TEST BANK
MENTAL HEALTH NURSING
,Fortinash: Psychiatric Mental Health Nursing
Chapter 01: Psychiatric Nursing: Theory, Principles, And Trends
1. Which Understanding Is The Basis For The Nursing Actions Focused On
Minimizing Mental Health Promotion Of Families With Chronically Mentally Ill
Members?
A. Family Members Are At An Increased Risk For Mental Illness.
B. The Mental Health Care System Is Not Prepared To Deal With Family Crises.
C. Family Members Are Seldom Prepared To Cope With A Chronically Ill Individual.
D. The Chronically Mentally Ill Receive Care Best When Delivered In A Formal
Setting.
ANSWER: A
When Families Live With A Dominant Member Who Has A Persistent And Severe
Mental Disorder The Outcomes Are Often Expressed As Family Members Who Are At
Increased Risk For Physical And Mental Illnesses. The Remaining Options Are Not
Necessarily True.
DIF: Cognitive Level: Application REF: Page 3
2. Which Nursing Activity Shows The Nurse Actively Engaged In The Primary Prevention
Of Mental Disorders?
A. Providing A Patient, Whose Depression Is Well Managed, With Medication On
Time
B. Making Regular Follow-Up Visits To A New Mother At Risk For Post-Partum
Depression
C. Providing The Family Of A Patient, Diagnosed With Depression, Information On
Suicide Prevention
D. Assisting A Patient Who Has Obsessive Compulsive Tendencies Prepare And
Practice For A Job Interview
ANSWER: B
Primary Prevention Helps To Reduce The Occurrence Of Mental Disorders By Staying
Involved With A Patient. Providing Medication And Information On Existing Illnesses Are
Examples Of Secondary Prevention Which Helps To Reduce The Prevalence Of Mental
Disorders. Assisting A Mentally Ill Patient With Preparation For A Job Interview Is Tertiary
Prevention Since It Involves Rehabilitation.
DIF: Cognitive Level: Application REF: Page 4
3. Which Intervention Reflects Attention Being Focused On The Patient‘s Intentions
Regarding His Diagnosis Of Severe Depression?
A. Being Placed On Suicide Precautions
B. Encouraging Visits By His Family Members
C. Receiving A Combination Of Medications To Address His Emotional Needs
D. Being Asked To Decide Where He Will Attend His Prescribed Therapy Sessions
ANSWER: D
A Primary Factor In Patient Treatment Includes Consideration Of The Patient‘s Intentions
Regarding His Or Her Own Care. Patients Are Central To The Process That Determines
Their Care As Their Abilities Allow. Under The Guidance Of PMH Nurses And Other Mental
Health Personnel, Patients Are Encouraged To Make Decisions And To Actively Engage In
Their Own Treatment Plans To Meet Their Needs. The Remaining Options Are Focused On
Specifics Of The Determined Plan Of Care.
DIF: Cognitive Level: Application REF: Page 5
1
,4. When A Patient‘s Family Asks Why Their Chronically Mentally Ill Adult Child Is
Being Discharged To A Community-Based Living Facility, The Nurse Responds:
A. ―It Is A Way To Meet The Need For Social Support.‖
B. ―It Is Too Expensive To Keep Stabilized Patients In Acute Care Settings.‖
C. ―This Type Of Facility Will Provide The Specialized Care That Is Needed.‖
D. ―Being Out In The Community Will Help Provide Hope And Purpose For Living.‖
ANSWER: D
Hospitalization May Be Necessary For Acute Care, But, When Patients Are Stabilized, They
Move Into Community-Based, Patient-Centered Settings Or Are Discharged Home With
Continued Outpatient Treatment In The Community. Concentrated Efforts Are Made To
Reduce The Patient‘s Sick Role By Providing Opportunities For The Development Of A
Purposeful Life And Instilling Hope For Each Patient‘s Future. Although Social Support Is
Important, Such A Living Arrangement Is Not The Only Way To Achieve It. Although
Acute Care Is Expensive, It Is Not The Major Concern When Determining Long-Term Care
Options. Community-Based Facilities Are Not The Only Option For Specialized Care.
DIF: Cognitive Level: Application REF: Page 5
5. What Is The Best Explanation To Offer When The Mother Of A Chronically Ill
Teenage Patient Asks, ―Under What Circumstances Would He Be Considered
Incompetent?‖
a.
b.
c.
d.
Re
ANSWER: D
When A Person Is Unable To Cognitively Process Information Or To Make Decisions
About His Or Her Own Welfare, The Person May Be Determined To Be Mentally
Incompetent.
Providing Self-Care Is Not The Only Criteria Considered. Age Is Not A Factor Considered. The
Decision Is Often Based On The Potential For Such Behavior.
DIF: Cognitive Level: Application REF: Page 6
6. Which Psychiatric Nursing Intervention Shows An Understanding Of Integrated Care?
a.
b.
c.
d. S.
