,Essential Q&A for Psychiatric Nursing
Mastery | Townsend/Morgan 2025 NCLEX
Companion
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 (8 questions)
1. Which of the following best describes the primary
objective of Chapter 1?
A. To outline pharmacologic interventions for anxiety
B. To define stress and explain adaptation mechanisms
(Correct)
C. To compare different personality disorders
D. To detail community mental health services
Rationale: Chapter 1 focuses on defining stress and
exploring how individuals adapt physiologically and
psychologically.
Subtopic: Objectives
2. An important goal of this chapter is to enable the student
to:
A. Prescribe antidepressants appropriately
B. Recognize stressors and describe coping strategies
(Correct)
C. Diagnose schizophrenia accurately
D. Develop group therapy programs
Rationale: One key objective is understanding stressors
and coping to support patient care.
Subtopic: Objectives
3. One stated objective is for students to explain:
A. The stages of group psychotherapy
, B. The relationship between stress and health (Correct)
C. The principles of motivational interviewing
D. The roles of advanced practice nurses
Rationale: The chapter emphasizes the link between stress
and physical/mental health outcomes.
Subtopic: Objectives
4. A learning outcome of this chapter includes the ability to:
A. Identify social determinants of mental illness
B. Differentiate between stress as a stimulus and as a
response (Correct)
C. Conduct behavioral assessments
D. Develop individualized therapy plans
Rationale: Understanding stress in its multiple
conceptualizations is central to the chapter.
Subtopic: Objectives
5. Students are expected to describe:
A. The epidemiology of depression
B. Pathways of the general adaptation syndrome (Correct)
C. Principles of psychopharmacology
D. Techniques for motivational enhancement
Rationale: The general adaptation syndrome is a key
biological framework discussed.
Subtopic: Objectives
6. One objective is to compare:
A. Cognitive therapy and pharmacotherapy
B. Acute versus chronic stress and their effects (Correct)
, C. Individual and group therapy outcomes
D. Primary and secondary prevention in mental health
Rationale: The chapter differentiates acute/chronic stress
to illustrate varied adaptation demands.
Subtopic: Objectives
7. By the end of the chapter, students should be able to:
A. Calculate therapeutic drug levels
B. Apply the concept of appraisal in stress response
(Correct)
C. Perform a mental status exam
D. Design a community outreach program
Rationale: Appraisal (primary/secondary) is fundamental
to the transactional model of stress.
Subtopic: Objectives
8. Chapter 1 aims to introduce students to:
A. Stress management techniques for nurse self-care
(Correct)
B. Advanced diagnosis of personality disorders
C. Methods for group psychotherapy evaluation
D. Ethics in psychiatric research
Rationale: Self-care and management strategies for stress
are covered under stress management.
Subtopic: Objectives
Stress as a Biological Response (8 questions)
,9. Which hormone is primarily released during the alarm
stage of the general adaptation syndrome?
A. Cortisol (Correct)
B. Insulin
C. Melatonin
D. Growth hormone
Rationale: Cortisol is secreted by the adrenal cortex in
response to ACTH during alarm.
Subtopic: Stress as a Biological Response
10. The fight-or-flight response is mediated by
activation of the:
A. Parasympathetic nervous system
B. Somatic nervous system
C. Sympathetic nervous system (Correct)
D. Central nervous system
Rationale: Sympathetic activation triggers adrenaline
release, increasing heart rate and BP.
Subtopic: Stress as a Biological Response
11. During the resistance stage, the body attempts to:
A. Return to baseline despite ongoing stressors (Correct)
B. Shut down all nonessential functions
C. Enter a state of unconsciousness
D. Increase inflammatory processes
Rationale: Resistance involves adapting to sustain function
under stress.
Subtopic: Stress as a Biological Response
,12. Which of the following is NOT a characteristic of the
exhaustion stage?
A. Resource depletion
B. Increased vulnerability to illness
C. Enhanced coping capacity (Correct)
D. Possible collapse of adaptation
Rationale: Exhaustion depletes coping resources—
capacity is reduced, not enhanced.
Subtopic: Stress as a Biological Response
13. The hypothalamic–pituitary–adrenal (HPA) axis
includes all EXCEPT:
A. Hypothalamus
B. Thyroid gland (Correct)
C. Pituitary gland
D. Adrenal cortex
Rationale: The thyroid gland is part of the endocrine
system but not the HPA axis.
Subtopic: Stress as a Biological Response
14. Which physiological change is typical during acute
stress?
A. Decreased respiratory rate
B. Bronchoconstriction
C. Pupillary constriction
D. Increased blood glucose (Correct)
Rationale: Cortisol and catecholamines mobilize glucose
, for energy.
Subtopic: Stress as a Biological Response
15. An elevated heart rate in stress is due to stimulation
of:
A. Beta-1 adrenergic receptors (Correct)
B. Alpha-2 adrenergic receptors
C. Cholinergic receptors
D. Dopaminergic receptors
Rationale: Beta-1 receptors on the myocardium increase
rate and contractility.
Subtopic: Stress as a Biological Response
16. Which neurotransmitter is primarily involved in the
stress response?
A. Serotonin
B. Gamma-aminobutyric acid (GABA)
C. Norepinephrine (Correct)
D. Endorphins
Rationale: Norepinephrine from the locus coeruleus
heightens arousal and vigilance.
