biological Response
12. Cortisol release in stress adaptation is regulated by:
A. Hypothalamic–pituitary–adrenal axis (Correct)
B. Renin–angiotensin system
C. Gastrointestinal hormones
D. Pancreatic feedback
Rationale: The HPA axis controls cortisol secretion.
Subtopic: Stress as a Biological Response
13. Which change is characteristic of the exhaustion
stage?
A. Heightened alertness
B. Decreased immunity (Correct)
C. Elevated energy
D. Improved performance
Rationale: Prolonged stress exhausts adaptive resources,
lowering immunity.
Subtopic: Stress as a Biological Response
14. Homeostasis refers to:
A. Maximum stress tolerance
B. Constant internal environment (Correct)
C. Rapid heart rate
, D. Chronic fatigue
Rationale: Homeostasis is the body’s effort to maintain
stable internal conditions.
Subtopic: Stress as a Biological Response
15. Which neurotransmitter increases during acute
stress?
A. Serotonin
B. GABA
C. Norepinephrine (Correct)
D. Adenosine
Rationale: Norepinephrine rises to facilitate alertness.
Subtopic: Stress as a Biological Response
16. A prolonged elevation of cortisol can lead to:
A. Improved memory
B. Muscle hypertrophy
C. Immunosuppression (Correct)
D. Decreased blood sugar
Rationale: Chronic cortisol impairs immune function and
increases glucose.
Subtopic: Stress as a Biological Response
17. What term describes the body’s initial, nonspecific
reaction to stress?
A. Adaptation
B. Alarm reaction (Correct)
C. Coping
D. Appraisal