ANSWER: A
The Majority Of Health Disciplines Now Recognize That Mental Disorders And Physical
Illnesses Are Closely Linked. The Presence Of A Mental Disorder Increases The Risk For
The Development Of Physical Illnesses And Vice Versa. Assessing A Chronically Abused
Individual For Anxiety Call Should Attention To The Psychiatric Disorder That Could
Develop From The Abuse. The Remaining Options Show Interventions That Are
Appropriate For The Mental Disorder.
DIF: Cognitive Level: Application REF: Page 6
7. What Reason Does The Nurse Give The Patient For The Emphasis And Attention Being
2
, Paid To The Recovery Phase Of Their Treatment Plan?
A. Recovery Care, Even When Intensive, Is Less Expensive Than Acute Psychiatric
Care.
B. Effective Recovery Care Is Likely To Result In Fewer Relapses And Subsequent
Hospitalizations.
C. Planning For Recovery Care Is Time Consuming And Involves Dealing With Many
Complicated Details.
D. Recovery Care Is Usually Done On An Outpatient Basis And So Is Generally Better
Accepted By Patients.
ANSWER: B
Much Attention Is Paid To Recovery Care Since Effective Recovery Care Helps Improve
Patient Outcomes And Thus Minimize Subsequent Hospitalizations. Recovery Care Is Not
Necessarily Less Expensive Than Acute Care. Although Effective Recovery Care Planning
May Be Time Consuming And Detail Oriented, That Is Not The Reason For Implementing
It. Recovery Care Is Not Necessarily Well Accepted By Patients.
DIF: Cognitive Level: Application REF: Page 7
8. The Nurse Is Attending A Neighborhood Meeting Where A Half-Way House Is
Being Proposed For The Neighborhood When A Member Of The Community States,
―We Don‘t Want The Facility; We Especially Don‘t Want Violent People Living Near
Us.‖ The Response By The Nurse That Best Addresses The Public‘s Concern Is:
a.
b.
c. Y
d.
ANSWER: A
A Major Reason For The Existence Of The Stigma Placed On Persons With Mental Illness Is
Lack Of Knowledge. The Main Fear Is Of Violence, Although Only A Small Percentage Of
Patients With Mental Illness Display This Behavior. Providing The Public With Accurate
Information Can Help Reduce Stigma. The Remaining Options Do Not Directly Address The
Concerns Stated.
DIF: Cognitive Level: Application REF: Pages 13-14
9. Which Activity Shows That A Therapeutic Alliance Has Been Established Between
The Nurse And Patient?
a. E
b. N
c.
d.
ANSWER: C
A Primary Aspect Of Working With Patients In Any Setting And Particularly In The
3
,Psychiatric Setting Is The Development Of A Therapeutic Alliance With The Patient. Such
An Alliance Is Established On Trust. It Is A Professional Bond Between The Nurse And The
Patient That Serves As A Vehicle For Patients To Freely Discuss Their Needs And Problems
In The Absence Of The Nurse‘s Criticism Or Judgment. Any Nurse Has An Obligation To
Respect The Patient‘s Rights And Administer Care Effectively. The Patient‘s Willingness
To Participate In The Plan Of Care Reflects Self Motivation.
DIF: Cognitive Level: Application REF: Page 9
10. Mental Health Care Reform Has Called For Parity Between Psychiatric And
Medical Diagnoses. Which Is An Example Of Such Parity?
a.
b.
c.
d. .
ANSWER: D
The Term Parity As Used Here Refers To Payments For Mental Health Services That
Equal Payment Schedules For Medical Or Surgical Conditions. The Remaining Options(B
And C) Do Not Relate To Financial Reimbursement Or Funds Allocated For Mental Health
Care Being Equal To Those Of Medical Diagnoses.
DIF: Cognitive Level: Application REF: Page 15
1. Which Assessment Findings Suggest To The Nurse That This Patient Has
Characteristics Seen In An Individual Who Has Reached Self-Actualization? Select All
That Apply.
A. Reports To Have, ―Found Peace And Security In My Religious Faith‖
B. Effectively ―Changed Occupations‖ When A Chronic Vision Problem Worsened
C. Has Consistently Earned A Six-Figure Salary As An Architect For The Last 10
Years
D. Has Been In A Supportive, Loving Relationship With The Same Individual For 15
Years
E. Provides Free Literacy Tutoring Help At The Local Homeless Shelter 3 Evenings
A Week
ANSWER: A, B, D, E
Characteristics Of Self Actualization Would Include: Spiritual Well-Being, Open And Flexible,
Relationally Fulfilled, And Generosity Toward Others. Salary Doesn‘t Necessarily Reflect Self -
Actualization.
DIF: Cognitive Level: Application REF: Page 4
2. Which Nursing Activities Represent The Tertiary Level Of Mental Health Care? Select
All That Apply.
a.
b.
c.
d. T
e. s
O
l
ANSWER: B, D
Tertiary Prevention Reduces The Residual Effects Of The Disorder Such As Depression And
Mental Retardation. There Is No Quaternary Level Of Prevention. Primary Prevention
Reduces Occurrences Of Mental Disorders Such As Screenings And Parenting Classes, And
Secondary Prevention Reduces The Prevalence Of Disorders As Evidenced By Assessing
,4
,Knowledge.