Subtopic: Stress as a Biological Response
Stress as an Environmental Event (8 questions)
17. A “stressor” is best defined as:
A. A coping mechanism
B. An environmental demand requiring adaptation
Mastery | Townsend/Morgan 2025 NCLEX
Companion
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 (8 questions)
1. Which of the following best describes the primary
objective of Chapter 1?
A. To outline pharmacologic interventions for anxiety
B. To define stress and explain adaptation mechanisms
(Correct)
C. To compare different personality disorders
D. To detail community mental health services
Rationale: Chapter 1 focuses on defining stress and
exploring how individuals adapt physiologically and
psychologically.
Subtopic: Objectives
2. An important goal of this chapter is to enable the student
to:
A. Prescribe antidepressants appropriately
B. Recognize stressors and describe coping strategies
(Correct)
C. Diagnose schizophrenia accurately
D. Develop group therapy programs
Rationale: One key objective is understanding stressors
and coping to support patient care.
Subtopic: Objectives
3. One stated objective is for students to explain:
A. The stages of group psychotherapy
, B. The relationship between stress and health (Correct)
C. The principles of motivational interviewing
D. The roles of advanced practice nurses
Rationale: The chapter emphasizes the link between stress
and physical/mental health outcomes.
Subtopic: Objectives
4. A learning outcome of this chapter includes the ability to:
A. Identify social determinants of mental illness
B. Differentiate between stress as a stimulus and as a
response (Correct)
C. Conduct behavioral assessments
D. Develop individualized therapy plans
Rationale: Understanding stress in its multiple
conceptualizations is central to the chapter.
Subtopic: Objectives
5. Students are expected to describe:
A. The epidemiology of depression
B. Pathways of the general adaptation syndrome (Correct)
C. Principles of psychopharmacology
D. Techniques for motivational enhancement
Rationale: The general adaptation syndrome is a key
biological framework discussed.
Subtopic: Objectives
6. One objective is to compare:
A. Cognitive therapy and pharmacotherapy
B. Acute versus chronic stress and their effects (Correct)
, C. Individual and group therapy outcomes
D. Primary and secondary prevention in mental health
Rationale: The chapter differentiates acute/chronic stress
to illustrate varied adaptation demands.
Subtopic: Objectives
7. By the end of the chapter, students should be able to:
A. Calculate therapeutic drug levels
B. Apply the concept of appraisal in stress response
(Correct)
C. Perform a mental status exam
D. Design a community outreach program
Rationale: Appraisal (primary/secondary) is fundamental
to the transactional model of stress.
Subtopic: Objectives
8. Chapter 1 aims to introduce students to:
A. Stress management techniques for nurse self-care
(Correct)
B. Advanced diagnosis of personality disorders
C. Methods for group psychotherapy evaluation
D. Ethics in psychiatric research
Rationale: Self-care and management strategies for stress
are covered under stress management.
Subtopic: Objectives
Stress as a Biological Response (8 questions)
,9. Which hormone is primarily released during the alarm
stage of the general adaptation syndrome?
A. Cortisol (Correct)
B. Insulin
C. Melatonin
D. Growth hormone
Rationale: Cortisol is secreted by the adrenal cortex in
response to ACTH during alarm.
Subtopic: Stress as a Biological Response
10. The fight-or-flight response is mediated by
activation of the:
A. Parasympathetic nervous system
B. Somatic nervous system
C. Sympathetic nervous system (Correct)
D. Central nervous system
Rationale: Sympathetic activation triggers adrenaline
release, increasing heart rate and BP.
Subtopic: Stress as a Biological Response
11. During the resistance stage, the body attempts to:
A. Return to baseline despite ongoing stressors (Correct)
B. Shut down all nonessential functions
C. Enter a state of unconsciousness
D. Increase inflammatory processes
Rationale: Resistance involves adapting to sustain function
under stress.
Subtopic: Stress as a Biological Response
,12. Which of the following is NOT a characteristic of the
exhaustion stage?
A. Resource depletion
B. Increased vulnerability to illness
C. Enhanced coping capacity (Correct)
D. Possible collapse of adaptation
Rationale: Exhaustion depletes coping resources—
capacity is reduced, not enhanced.
Subtopic: Stress as a Biological Response
13. The hypothalamic–pituitary–adrenal (HPA) axis
includes all EXCEPT:
A. Hypothalamus
B. Thyroid gland (Correct)
C. Pituitary gland
D. Adrenal cortex
Rationale: The thyroid gland is part of the endocrine
system but not the HPA axis.
Subtopic: Stress as a Biological Response
14. Which physiological change is typical during acute
stress?
A. Decreased respiratory rate
B. Bronchoconstriction
C. Pupillary constriction
D. Increased blood glucose (Correct)
Rationale: Cortisol and catecholamines mobilize glucose
, for energy.
Subtopic: Stress as a Biological Response
15. An elevated heart rate in stress is due to stimulation
of:
A. Beta-1 adrenergic receptors (Correct)
B. Alpha-2 adrenergic receptors
C. Cholinergic receptors
D. Dopaminergic receptors
Rationale: Beta-1 receptors on the myocardium increase
rate and contractility.
Subtopic: Stress as a Biological Response
16. Which neurotransmitter is primarily involved in the
stress response?
A. Serotonin
B. Gamma-aminobutyric acid (GABA)
C. Norepinephrine (Correct)
D. Endorphins
Rationale: Norepinephrine from the locus coeruleus
heightens arousal and vigilance.
Subtopic: Stress as a Biological Response
Stress as an Environmental Event (8 questions)
17. A “stressor” is best defined as:
A. A coping mechanism
B. An environmental demand requiring adaptation
