Chapter1
1. Thenurseisassessingthefactorscontributingtothewell-
beingofanewlyadmittedclient.Whichofthefollowingwouldthenurseidentifyashavingap
ositiveimpactontheindividual'smentalhealth?
A) Notneedingothersforcompanionship
B) Theabilitytoeffectivelymanagestress
C) Afamilyhistoryofmentalillness
D) Strivingfortotalself-
relianceAns:B
Feedback:
Individualfactorsinfluencingmentalhealthincludebiologicmakeup,autonomy,independen
ce,self-
esteem,capacityforgrowth,vitality,abilitytofindmeaninginlife,emotionalresilienceorhardi
ness,senseofbelonging,realityorientation,andcopingorstressmanagementabilities.Interpe
rsonalfactorssuchasintimacyandabalanceofseparatenessandconnectednessarebothneeded
forgoodmentalhealth,andthereforeahealthypersonwouldneedothersforcompanionship.Af
amilyhistoryofmentalillnesscouldrelatetothebiologicmakeupofanindividual,whichmayha
veanegativeimpactonanindividual'smentalhealth,aswellasanegativeimpactonanindividua
l'sinterpersonalandsocialñculturalfactorsofhealth.Totalself-
relianceisnotpossible,andapositivesocial/culturalfactorisaccesstoadequateresources.
2. Whichofthefollowingstatementsaboutmentalillnessaretrue?Selectallthatapply.
A) Mentalillnesscancausesignificantdistress,impairedfunctioning,orboth.
B) Mentalillnessisonlyduetosocial/culturalfactors.
C) Social/culturalfactorsthatrelatetomentalillnessincludeexcessivedependencyonor
withdrawalfromrelationships.
D) Individualssufferingfrommentalillnessareusuallyabletocopeeffectivelywithdailyli
fe.
E) Individualssufferingfrommentalillnessmayexperiencedissatisfactionwithrelat
ionshipsandself.
Ans:A,D,E
Feedback:
Mentalillnesscancausesignificantdistress,impairedfunctioning,orboth.Mentalillnessmay
berelatedtoindividual,interpersonal,orsocial/culturalfactors.Excessivedependencyonorw
ithdrawalfromrelationshipsareinterpersonalfactorsthatrelatetomentalillness.Individualss
ufferingfrommentalillnesscanfeeloverwhelmedwithdailylife.Individualssufferingfromm
entalillnessmayexperiencedissatisfactionwithrelationshipsandself.
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,3. Whichofthefollowingaretrueregardingmentalhealthandmentalillness?
A) Behaviorthatmaybeviewedasacceptableinonecultureisalwaysunacceptableinother
cultures.
B) Itiseasytodetermineifapersonismentallyhealthyormentallyill.
C) Inmostcases,mentalhealthisastateofemotional,psychological,andsocialwellness
evidencedbysatisfyinginterpersonalrelationships,effectivebehaviorandcoping,p
ositiveself-concept,andemotionalstability.
D) Personswhoengageinfantasiesarementallyill.Ans
:C
Feedback:
Whatonesocietymayviewasacceptableandappropriatebehavior,anothersocietymayseethat
asmaladaptive,andinappropriate.Mentalhealthandmentalillnessaredifficulttodefineprecise
ly.Inmostcases,mentalhealthisastateofemotional,psychological,andsocialwellnessevidenc
edbysatisfyinginterpersonalrelationships,effectivebehaviorandcoping,positiveself-
concept,andemotionalstability.Personswhoengageinfantasiesmaybementallyhealthy,butt
heinabilitytodistinguishrealityfromfantasyisanindividualfactorthatmaycontributetomenta
lillness.
4. Aclientgrievingtherecentlossofherhusbandasksifsheisbecomingmentallyillbecauses
heissosad.Thenurse'sbestresponsewouldbe,
A) ìYoumayhaveatemporarymentalillnessbecauseyouareexperiencingsomuchpain.î
B) ìYouarenotmentallyill.Thisisanexpectedreactiontothelossyouhaveexperien
ced.î
C) ìWereyougenerallydissatisfiedwithyourrelationshipbeforeyourhusband'sdeath
?î
D) ìTrynottoworryaboutthatrightnow.Youneverknowwhatthefuturebrings.îAns:B
Feedback:
Mentalillnessincludesgeneraldissatisfactionwithself,ineffectiverelationships,ineffective
coping,andlackofpersonalgrowth.Additionallythebehaviormustnotbeculturallyexpected.