DIF: Cognitive Level: Application REF: Page 4
3. Which Nursing Actions Indicate An Understanding Of The Priority Issues
Currently Facing Psychiatric Mental Health Nursing Today? Select All That
Apply.
a.
b.
S
c.
d.
G
e.
F
ANSWER: A, C, D, E
Priority Issues Include Funding, Safety Issues In Psychiatric Treatment Centers—
Particularly The Use Of Patient Restraints, Quality-Of-Care Issues, Access To Health Care
For Minority Populations, And Standardization Of Advanced Practice Nurse Roles.
DIF: Cognitive Level: Application REF: Page 9
4. Which Assessment Findings Describe Risk Factors That Increase The Potential Risk
For Mental Illness? Select All That Apply.
A. Possesses High Tolerance For Stress
B. Is Very Curious About ‗How Things Work‘
C. Admits To Being A Member Of An Ethnic Gang
D. Only Practicing Jew Among School Classmates
E. Has A Younger Sibling Who Is Mentally Challenged
ANSWER: C, D, E
Risk Factors Are Internal Predisposing Characteristics And External Influences That
Increase A Person‘s Vulnerability And Potential For Developing Mental Disorders. Types
Of Risk Factors And Examples Include The Following: Having A Mentally-Challenged
Family Member In The Home; Belonging To A Punitive Gang; And Being The Object Of
Reject Or Bullying. The Remaining Options Are Protective Factors.
DIF: Cognitive Level: Application REF: Page 11
5. Which Nursing Actions Show A Focus On The Fundamental Goals That Guide
Psychiatric Mental Health Nurses In Providing Patient Care? Select All That Apply.
a.
b.
c.
d.
e. H
ANSWER: A, B, D, E
5
,Standard Objectives Guide PMH Nurses And Members Of Related Disciplines In The Care
Of Patients (Individuals, Families, Communities, And Organizations). The Objectives And
Criteria Are As Follows: The Promotion And Protection Of Mental Health, The Prevention
Of Mental Disorders, The Treatment Of Mental Disorders, And Recovery And
Rehabilitation.
Keeping Appropriate Boundaries Is A Generalized Nursing
Responsibility. DIF: Cognitive Level: Analysis
REF: Page 3
Chapter 02: Nursing Practice In The Clinical Setting
1. Which Nursing Action Is A Reflection Of Hildegard Peplau‘s Theoretic Framework
Regarding Psychiatric Mental Health Nursing?
A. Basing Patient Outcomes On Expected Instinctual Responses
B. Discussing A Patient‘s Feelings Regarding Parents And Siblings
C. Providing The Patient With Clean Clothes And Wholesome Food
D. Centering Professional Practice In A State Run Psychiatric Facility
ANSWER: B
Peplau‘s Pioneering Endeavors And Contributions Were Largely Influenced By
Interpersonal Psychotherapy. She Believed That Disorders Evolved In The Social Context
Of Interpersonal Interactions. (I.E., What Went On Between People). Instinctual Responses
Are More Related To Intrapersonal Interactions. Florence Nightingale Was Instrumental In
The Holistic Approach To Nursing Care, Whereas Linda Richards‘ Practice Was Centered
On Institutional Care Of The Mental Ill.
DIF: Cognitive Level: Application REF: Page 18
2. The Nurse Is Attempting To Provide A Safe Environment For A Patient At Great Risk
For Self-Harm. Which Intervention Shows An Understanding Of Evidence-Based
Practice (EBP)?
a. E
b.
c. N
d. R
ANSWER: B
Health Care Systems Are Participating In The Shift In Nursing Practice By Encouraging
Research In Their Facilities And By Implementing Interventions That Increase Nurses‘
Knowledge About EBP. Nurses Are Participating To Make Evidence-Based Nursing
Practices Available For Their Use, And They Are Helping To Determine The Outcomes
That Will Benefit Patients. The Remaining Options Are Examples Of Long-Standing
Practice Related To The Use Of Physical Restraints.
DIF: Cognitive Level: Application REF: Page 19
3. Which Statement By The Patient Reflects Patient Education That Was Based On
The Concept Of Integrated Patient Care?
A. ―I Know I‘m Anxious When I Get A Tension Headache.‖
B. ―My Anxiety Is A Result Of Stressors I Don‘t Cope Well With.‖
C. ―Medication Has Helped Me Tremendously With Anxiety Control.‖
6
, D. ―Anxiety Runs In My Family; My Entire Family Is Trying To Deal With It.‖
ANSWER: A
Integrated Patient Care Is The Recognition Of The Interplay Between Physical And Mental
Health. In Integrated Care, These Disorders Are Not Treated As Separate Illnesses; Rather,
They Are Treated Together. The Remaining Options Make No Mention Of A Relationship
Between Mental And Physical Illness.
