,Master Psychiatric Mental Health Nursing
| Verified NCLEX Questions from
Townsend’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).
Subtopic: Objectives
1. Which of the following is the primary goal of Chapter 1 in
understanding stress adaptation?
A. To define all psychiatric disorders
B. To identify physiological signs of mood disorders
C. To describe the concept of stress and its influence on
health ✔
D. To outline pharmacologic interventions for anxiety
o Rationale: Chapter 1’s objectives focus on defining
stress concepts and their impact on health, not on
specific disorders or treatments.
2. One stated objective is to explain the difference between
stressors and stress. Which best describes that
distinction?
A. Stressors are internal; stress is external
B. Stressors are events or demands; stress is the body’s
reaction ✔
C. Stressors cause pathology; stress always leads to illness
D. Stressors are psychological; stress is physiological
o Rationale: Stressors are environmental or internal
events; stress is the individual’s biological and
psychological response.
,3. Chapter 1 aims to help the student differentiate between
adaptation and maladaptation. Which definition aligns
with “maladaptation”?
A. Physiological change that maintains homeostasis
B. Effective coping resulting in growth
C. Ineffective coping resulting in dysfunction ✔
D. Neutral response with no change
o Rationale: Maladaptation refers to coping responses
that fail to restore balance and impair functioning.
4. An objective is to list factors that influence a person’s
appraisal of stress. Which factor is included?
A. Genetic expression
B. Past experiences ✔
C. Blood pressure
D. Caloric intake
o Rationale: Past experiences shape cognitive appraisal
of whether an event is threatening or manageable.
5. Which learning outcome aligns with the chapter’s
objectives?
A. Analyze neurotransmitter pathways in depression
B. Compare models of stress adaptation and recovery ✔
C. Prescribe antipsychotic medications
D. Diagnose anxiety disorders
, o Rationale: Students should be able to compare
stress‐adaptation models, per the chapter’s
objectives.
Subtopic: Stress as a Biological Response
6. Which physiological system is first activated in the stress
“fight-or-flight” response?
A. HPG axis
B. Sympathetic-adrenomedullary system ✔
C. Parasympathetic nervous system
D. Hypothalamic-pituitary-thyroid axis
o Rationale: The sympathetic-adrenomedullary system
triggers catecholamine release as the initial acute
stress response.
7. During acute stress, cortisol is released by which
structure?
A. Adrenal medulla
B. Anterior pituitary
C. Adrenal cortex ✔
D. Hypothalamus
o Rationale: ACTH from the pituitary stimulates cortisol
secretion from the adrenal cortex.
8. The General Adaptation Syndrome’s stage of resistance is
characterized by:
, A. Exhaustion of coping resources
B. Return to baseline immediately
C. Sustained hormone release to combat stressors ✔
D. Absence of physiological change
o Rationale: In resistance, the body attempts to adapt
by sustaining stress hormone production.
9. Which neurotransmitter surge contributes to increased
heart rate during stress?
A. Gamma-aminobutyric acid
B. Dopamine
C. Norepinephrine ✔
D. Serotonin
o Rationale: Norepinephrine from sympathetic fibers
raises cardiac output in acute stress.
10. Allostatic load refers to:
A. The initial fight-or-flight response
B. Cumulative wear and tear on the body from chronic
stress ✔
C. A single traumatic event’s impact
D. The stress threshold in children
o Rationale: Allostatic load is the cost of chronic
activation of adaptive systems.
Subtopic: Stress as an Environmental Event
,11. An environmental stressor is best defined as:
A. A physiological change in the body
B. An external circumstance requiring adaptation ✔
C. A mood disturbance
D. A genetic predisposition
o Rationale: Environmental stressors are external
events or conditions that challenge homeostasis.
12. Which is an example of a chronic environmental
stressor?
A. Earthquake
B. Daily commute in heavy traffic ✔
C. Sudden job loss
D. Acute infection
o Rationale: Chronic stressors persist over time, such as
ongoing traffic delays.
13. According to Townsend & Morgan, which category
does divorce fall into?
A. Situational crisis
B. Maturational crisis
C. Adventitious crisis ✔
D. Biological crisis
o Rationale: Divorce is an unexpected external event
that disrupts life, classed as an adventitious crisis.
14. Which appraisal characterizes an environmental
event as harmful?
, A. Primary appraisal labeling it as a challenge
B. Secondary appraisal focusing on coping resources
C. Primary appraisal labeling it as a threat ✔
D. Tertiary appraisal seeking social support
o Rationale: Primary appraisal judges an event’s
potential for harm (threat) or benefit.
15. Which factor does NOT influence whether an
environmental event is perceived as stressful?
A. Predictability
B. Novelty
C. Coping mechanisms
D. Core body temperature ✔
o Rationale: Physical factors like temperature don’t
directly shape cognitive appraisal of stressors.
Subtopic: Stress as a Transaction Between the Individual and
the Environment
16. Lazarus’s transactional model emphasizes:
A. Only internal physiological responses
B. The two-way dynamic between person and
environment ✔
C. Stress solely as environmental events
D. Genetic determinants of stress
| Verified NCLEX Questions from
Townsend’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).
