lOMoARcPSD| 7906827
Essentials of Psychiatric Mental Health Nursing 8th
Edition Concepts of Care in Evidence - Based
Practice 8th Edition Morgan Townsend
Chapter 1. Mental Health and Mental
Y5 Y5 Y5 Y5 Y5
Y5 IllnessMultiple Choice Y5
1. A nurse is assessing a client who is experiencing occasional feelings of sadness
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
because of therecent death of a beloved pet. The clients appetite, sleep patterns, and
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
daily routine have not changed. How should the nurse interpret the clients
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
2. The clients behaviors are extensive, which indicates the presence of mental illness.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
3. The clients behaviors are not congruent with cultural norms.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
4. The clients behaviors demonstrate no functional impairment, indicating no
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 mental illness. Y5
ANS: 4 Y5
Rationale: The nurse should assess that the clients daily functioning is not impaired.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 The clientwho experiences feelings of sadness after the loss of a pet is responding
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
within normal expectations. Without significant impairment, the clients distress
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 does not indicate a mental illness.
Y5 Y5 Y5 Y5 Y5
Cognitive Level: Analysis Y5 Y5
Y5 Integrated Process: Y5
Assessment
2. At what point should the nurse determine that a client is at risk for
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
developing a mentalillness?
Y5 Y5 Y5
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
2. When maladaptive responses to stress are coupled with interference in
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
daily functioning.
Y5 Y5
3. When a client communicates significant distress.
Y5 Y5 Y5 Y5 Y5
4. When a client uses defense mechanisms as ego protection.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
ANS: 2 Y5
Rationale: The nurse should determine that the client is at risk for mental illness when
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
,responsesto stress are maladaptive and interfere with daily functioning. The DSM-5
lOMoARcPSD| 7906827
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 indicates that in orderto be diagnosed with a mental illness, daily functioning must
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 be significantly impaired. The clients ability to communicate distress would be
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 considered a positive attribute. Y5 Y5 Y5
Cognitive Level: Application Y5 Y5
Y5 Integrated Process: Y5
Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
differently to stress.One twin becomes anxious and irritable, and the other
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 withdraws and cries. How should the nurse explain these different stress
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 responses to the parents? Y5 Y5 Y5
1. Reactions to stress are relative rather than absolute; individual responses to
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
stress vary.
Y5 Y5
2. It is abnormal for identical twins to react differently to similar stressors.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
3. Identical twins should share the same temperament and respond similarly to stress.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
4. Environmental influences to stress weigh more heavily than genetic influences.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
, lOMoARcPSD| 7906827
ANS: 1 Y5
Rationale: The nurse should explain to the parents that, although the twins have
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 identical DNA,there are several other factors that affect reactions to stress. Mental
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 health is a state of being thatis relative to the individual client. Environmental
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 influences and temperament can affect stress reactions.
Y5 Y5 Y5 Y5 Y5 Y5
Cognitive Level: Application Y5 Y5
Y5 Integrated Process: Y5
Implementation
4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
1. A Jewish, female social worker.
Y5 Y5 Y5 Y5
2. A Baptist, homeless male.
Y5 Y5 Y5
3. A Catholic, black male.
Y5 Y5 Y5
4. A Protestant, Swedish business executive.
Y5 Y5 Y5 Y5
ANS: 1 Y5
Rationale: The nurse should anticipate that the client of Jewish culture would place
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 a high importance on preventative health care and would consider mental health as
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 equally important asphysical health. Women are also more likely to seek treatment
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
for mental health problems than men.
Y5 Y5 Y5 Y5 Y5 Y5
Cognitive Level: Y5
ApplicationIntegrated
Process: Planning
Y5 Y5
5. A psychiatric nurse intern states, This clients use of defense mechanisms should
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
be eliminated.Which is a correct evaluation of this nurses statement?
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
1. Defense mechanisms can be appropriate responses to stress and need not
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 be eliminated.
Y5
2. Defense mechanisms are a maladaptive attempt of the ego to manage
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
anxiety and shouldalways be eliminated.
Y5 Y5 Y5 Y5 Y5
3. Defense mechanisms, used by individuals with weak ego integrity, should
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 be discouraged andnot eliminated.
Y5 Y5 Y5
4. Defense mechanisms cause disintegration of the ego and should be fostered
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 and encouraged. Y5
ANS: 1 Y5
, lOMoARcPSD| 7906827
ANS: 1 Y5
Rationale: The nurse should determine that defense mechanisms can be appropriate
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 during timesof stress. The client with no defense mechanisms may have a lower
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 tolerance for stress, thus leading to anxiety disorders. Defense mechanisms should
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
be confronted when they impede the client from developing healthy coping skills.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Cognitive Level: Y5
Application Integrated Y5
Y5 Process: Evaluation Y5
6. During an intake assessment, a nurse asks both physiological and psychosocial
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 questions. Theclient angrily responds, Im here for my heart, not my head
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 problems. Which is the nurses best response?
Y5 Y5 Y5 Y5 Y5 Y5
1. Its just a routine part of our assessment. All clients are asked these same questions.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
2. Why are you concerned about these types of questions?
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
3. Psychological factors, like excessive stress, have been found to affect Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 medical conditions. Y5
4. We can skip these questions, if you like. It isnt imperative that we complete
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
this section.