DIF: Cognitive Level: Application REF: Page 19
4. The Nurse Demonstrates Objective Patient Care When:
A. Being Sympathetic To The Patient‘s Recent Loss Of A Spouse
B. Protecting The Anxious Patient By Eliminating Stressors In The Milieu
C. Responding To The Patient By Stating, ―I Know Exactly How You Feel.‖
D. Facilitating The Patient‘s Exploration Of Various Stress Reduction Techniques
ANSWER: D
The Nurse Demonstrates Objectivity By Helping The Patient To Process And Organize
Thoughts That Are Directed Toward The Solving Of His Or Her Own Problems. With
Sympathy, The Nurse Loses Objectivity And Moves Into His Or Her Own Personal Feelings.
Removing All Stress Does Not Allow The Patient To Develop Necessary Coping Skills.
DIF: Cognitive Level: Application REF: Pages 21- 22
5. Which Nursing Intervention Would Be Appropriately Addressed During The
Orientation Phase Of The Nurse–Patient Relationship?
A. Self Reflection By The Nurse Regarding Personal Biases And Prejudices
Regarding The Patient
B. Patient Works At Prioritizing Personal Needs And Develops Realistic Expected
Outcomes
C. Establishing The Contract Between The Nurse And The Patient Regarding Mutual
Needs And Expectations
D. Patient Commits To The Reinforcement Of Positive Personal Characteristics While
Working On Problems And Concerns
ANSWER: C
A Contract Or Agreement Is Established During The Orientation Phase Of The
Relationship. The Contract Defines Limits And Expectations Of Both The Patient And The
Nurse. Self Reflection Occurs During The Pre-Orientation Phase While The Remaining
Options Are Addressed During The Working Phase Of The Relationship.
DIF: Cognitive Level: Analysis REF: Page 22
6. Which Action On The Part Of A Novice Psychiatric Mental Health Nurse Shows A
Need For Future Development Of Altruism?
a.
b. E
c.
d.
ANSWER: A
7
, This Option Shows A Misguided Kindness That Will Ultimately Have A Negative Impact
On The Patient‘s Treatment. The Remaining Options Show Responsible Nursing
Interventions That Include Self-Reflection Of Personal Motivation For Such Work.
DIF: Cognitive Level: Application REF: Page 24
7. The Greatest Negative Outcome Resulting From A Nurse‘s Fear Of A Mentally Ill
Patient Is That The:
A. Nurse Will Reinforce Negative Stereotyping Of The Mentally Ill.
B. Patient Will Experience Increased Bias Against The Nursing Staff.
C. Public‘s Fearfulness Of The Mentally Ill Will Continue To Be Exaggerated.
D. Therapeutic Alliance Between The Nurse And Patient Will Not Develop Effectively.
ANSWER: D
Unrealistic Preconceived Images, Stereotyping, And Biases Have An Effect On Nurses That,
When Resulting In Fear, Will Negatively Impact The Therapeutic Effectiveness Of The Nurse
And The Care Provided. The Remaining Options Do Not Have The Priority That Providing
Quality Patient Care Has.
DIF: Cognitive Level: Application REF: Page 26
8. Which Action On The Part Of A Novice Mental Health Nurse Will Best Minimize
Fear Related To Effectively Working With The Psychotic Patient?
A. Be Knowledgeable About Psychotropic Medications And Their Affect On Psychosis
B. Always Arrange For Staff Support When Working One-On-One With A Psychotic
Patient.
C. Take Advantage Of Opportunities To Attend Workshops Devoted To The Care Of
The Psychotic Patient.
D. Recognize That The Psychotic Patient Is Not In Control Of Their Behaviors Due To
Their Altered Though Processes.
ANSWER: C
Fear Breeds Avoidance, But Knowledge And Preparation Diminish Fear And Bring
Confidence. Being Prepared Before Entering The Psychiatric Setting Includes Having
Knowledge And Understanding Of Mental Disorders. The Remaining Options Do Not
Provide Confidence But Rather Means Of Controlling Or Avoiding The Psychotic Patient.
DIF: Cognitive Level: Analysis REF: Page 26
9. Which Response By The Nurse Manager To A Novice Mental Health Nurse Is Most
Effective When The Nurse Asks, ―How Do I Justify Not Keeping A Patient‘s
Secret?‖
A. ―Never Promise The Patient That You Will Keep A Secret For Them.‖
B. ―Always Stop The Patient From Telling You Something As A Secret.‖
C. ―Let The Patient Know That You Will Not Keep A Secret That Could Ultimately
Cause Harm Or Affect Their Treatment.‖
D. ―Keep Reminding Yourself That You Are Not The Patient‘s Friend But Rather A
Professional Mental Health Provider.‖
ANSWER: C
Nurses And Other Healthcare Professionals Do Not Keep Secrets Or Make Promises To
Patients When The Secret May Interfere With The Patient‘s Treatment Or Put Them Or
Others At Risk For Harm. The Remaining Options Offer Appropriate Nursing Actions But
Do Not Effectively Answer The Nurse‘s Question.
