Townsend’s Essentials of
Psychiatric Mental Health
A nurse is assessing a client who experiences occasional feelings of sadness because of the
recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not
changed. How would the nurse interpret the client's behaviors?
1. The client's behaviors demonstrate mental illness in the form of depression.
2. The client's behaviors are inappropriate, which indicates the presence of mental illness.
3. The client's behaviors are not congruent with cultural norms.
4. The client's behaviors demonstrate no functional impairment, indicating no mental illness. -
ANS-- 4. The client's behaviors demonstrate no functional impairment, indicating no mental
illness.
At which point would the nurse determine that a client is at risk for developing a mental illness?
1. When thoughts, feelings, and behaviors are not reflective of the criteria for mental illness.
2. When maladaptive responses to stress are coupled with interference in daily functioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection. - ANS-- 2. When maladaptive
responses to stress are coupled with interference in daily functioning.
A client has been given a diagnosis of HIV. Which statement made by the client does the nurse
recognize as the bargaining stage of grief?
1. "I hate my partner for giving me this disease I will die from!"
2. "If I don't do IV drugs anymore, God won't let me die."
3. "I am going to support groups and learning more about the disease."
4. "Can you please re-draw the test results; I think they may be wrong?" - ANS-- 2. "If I don't do
IV drugs anymore, God won't let me die."
A nurse notes that a client is extremely withdrawn, delusional, and emotionally exhausted. The
nurse assesses the client's anxiety as which level?
1. Mild anxiety
2. Moderate anxiety
, 3. Severe anxiety
4. Panic anxiety - ANS-- 4. Panic anxiety
A psychiatric nurse intern states, "This client's use of defense mechanisms should be
eliminated." Which is a correct evaluation of this nurse's statement?
1. Defense mechanisms can be appropriate responses to stress and need not be eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should
always be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged
and not completely eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged. - ANS-- 1. Defense mechanisms can be appropriate responses to stress and need
not be eliminated.
During an intake assessment, a nurse asks both physiological and psychosocial questions. The
client angrily responds, "I'm here for my heart, not my head problems." Which is the nurse's best
response?
1. "It is just a routine part of our assessment. All clients are asked these same
questions."
2. "Why are you concerned about these types of questions?"
3. "Psychological factors, like excessive stress, have been found to affect medical conditions."
4. "We can skip these questions, if you like. It isn't imperative that we complete this section." -
ANS-- 3. "Psychological factors, like excessive stress, have been found to affect medical
conditions."
A client who is being treated for chronic kidney disease complains to the health-care provider
that he does not like the food available to him while hospitalized. The health-care provider
insists that the client strictly adhere to the diet plan. What action can be expected if the client
uses the defense mechanism of displacement?
1. The client assertively confronts the health-care provider.
2. The client insists on being discharged and goes for a long, brisk walk.
3. The client snaps at the nurse and criticizes the nursing care provided.
4. The client hides his anger by explaining the logical reasoning for the diet to his spouse. -
ANS-- 3. The client snaps at the nurse and criticizes the nursing care provided.
A fourth-grade boy teases and makes jokes about a cute girl in his class. A nurse would
recognize this behavior as indicative of which defense mechanism?
1. Displacement
2. Projection
3. Reaction formation