Subtopic: Objectives
1. Which of the following is the primary goal of Chapter 1 in
understanding stress adaptation?
A. To define all psychiatric disorders
B. To identify physiological signs of mood disorders
C. To describe the concept of stress and its influence on
health ✔
D. To outline pharmacologic interventions for anxiety
o Rationale: Chapter 1’s objectives focus on defining
stress concepts and their impact on health, not on
specific disorders or treatments.
2. One stated objective is to explain the difference between
stressors and stress. Which best describes that
distinction?
A. Stressors are internal; stress is external
B. Stressors are events or demands; stress is the body’s
reaction ✔
C. Stressors cause pathology; stress always leads to illness
D. Stressors are psychological; stress is physiological
o Rationale: Stressors are environmental or internal
events; stress is the individual’s biological and
psychological response.
,3. Chapter 1 aims to help the student differentiate between
adaptation and maladaptation. Which definition aligns
with “maladaptation”?
A. Physiological change that maintains homeostasis
B. Effective coping resulting in growth
C. Ineffective coping resulting in dysfunction ✔
D. Neutral response with no change
o Rationale: Maladaptation refers to coping responses
that fail to restore balance and impair functioning.
4. An objective is to list factors that influence a person’s
appraisal of stress. Which factor is included?
A. Genetic expression
B. Past experiences ✔
C. Blood pressure
D. Caloric intake
o Rationale: Past experiences shape cognitive appraisal
of whether an event is threatening or manageable.
5. Which learning outcome aligns with the chapter’s
objectives?
A. Analyze neurotransmitter pathways in depression
B. Compare models of stress adaptation and recovery ✔
C. Prescribe antipsychotic medications
D. Diagnose anxiety disorders
, o Rationale: Students should be able to compare
stress‐adaptation models, per the chapter’s
objectives.
Subtopic: Stress as a Biological Response
6. Which physiological system is first activated in the stress
“fight-or-flight” response?
A. HPG axis
B. Sympathetic-adrenomedullary system ✔
C. Parasympathetic nervous system
D. Hypothalamic-pituitary-thyroid axis
o Rationale: The sympathetic-adrenomedullary system
triggers catecholamine release as the initial acute
stress response.
7. During acute stress, cortisol is released by which
structure?
A. Adrenal medulla
B. Anterior pituitary
C. Adrenal cortex ✔
D. Hypothalamus
o Rationale: ACTH from the pituitary stimulates cortisol
secretion from the adrenal cortex.
8. The General Adaptation Syndrome’s stage of resistance is
characterized by:
, A. Exhaustion of coping resources
B. Return to baseline immediately
C. Sustained hormone release to combat stressors ✔
D. Absence of physiological change
o Rationale: In resistance, the body attempts to adapt
by sustaining stress hormone production.
9. Which neurotransmitter surge contributes to increased
heart rate during stress?
A. Gamma-aminobutyric acid
B. Dopamine
C. Norepinephrine ✔
D. Serotonin
o Rationale: Norepinephrine from sympathetic fibers
raises cardiac output in acute stress.
10. Allostatic load refers to:
A. The initial fight-or-flight response
B. Cumulative wear and tear on the body from chronic
stress ✔
C. A single traumatic event’s impact
D. The stress threshold in children
o Rationale: Allostatic load is the cost of chronic
activation of adaptive systems.
Subtopic: Stress as an Environmental Event
,11. An environmental stressor is best defined as:
A. A physiological change in the body
B. An external circumstance requiring adaptation ✔
C. A mood disturbance
D. A genetic predisposition
o Rationale: Environmental stressors are external
events or conditions that challenge homeostasis.
12. Which is an example of a chronic environmental
stressor?
A. Earthquake
B. Daily commute in heavy traffic ✔
C. Sudden job loss
D. Acute infection
o Rationale: Chronic stressors persist over time, such as
ongoing traffic delays.
13. According to Townsend & Morgan, which category
does divorce fall into?
A. Situational crisis
B. Maturational crisis
C. Adventitious crisis ✔
D. Biological crisis
o Rationale: Divorce is an unexpected external event
that disrupts life, classed as an adventitious crisis.
14. Which appraisal characterizes an environmental
event as harmful?
, A. Primary appraisal labeling it as a challenge
B. Secondary appraisal focusing on coping resources
C. Primary appraisal labeling it as a threat ✔
D. Tertiary appraisal seeking social support
o Rationale: Primary appraisal judges an event’s
potential for harm (threat) or benefit.
15. Which factor does NOT influence whether an
environmental event is perceived as stressful?
A. Predictability
B. Novelty
C. Coping mechanisms
D. Core body temperature ✔
o Rationale: Physical factors like temperature don’t
directly shape cognitive appraisal of stressors.
Subtopic: Stress as a Transaction Between the Individual and
the Environment
16. Lazarus’s transactional model emphasizes:
A. Only internal physiological responses
B. The two-way dynamic between person and
environment ✔
C. Stress solely as environmental events
D. Genetic determinants of stress