DIF: Cognitive Level: Analysis REF: Page 30
8
MENTAL HEALTH NURSING
,Fortinash: Psychiatric Mental Health Nursing
Chapter 01: Psychiatric Nursing: Theory, Principles, And Trends
1. Which Understanding Is The Basis For The Nursing Actions Focused On
Minimizing Mental Health Promotion Of Families With Chronically Mentally Ill
Members?
A. Family Members Are At An Increased Risk For Mental Illness.
B. The Mental Health Care System Is Not Prepared To Deal With Family Crises.
C. Family Members Are Seldom Prepared To Cope With A Chronically Ill Individual.
D. The Chronically Mentally Ill Receive Care Best When Delivered In A Formal
Setting.
ANSWER: A
When Families Live With A Dominant Member Who Has A Persistent And Severe
Mental Disorder The Outcomes Are Often Expressed As Family Members Who Are At
Increased Risk For Physical And Mental Illnesses. The Remaining Options Are Not
Necessarily True.
DIF: Cognitive Level: Application REF: Page 3
2. Which Nursing Activity Shows The Nurse Actively Engaged In The Primary Prevention
Of Mental Disorders?
A. Providing A Patient, Whose Depression Is Well Managed, With Medication On
Time
B. Making Regular Follow-Up Visits To A New Mother At Risk For Post-Partum
Depression
C. Providing The Family Of A Patient, Diagnosed With Depression, Information On
Suicide Prevention
D. Assisting A Patient Who Has Obsessive Compulsive Tendencies Prepare And
Practice For A Job Interview
ANSWER: B
Primary Prevention Helps To Reduce The Occurrence Of Mental Disorders By Staying
Involved With A Patient. Providing Medication And Information On Existing Illnesses Are
Examples Of Secondary Prevention Which Helps To Reduce The Prevalence Of Mental
Disorders. Assisting A Mentally Ill Patient With Preparation For A Job Interview Is Tertiary
Prevention Since It Involves Rehabilitation.
DIF: Cognitive Level: Application REF: Page 4
3. Which Intervention Reflects Attention Being Focused On The Patient‘s Intentions
Regarding His Diagnosis Of Severe Depression?
A. Being Placed On Suicide Precautions
B. Encouraging Visits By His Family Members
C. Receiving A Combination Of Medications To Address His Emotional Needs
D. Being Asked To Decide Where He Will Attend His Prescribed Therapy Sessions
ANSWER: D
A Primary Factor In Patient Treatment Includes Consideration Of The Patient‘s Intentions
Regarding His Or Her Own Care. Patients Are Central To The Process That Determines
Their Care As Their Abilities Allow. Under The Guidance Of PMH Nurses And Other Mental
Health Personnel, Patients Are Encouraged To Make Decisions And To Actively Engage In
Their Own Treatment Plans To Meet Their Needs. The Remaining Options Are Focused On
Specifics Of The Determined Plan Of Care.
DIF: Cognitive Level: Application REF: Page 5
1
,4. When A Patient‘s Family Asks Why Their Chronically Mentally Ill Adult Child Is
Being Discharged To A Community-Based Living Facility, The Nurse Responds:
A. ―It Is A Way To Meet The Need For Social Support.‖
B. ―It Is Too Expensive To Keep Stabilized Patients In Acute Care Settings.‖
C. ―This Type Of Facility Will Provide The Specialized Care That Is Needed.‖
D. ―Being Out In The Community Will Help Provide Hope And Purpose For Living.‖
ANSWER: D
Hospitalization May Be Necessary For Acute Care, But, When Patients Are Stabilized, They
Move Into Community-Based, Patient-Centered Settings Or Are Discharged Home With
Continued Outpatient Treatment In The Community. Concentrated Efforts Are Made To
Reduce The Patient‘s Sick Role By Providing Opportunities For The Development Of A
Purposeful Life And Instilling Hope For Each Patient‘s Future. Although Social Support Is
Important, Such A Living Arrangement Is Not The Only Way To Achieve It. Although
Acute Care Is Expensive, It Is Not The Major Concern When Determining Long-Term Care
Options. Community-Based Facilities Are Not The Only Option For Specialized Care.
DIF: Cognitive Level: Application REF: Page 5
5. What Is The Best Explanation To Offer When The Mother Of A Chronically Ill
Teenage Patient Asks, ―Under What Circumstances Would He Be Considered
Incompetent?‖
a.
b.
c.
d.
Re
ANSWER: D
When A Person Is Unable To Cognitively Process Information Or To Make Decisions
About His Or Her Own Welfare, The Person May Be Determined To Be Mentally
Incompetent.
Providing Self-Care Is Not The Only Criteria Considered. Age Is Not A Factor Considered. The
Decision Is Often Based On The Potential For Such Behavior.
DIF: Cognitive Level: Application REF: Page 6
6. Which Psychiatric Nursing Intervention Shows An Understanding Of Integrated Care?
a.
b.
c.
d. S.