Y5 Y5
Essentials of Psychiatric Mental Health Nursing 8th
Edition Concepts of Care in Evidence - Based
Practice 8th Edition Morgan Townsend
Chapter 1. Mental Health and Mental
Y5 Y5 Y5 Y5 Y5
Y5 IllnessMultiple Choice Y5
1. A nurse is assessing a client who is experiencing occasional feelings of sadness
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
because of therecent death of a beloved pet. The clients appetite, sleep patterns, and
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
daily routine have not changed. How should the nurse interpret the clients
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
2. The clients behaviors are extensive, which indicates the presence of mental illness.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
3. The clients behaviors are not congruent with cultural norms.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
4. The clients behaviors demonstrate no functional impairment, indicating no
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 mental illness. Y5
ANS: 4 Y5
Rationale: The nurse should assess that the clients daily functioning is not impaired.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 The clientwho experiences feelings of sadness after the loss of a pet is responding
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
within normal expectations. Without significant impairment, the clients distress
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 does not indicate a mental illness.
Y5 Y5 Y5 Y5 Y5
Cognitive Level: Analysis Y5 Y5
Y5 Integrated Process: Y5
Assessment
2. At what point should the nurse determine that a client is at risk for
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
developing a mentalillness?
Y5 Y5 Y5
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
2. When maladaptive responses to stress are coupled with interference in
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
daily functioning.
Y5 Y5
3. When a client communicates significant distress.
Y5 Y5 Y5 Y5 Y5
4. When a client uses defense mechanisms as ego protection.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
ANS: 2 Y5
Rationale: The nurse should determine that the client is at risk for mental illness when
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
,responsesto stress are maladaptive and interfere with daily functioning. The DSM-5
lOMoARcPSD| 7906827
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 indicates that in orderto be diagnosed with a mental illness, daily functioning must
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 be significantly impaired. The clients ability to communicate distress would be
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 considered a positive attribute. Y5 Y5 Y5
Cognitive Level: Application Y5 Y5
Y5 Integrated Process: Y5
Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
differently to stress.One twin becomes anxious and irritable, and the other
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 withdraws and cries. How should the nurse explain these different stress
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 responses to the parents? Y5 Y5 Y5
1. Reactions to stress are relative rather than absolute; individual responses to
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
stress vary.
Y5 Y5
2. It is abnormal for identical twins to react differently to similar stressors.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
3. Identical twins should share the same temperament and respond similarly to stress.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
4. Environmental influences to stress weigh more heavily than genetic influences.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
, lOMoARcPSD| 7906827
ANS: 1 Y5
Rationale: The nurse should explain to the parents that, although the twins have
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 identical DNA,there are several other factors that affect reactions to stress. Mental
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 health is a state of being thatis relative to the individual client. Environmental
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 influences and temperament can affect stress reactions.
Y5 Y5 Y5 Y5 Y5 Y5
Cognitive Level: Application Y5 Y5
Y5 Integrated Process: Y5
Implementation
4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
1. A Jewish, female social worker.
Y5 Y5 Y5 Y5
2. A Baptist, homeless male.
Y5 Y5 Y5
3. A Catholic, black male.
Y5 Y5 Y5
4. A Protestant, Swedish business executive.
Y5 Y5 Y5 Y5
ANS: 1 Y5
Rationale: The nurse should anticipate that the client of Jewish culture would place
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 a high importance on preventative health care and would consider mental health as
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 equally important asphysical health. Women are also more likely to seek treatment
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
for mental health problems than men.
Y5 Y5 Y5 Y5 Y5 Y5
Cognitive Level: Y5
ApplicationIntegrated
Process: Planning
Y5 Y5
5. A psychiatric nurse intern states, This clients use of defense mechanisms should
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
be eliminated.Which is a correct evaluation of this nurses statement?
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
1. Defense mechanisms can be appropriate responses to stress and need not
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 be eliminated.
Y5
2. Defense mechanisms are a maladaptive attempt of the ego to manage
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
anxiety and shouldalways be eliminated.
Y5 Y5 Y5 Y5 Y5
3. Defense mechanisms, used by individuals with weak ego integrity, should
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 be discouraged andnot eliminated.
Y5 Y5 Y5
4. Defense mechanisms cause disintegration of the ego and should be fostered
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 and encouraged. Y5
ANS: 1 Y5
, lOMoARcPSD| 7906827
ANS: 1 Y5
Rationale: The nurse should determine that defense mechanisms can be appropriate
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 during timesof stress. The client with no defense mechanisms may have a lower
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 tolerance for stress, thus leading to anxiety disorders. Defense mechanisms should
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
be confronted when they impede the client from developing healthy coping skills.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Cognitive Level: Y5
Application Integrated Y5
Y5 Process: Evaluation Y5
6. During an intake assessment, a nurse asks both physiological and psychosocial
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 questions. Theclient angrily responds, Im here for my heart, not my head
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 problems. Which is the nurses best response?
Y5 Y5 Y5 Y5 Y5 Y5
1. Its just a routine part of our assessment. All clients are asked these same questions.
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
2. Why are you concerned about these types of questions?
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
3. Psychological factors, like excessive stress, have been found to affect Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
Y5 medical conditions. Y5
4. We can skip these questions, if you like. It isnt imperative that we complete
Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5 Y5
this section.
Y5 Y5