Acutegriefreactionsareexpectedandthereforenotconsideredmentalillness.Falsereassuranc
eoroveranalysisdoesnotaccuratelyaddresstheclient'sconcerns.
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,5. ThenurseconsultstheDSMforwhichofthefollowingpurposes?
A) Todeviseaplanofcareforanewlyadmittedclient
B) Topredicttheclient'sprognosisoftreatmentoutcomes
C) Todocumenttheappropriatediagnosticcodeintheclient'smedicalrecord
D) ToserveasaguideforclientassessmentAns
:D
Feedback:
TheDSMprovidesstandardnomenclature,presentsdefiningcharacteristics,andidentifiesun
derlyingcausesofmentaldisorders.Itdoesnotprovidecareplansorprognosticoutcomesoftre
atment.DiagnosisofmentalillnessisnotwithinthegeneralistRN'sscopeofpractice,sodocum
entingthecodeinthemedicalrecordwouldbeinappropriate.
6. WhichwouldbeareasonforastudentnursetousetheDSM?
A) Identifyingthemedicaldiagnosis
B) Treatclients
C) Evaluatetreatments
D) Understandthereasonfortheadmissionandthenatureofpsychiatricillnesses.Ans:D
Feedback:
AlthoughstudentnursesdonotusetheDSMtodiagnoseclients,theywillfinditahelpfulresou
rcetounderstandthereasonfortheadmissionandtobeginbuildingknowledgeaboutthenatur
eofpsychiatricillnesses.Identifyingthemedicaldiagnosis,treating,andevaluatingtreatmen
tsarenotapartofthenursingprocess.
7. Thelegislationenactedin1963waslargelyresponsibleforwhichofthefollowingshiftsincaref
orthementallyill?
A) Thewidespreaduseofcommunity-basedservices
B) Theadvancementinpharmacotherapies
C) Increasedaccesstohospitalization
D) Improvedrightsforclientsinlong-
terminstitutionalcareAns:A
Feedback:
TheCommunityMentalHealthCentersConstructionActof1963accomplishedthereleas
eofindividualsfromlong-
termstaysinstateinstitutions,thedecreaseinadmissionstohospitals,andthedevelopment
ofcommunity-basedservicesasanalternativetohospitalcare.
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, 8. Whichoneofthefollowingisaresultoffederallegislation?
A) Makingiteasiertocommitpeopleformentalhealthtreatmentagainsttheirwill.
B) Makingitmoredifficulttocommitpeopleformentalhealthtreatmentagainsttheirw
ill.
C) Statementalinstitutionsbeingtheprimarysourceofcareformentallyillpersons.
D) Improvedcareformentallyillpersons.An
s:B
Feedback:
Commitmentlawschangedintheearly1970s,makingitmoredifficulttocommitpeoplefor
mentalhealthtreatmentagainsttheirwill.Deinstitutionalizationaccomplishedtherelease
ofindividualsfromlong-
termstaysinstateinstitutions.Deinstitutionalizationalsohadnegativeeffectsinthatsome
mentallyillpersonsaresubjectedtotherevolvingdooreffect,whichmaylimitcareforment
allyillpersons.
9. Thegoalofthe1963CommunityMentalHealthCentersActwasto
A) ensurepatients'rightsforthementallyill.
B) deinstitutionalizestatehospitals.
C) providefundstobuildhospitalswithpsychiatricunits.
D) treatpeoplewithmentalillnessinahumanefashion.Ans:
B
Feedback:
The1963CommunityMentalHealthCentersActintimatedthemovementtowardtreatingt
hosewithmentalillnessinalessrestrictiveenvironment.Thislegislationresultedintheshift
ofclientswithmentalillnessfromlargestateinstitutionstocarebasedinthecommunity.Ans
werchoicesA,C,andDwerenotpurposesofthe1963CommunityMentalHealthCentersAc
t.
10. Thecreationofasylumsduringthe1800swasmeantto
A) improvetreatmentofmentaldisorders.
B) providefoodandshelterforthementallyill.
C) punishpeoplewithmentalillnesswhowerebelievedtobepossessed.
D) removedangerouspeoplewithmentalillnessfromthecommunity.Ans:
B
Feedback:
Theasylumwasmeanttobeasafehavenwithfood,shelter,andhumanetreatmentforthementa
llyill.Asylumswerenotusedtoimprovetreatmentofmentaldisordersortopunishmentallyill
peoplewhowerebelievedtobepossessed.Theasylumwasnotcreatedtoremovethedangerou
slymentallyillfromthecommunity.
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