ANSWER: A
The Majority Of Health Disciplines Now Recognize That Mental Disorders And Physical
Illnesses Are Closely Linked. The Presence Of A Mental Disorder Increases The Risk For
The Development Of Physical Illnesses And Vice Versa. Assessing A Chronically Abused
Individual For Anxiety Call Should Attention To The Psychiatric Disorder That Could
Develop From The Abuse. The Remaining Options Show Interventions That Are
Appropriate For The Mental Disorder.
DIF: Cognitive Level: Application REF: Page 6
7. What Reason Does The Nurse Give The Patient For The Emphasis And Attention Being
2
, Paid To The Recovery Phase Of Their Treatment Plan?
A. Recovery Care, Even When Intensive, Is Less Expensive Than Acute Psychiatric
Care.
B. Effective Recovery Care Is Likely To Result In Fewer Relapses And Subsequent
Hospitalizations.
C. Planning For Recovery Care Is Time Consuming And Involves Dealing With Many
Complicated Details.
D. Recovery Care Is Usually Done On An Outpatient Basis And So Is Generally Better
Accepted By Patients.
ANSWER: B
Much Attention Is Paid To Recovery Care Since Effective Recovery Care Helps Improve
Patient Outcomes And Thus Minimize Subsequent Hospitalizations. Recovery Care Is Not
Necessarily Less Expensive Than Acute Care. Although Effective Recovery Care Planning
May Be Time Consuming And Detail Oriented, That Is Not The Reason For Implementing
It. Recovery Care Is Not Necessarily Well Accepted By Patients.
DIF: Cognitive Level: Application REF: Page 7
8. The Nurse Is Attending A Neighborhood Meeting Where A Half-Way House Is
Being Proposed For The Neighborhood When A Member Of The Community States,
―We Don‘t Want The Facility; We Especially Don‘t Want Violent People Living Near
Us.‖ The Response By The Nurse That Best Addresses The Public‘s Concern Is:
a.
b.
c. Y
d.
ANSWER: A
A Major Reason For The Existence Of The Stigma Placed On Persons With Mental Illness Is
Lack Of Knowledge. The Main Fear Is Of Violence, Although Only A Small Percentage Of
Patients With Mental Illness Display This Behavior. Providing The Public With Accurate
Information Can Help Reduce Stigma. The Remaining Options Do Not Directly Address The
Concerns Stated.
DIF: Cognitive Level: Application REF: Pages 13-14
9. Which Activity Shows That A Therapeutic Alliance Has Been Established Between
The Nurse And Patient?
a. E
b. N
c.
d.
ANSWER: C
A Primary Aspect Of Working With Patients In Any Setting And Particularly In The
3
,Psychiatric Setting Is The Development Of A Therapeutic Alliance With The Patient. Such
An Alliance Is Established On Trust. It Is A Professional Bond Between The Nurse And The
Patient That Serves As A Vehicle For Patients To Freely Discuss Their Needs And Problems
In The Absence Of The Nurse‘s Criticism Or Judgment. Any Nurse Has An Obligation To
Respect The Patient‘s Rights And Administer Care Effectively. The Patient‘s Willingness
To Participate In The Plan Of Care Reflects Self Motivation.
DIF: Cognitive Level: Application REF: Page 9
10. Mental Health Care Reform Has Called For Parity Between Psychiatric And
Medical Diagnoses. Which Is An Example Of Such Parity?
a.
b.
c.
d. .
ANSWER: D
The Term Parity As Used Here Refers To Payments For Mental Health Services That
Equal Payment Schedules For Medical Or Surgical Conditions. The Remaining Options(B
And C) Do Not Relate To Financial Reimbursement Or Funds Allocated For Mental Health
Care Being Equal To Those Of Medical Diagnoses.
DIF: Cognitive Level: Application REF: Page 15
1. Which Assessment Findings Suggest To The Nurse That This Patient Has
Characteristics Seen In An Individual Who Has Reached Self-Actualization? Select All
That Apply.
A. Reports To Have, ―Found Peace And Security In My Religious Faith‖
B. Effectively ―Changed Occupations‖ When A Chronic Vision Problem Worsened
C. Has Consistently Earned A Six-Figure Salary As An Architect For The Last 10
Years
D. Has Been In A Supportive, Loving Relationship With The Same Individual For 15
Years
E. Provides Free Literacy Tutoring Help At The Local Homeless Shelter 3 Evenings
A Week
ANSWER: A, B, D, E
Characteristics Of Self Actualization Would Include: Spiritual Well-Being, Open And Flexible,
Relationally Fulfilled, And Generosity Toward Others. Salary Doesn‘t Necessarily Reflect Self -
Actualization.
DIF: Cognitive Level: Application REF: Page 4
2. Which Nursing Activities Represent The Tertiary Level Of Mental Health Care? Select
All That Apply.
a.
b.
c.
d. T
e. s
O
l
ANSWER: B, D
Tertiary Prevention Reduces The Residual Effects Of The Disorder Such As Depression And
Mental Retardation. There Is No Quaternary Level Of Prevention. Primary Prevention
Reduces Occurrences Of Mental Disorders Such As Screenings And Parenting Classes, And
Secondary Prevention Reduces The Prevalence Of Disorders As Evidenced By Assessing
,4
,Knowledge.
