Test Bank – Varcarolis’s Canadian Psychiatric Mental Health Nursing,
3rd Edition (Jakubec & Pollard) | Verified Q&A | ISBN 9780323778794
Chapter 01: Mental Health and Mental Illness
Pollard: Varcarolis’s Canadian Psychiatric Mental Health Nursing: A Clinical Approach, 3rd
Edition
MULTIPLE CHOICE
1. Which of the following is considered an Advanced Practice
Intervention?
a. Conducting mental health assessments (MSA)
b. Prescribing psychotropic medication
c. Establishing therapeutic relationships
d. Individualizing nursing care plans
ANS: B
Registered nurses and registered psychiatric nurses can further their
education at a baccalaureate levelor at the graduate level (master’s
doctorate) and become qualified to practise psychiatric mental health
nursing at two levels – basic and advanced – developing on their
education preparation. Prescriptive privileges are granted to master’s-
prepared Nurse Practitioners (NPs) as they have taken additional advanced courses on prescribing
medication. Appropriate use of diagnostic tests must be completed aswell as having hospital admitting
privileges. Establishing therapeutic relationship, conducting mental health assessments (MSAs), and
individualizing nursing care plans are foundational psychiatric nursing skills. Therefore, they are
considered Basic-Level Interventions.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment
2. Which has been identified as a priority for national plans and strategies in psychiatric mental health
nursing in Canada?
a. Decrease in the aging population
b. Increase in cultural diversity
c. Role of the advanced practice nurse
d. Shortage of physicians in rural and urban areas
ANS: B
In early phases of strategic development, the Mental Health Commission of Canada identified cultural
diversity as a priority for national plans and strategies. Increasing cultural diversity within Canada
warrants deeper attention to culturally safe care and concern for the mental health consequences of
colonization and racism. An aging population and shortage of physicians are important to future
trends. The role of the advanced practice nurse is continuing to evolve in psychiatric mental health
nursing in Canada.
, DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
3. Which serves as the official guide for diagnosing psychiatric disorders?
a. International Classification of Diseases (ICD-11)
b. Diagnostic and Statistical Manual of Mental Disorders (DSM)
c. A behavioural health reference manual
, d. NurseOne online
ANS: B
The first Diagnostic and Statistical Manual of Mental Disorders (DSM) was published by the
American Psychiatric Association in 1952. Its purpose was to provide clinicians, educators, and
researchers with a common framework to understand and communicate about mental disorders. With a
common understanding about mental disorders, researchers and clinicians could work together in their
attempts to improve care for people with mental illness. The current DSM-5 serves as the official guide
for diagnosing psychiatric disorders. The International Classification of Diseases (ICD) sets the global
health information standard for mortality and morbidity statistics. Clinicians and researchers use this
classification system to define diseases, study disease patterns, monitor outcomes, and subsequently
allocate resources based on the prevalence of disease. The Canadian Institute for Health Information
developed an enhanced version of the previous version, ICD-10 referred to as the ICD 10-CA period
that version extends beyond defining and classifying diseases to describe conditions and situations that
are not diseases, including for example, risk factors to health and psychosocial circumstances. A
behavioral health reference manual and NurseOne online are not used as official guides for diagnosis.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment MSC: Client Needs: Safe Effective Care Environment
4. When locating the description and diagnostic criteria for anxiety disorders, which resource would have
the most complete information?
a. Nursing Outcomes Classification (NOC)
b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
d. International Statistical Classification of Diseases and Related Health Problems
(ICD-10)
ANS: B
The DSM-5 details the diagnostic criteria for psychiatric clinical conditions and is the official guide for
diagnosing psychiatric disorders. The other references are good resources but do not define the
diagnostic criteria.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment
5. Which individual is demonstrating the highest level of resilience?
a. An individual repressing their stressors who is having a difficult time coping with
activities of daily living (ADLs)
b. An individual who is in a depressed state after the death of their spouse
c. An individual who lives in a shelter for 2 years after their home is destroyed by a
fire
d. An individual who navigates and negotiates resources to support their well-being
ANS: D
3
, A characteristic of mental health increasingly being promoted as essential to the recovery process is
resilience. Resilience is a process and outcome of complex, cultural systems, rather than as an
individual capacity to overcome adversity. In this way, when exposed to adversity, one’s resilience
depends on the navigation and negotiation of resources that can support well-being. Resilience is
closely associated with the process of adapting and helps people facing tragedies, loss, trauma, and
severe stress. An individual who is repressing their stressors may need support for developing coping
strategies. It is important for the individual who is in a depressed state after the death of their spouse to
navigate and negotiate resources that can support their well-being (e.g., grief support or counselling).