DIF: Cognitive Level: Application REF: Page 4
3. Which Nursing Actions Indicate An Understanding Of The Priority Issues
Currently Facing Psychiatric Mental Health Nursing Today? Select All That
Apply.
a.
b.
S
c.
d.
G
e.
F
ANSWER: A, C, D, E
Priority Issues Include Funding, Safety Issues In Psychiatric Treatment Centers—
Particularly The Use Of Patient Restraints, Quality-Of-Care Issues, Access To Health Care
For Minority Populations, And Standardization Of Advanced Practice Nurse Roles.
DIF: Cognitive Level: Application REF: Page 9
4. Which Assessment Findings Describe Risk Factors That Increase The Potential Risk
For Mental Illness? Select All That Apply.
A. Possesses High Tolerance For Stress
B. Is Very Curious About ‗How Things Work‘
C. Admits To Being A Member Of An Ethnic Gang
D. Only Practicing Jew Among School Classmates
E. Has A Younger Sibling Who Is Mentally Challenged
ANSWER: C, D, E
Risk Factors Are Internal Predisposing Characteristics And External Influences That
Increase A Person‘s Vulnerability And Potential For Developing Mental Disorders. Types
Of Risk Factors And Examples Include The Following: Having A Mentally-Challenged
Family Member In The Home; Belonging To A Punitive Gang; And Being The Object Of
Reject Or Bullying. The Remaining Options Are Protective Factors.
DIF: Cognitive Level: Application REF: Page 11
5. Which Nursing Actions Show A Focus On The Fundamental Goals That Guide
Psychiatric Mental Health Nurses In Providing Patient Care? Select All That Apply.
a.
b.
c.
d.
e. H
ANSWER: A, B, D, E
5
,Standard Objectives Guide PMH Nurses And Members Of Related Disciplines In The Care
Of Patients (Individuals, Families, Communities, And Organizations). The Objectives And
Criteria Are As Follows: The Promotion And Protection Of Mental Health, The Prevention
Of Mental Disorders, The Treatment Of Mental Disorders, And Recovery And
Rehabilitation.
Keeping Appropriate Boundaries Is A Generalized Nursing
Responsibility. DIF: Cognitive Level: Analysis
REF: Page 3
Chapter 02: Nursing Practice In The Clinical Setting
1. Which Nursing Action Is A Reflection Of Hildegard Peplau‘s Theoretic Framework
Regarding Psychiatric Mental Health Nursing?
A. Basing Patient Outcomes On Expected Instinctual Responses
B. Discussing A Patient‘s Feelings Regarding Parents And Siblings
C. Providing The Patient With Clean Clothes And Wholesome Food
D. Centering Professional Practice In A State Run Psychiatric Facility
ANSWER: B
Peplau‘s Pioneering Endeavors And Contributions Were Largely Influenced By
Interpersonal Psychotherapy. She Believed That Disorders Evolved In The Social Context
Of Interpersonal Interactions. (I.E., What Went On Between People). Instinctual Responses
Are More Related To Intrapersonal Interactions. Florence Nightingale Was Instrumental In
The Holistic Approach To Nursing Care, Whereas Linda Richards‘ Practice Was Centered
On Institutional Care Of The Mental Ill.
DIF: Cognitive Level: Application REF: Page 18
2. The Nurse Is Attempting To Provide A Safe Environment For A Patient At Great Risk
For Self-Harm. Which Intervention Shows An Understanding Of Evidence-Based
Practice (EBP)?
a. E
b.
c. N
d. R
ANSWER: B
Health Care Systems Are Participating In The Shift In Nursing Practice By Encouraging
Research In Their Facilities And By Implementing Interventions That Increase Nurses‘
Knowledge About EBP. Nurses Are Participating To Make Evidence-Based Nursing
Practices Available For Their Use, And They Are Helping To Determine The Outcomes
That Will Benefit Patients. The Remaining Options Are Examples Of Long-Standing
Practice Related To The Use Of Physical Restraints.
DIF: Cognitive Level: Application REF: Page 19
3. Which Statement By The Patient Reflects Patient Education That Was Based On
The Concept Of Integrated Patient Care?
A. ―I Know I‘m Anxious When I Get A Tension Headache.‖
B. ―My Anxiety Is A Result Of Stressors I Don‘t Cope Well With.‖
C. ―Medication Has Helped Me Tremendously With Anxiety Control.‖
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, D. ―Anxiety Runs In My Family; My Entire Family Is Trying To Deal With It.‖
ANSWER: A
Integrated Patient Care Is The Recognition Of The Interplay Between Physical And Mental
Health. In Integrated Care, These Disorders Are Not Treated As Separate Illnesses; Rather,
They Are Treated Together. The Remaining Options Make No Mention Of A Relationship
Between Mental And Physical Illness.