An individual living in a shelter needs immediate support and assistance when entering the shelter to
navigate services and supports. Shelters are short-term resources.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Psychosocial Integrity
6. A multidisciplinary team is working with two groups of patients diagnosed with depression. One group
of patients receives supportive interventions and psychotropic medication (e.g., antidepressants). The
other group receives only psychotropic medication. Outcomes are measured for each group. Which is
being studied?
a. Incidence
b. Prevalence
c. Comorbidity
d. Clinical epidemiology
ANS: D
Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if
there is no treatment and the problem is left to run its course) of an illness, studies of diagnostic
screening tests, and observational and experimental studies of interventions used to treat people with
the illness or symptoms. Prevalence refers to numbers of new cases. Comorbidity refers to having
more than one mental disorder at a time. Incidence refers to the number of new cases of mental
disorders in a healthy population within a given period.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
7. A category 5 tornado occurred in a community of 400 people, resulting in destruction of many homes
and businesses. In the 2 years after this disaster, 140 individuals were diagnosed with post-traumatic
stress disorder (PTSD). Which term best applies to these newly diagnosed individuals?
a. Prevalence
b. Comorbidity
c. Incidence
d. Clinical epidemiology
ANS: C
4
, Incidence refers to the number of new cases of mental disorders in a healthy population within a given
period of time. Prevalence describes the total number of cases, new and existing, in a given population
during a specific period of time, regardless of when they became ill. Clinical epidemiology is a broad
field that addresses what happens after people with illnesses are seen by clinical care providers.
Comorbidity refers to having more than one mental disorder at a time.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Planning| Nursing Process: Outcome Identification
MSC: Client Needs: Safe Effective Care Environment
8. Which individual is considered to have positive attributes of mental health?
a. An individual who can laugh and play
b. An individual who is unable to experience joy
c. An individual who has a difficult time managing interpersonal conflict
d. An individual who has limited insight and judgement
ANS: A
Mental health is described as more than merely the absence of mental disorders or disabilities.
Laughing and play are considered positive attributes of mental health. Individuals who are unable to
experience joy, who have a difficult time managing interpersonal conflict, and who have limited
insight and judgement may require further support, enhanced coping strategies and promotion of
positive mental health from mental health clinicians.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
9. Which report highlighted the importance of issues related to mental health and mental illness in
Canada?
a. The ERB Report
b. The ERG Report
c. The EDD Report
d. The EPP Report
ANS: D
Published in 1988, Mental Health for Canadians: Striking a Balance, commonly called the Epp
Report, highlighted the importance of issues related to mental health and mental illness in Canada. It
proposed seven guiding principles for the development of public policies to support mental health.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Planning| Nursing Process: Outcome Identification
MSC: Client Needs: Health Promotion and Maintenance
10. Which of the following indicates reflection and discovery of resilience?
a. Why do I not have the inner strength I once did?
b. How have I gotten through difficult times?
c. Why doesn’t anything ever go right for me?
d. Why do people always make me feel this way?
ANS: B
5
, When reflecting on resilience questions should be framed in a positive way. An individual asking,
“How have I gotten through difficult times?” demonstrates a positive reflection and an attempt to
discover progression through difficult times, thus indicating resilience. Questions relating to, “Why do
I not have the inner strength I once did,” “Why doesn’t anything ever go right for me,” and “Why do
people always make me feel this way” are not framed in a positive way. The distractors, are not related
to inner strength, competence, optimism, flexibility, and the ability to cope effectively when faced with