DIF: Cognitive Level: Application REF: Page 19
4. The Nurse Demonstrates Objective Patient Care When:
A. Being Sympathetic To The Patient‘s Recent Loss Of A Spouse
B. Protecting The Anxious Patient By Eliminating Stressors In The Milieu
C. Responding To The Patient By Stating, ―I Know Exactly How You Feel.‖
D. Facilitating The Patient‘s Exploration Of Various Stress Reduction Techniques
ANSWER: D
The Nurse Demonstrates Objectivity By Helping The Patient To Process And Organize
Thoughts That Are Directed Toward The Solving Of His Or Her Own Problems. With
Sympathy, The Nurse Loses Objectivity And Moves Into His Or Her Own Personal Feelings.
Removing All Stress Does Not Allow The Patient To Develop Necessary Coping Skills.
DIF: Cognitive Level: Application REF: Pages 21- 22
5. Which Nursing Intervention Would Be Appropriately Addressed During The
Orientation Phase Of The Nurse–Patient Relationship?
A. Self Reflection By The Nurse Regarding Personal Biases And Prejudices
Regarding The Patient
B. Patient Works At Prioritizing Personal Needs And Develops Realistic Expected
Outcomes
C. Establishing The Contract Between The Nurse And The Patient Regarding Mutual
Needs And Expectations
D. Patient Commits To The Reinforcement Of Positive Personal Characteristics While
Working On Problems And Concerns
ANSWER: C
A Contract Or Agreement Is Established During The Orientation Phase Of The
Relationship. The Contract Defines Limits And Expectations Of Both The Patient And The
Nurse. Self Reflection Occurs During The Pre-Orientation Phase While The Remaining
Options Are Addressed During The Working Phase Of The Relationship.
DIF: Cognitive Level: Analysis REF: Page 22
6. Which Action On The Part Of A Novice Psychiatric Mental Health Nurse Shows A
Need For Future Development Of Altruism?
a.
b. E
c.
d.
ANSWER: A
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, This Option Shows A Misguided Kindness That Will Ultimately Have A Negative Impact
On The Patient‘s Treatment. The Remaining Options Show Responsible Nursing
Interventions That Include Self-Reflection Of Personal Motivation For Such Work.
DIF: Cognitive Level: Application REF: Page 24
7. The Greatest Negative Outcome Resulting From A Nurse‘s Fear Of A Mentally Ill
Patient Is That The:
A. Nurse Will Reinforce Negative Stereotyping Of The Mentally Ill.
B. Patient Will Experience Increased Bias Against The Nursing Staff.
C. Public‘s Fearfulness Of The Mentally Ill Will Continue To Be Exaggerated.
D. Therapeutic Alliance Between The Nurse And Patient Will Not Develop Effectively.
ANSWER: D
Unrealistic Preconceived Images, Stereotyping, And Biases Have An Effect On Nurses That,
When Resulting In Fear, Will Negatively Impact The Therapeutic Effectiveness Of The Nurse
And The Care Provided. The Remaining Options Do Not Have The Priority That Providing
Quality Patient Care Has.
DIF: Cognitive Level: Application REF: Page 26
8. Which Action On The Part Of A Novice Mental Health Nurse Will Best Minimize
Fear Related To Effectively Working With The Psychotic Patient?
A. Be Knowledgeable About Psychotropic Medications And Their Affect On Psychosis
B. Always Arrange For Staff Support When Working One-On-One With A Psychotic
Patient.
C. Take Advantage Of Opportunities To Attend Workshops Devoted To The Care Of
The Psychotic Patient.
D. Recognize That The Psychotic Patient Is Not In Control Of Their Behaviors Due To
Their Altered Though Processes.
ANSWER: C
Fear Breeds Avoidance, But Knowledge And Preparation Diminish Fear And Bring
Confidence. Being Prepared Before Entering The Psychiatric Setting Includes Having
Knowledge And Understanding Of Mental Disorders. The Remaining Options Do Not
Provide Confidence But Rather Means Of Controlling Or Avoiding The Psychotic Patient.
DIF: Cognitive Level: Analysis REF: Page 26
9. Which Response By The Nurse Manager To A Novice Mental Health Nurse Is Most
Effective When The Nurse Asks, ―How Do I Justify Not Keeping A Patient‘s
Secret?‖
A. ―Never Promise The Patient That You Will Keep A Secret For Them.‖
B. ―Always Stop The Patient From Telling You Something As A Secret.‖
C. ―Let The Patient Know That You Will Not Keep A Secret That Could Ultimately
Cause Harm Or Affect Their Treatment.‖
D. ―Keep Reminding Yourself That You Are Not The Patient‘s Friend But Rather A
Professional Mental Health Provider.‖
ANSWER: C
Nurses And Other Healthcare Professionals Do Not Keep Secrets Or Make Promises To
Patients When The Secret May Interfere With The Patient‘s Treatment Or Put Them Or
Others At Risk For Harm. The Remaining Options Offer Appropriate Nursing Actions But
Do Not Effectively Answer The Nurse‘s Question.
DIF: Cognitive Level: Analysis REF: Page 30
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