adversity.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
11. Which is a standard measure for mental health?
a. The Epp Report
b. The Diagnostic and Statistical Manual for Mental Disorders (DSM)
c. There is no standard measure for mental health
d. Nature versus nurture
ANS: C
There is no standard measure for mental health, in part because it is culturally defined and is based on
interpretations of effective functioning according to societal norms. One approach to differentiating
mental health from mental illness is to consider what a particular culture regards as acceptable or
unacceptable behavior. The Epp Report highlights the importance of issues related to mental health
and mental illness in Canada but is not a standard measure. The DSM serves as the official guide for
diagnosing psychiatric disorders. Nature versus nurture is not a standard measure for mental health.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
12. Which is currently the most accepted explanation for mental illness?
a. Biological Model
b. Diathesis-Stress Model
c. Psychological Model
d. Sociological Model
ANS: B
Currently, the Diathesis-Stress Model, in which diathesis represents biological predisposition and
stress represents environmental stress or trauma, is the most accepted explanation for mental illness.
This nature-plus-nurture model asserts that most psychiatric disorders result from a combination of
genetic vulnerability and negative environmental stressors. Biological, Psychological, and Sociological
models only have a specific focus, which leads to segregation and isolation of people. Singularly these
models are not identified as causative factors for mental illness.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment
13. Crisis and risk management are considered which of the following?
a. Nursing Outcomes Classification (NOC)
b. Nursing Diagnoses
6
, c. Evidence-Informed Practice
d. Nursing Interventions Classification (NIC)
ANS: D
Crisis and risk management are considered to be part of the Nursing Interventions Classifications
(NIC) are another tool used to standardize, define, and measure nursing care. There are seven domains:
basic physiological, complex physiological, behavioural, safety, family, health system, and
community. Two domains relate specifically to psychiatric nursing behavioural, including
communication, coping, and education, and safety, covering crisis and risk management. The Nursing
Outcome Classification (NOC) provides a comprehensive list of standardized outcomes, definitions,
and measures to describe patient outcomes influenced by nursing practice. A nursing diagnosis is a
clinical judgement about individual, family, or community responses to actual or potential health
problems and life processes. Evidence-Informed Practice is care based on the collection, interpretation,
and integration of valid, important, and applicable patient-reported, clinician-observed, and research-
derived evidence.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
14. A college student is struggling with depressive symptoms and is identifying feeling overwhelmed. The
counsellor at the college working with the student, seeks support, assessment, and follow-up from a
psychiatrist at the local hospital using a secure video connection. This is an example of which of the
following?
a. Cultural diversity
b. Physical environments
c. Telepsychiatry
d. Resilience
ANS: C
Telepsychiatry is also known as telemedicine. In this practice, real-time consultations typically occur
in facilities using a secured telecommunication connection to enable psychiatric assessment or
consultation. With telepsychiatry, the mental health needs of a greater range of people in a wider range
of locations can be met with timely professional assessments and prescribed interventions. The
counsellor at the college working with a student and specifically seeking support, assessment, and a
follow-up from the psychiatrist in a local hospital using a secure video connection therefore at this
time cultural diversity, physical environment, and resilience would not apply. These may be discussed
in the assessment with the psychiatrist, student, and counsellor.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment
15. An individual diagnosed with schizophrenia has recently been diagnosed with hypertension. Which is
correct documentation?
a. The individual has a comorbid condition of schizophrenia and hypertension.
b. The individual has a diagnosis of schizophrenia and disparity of hypertension.
c. The individual has a diagnosis of hypertension secondary to schizophrenia.
d. The individual has a diagnosis of schizophrenia.
ANS: A
7
, Comorbid conditions are those disorders that occur at the same time as another condition. For
example, an individual diagnosed with schizophrenia may also have comorbid hypertension.
Hypertension is not a specific disparity of schizophrenia. Hypertension is not diagnosed secondary to
schizophrenia. Not acknowledging hypertension in the person at all is incorrect.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
16. A psychiatric mental health nurse is invited to a local college to discuss mental health and mental
illness. A student asks about the role of psychiatric mental health nurses. Which is the best response?
a. “We practice in safer environments than other specialties. Nurse-to-patient ratios
are significantly lower because of the nature of the patients’ concerns.”
b. “We work with a broad population of patients in diverse settings. We use
therapeutic communication skills, as well as critical thinking to promote optimal
mental health.”
c. “We frequently use high technology monitoring equipment and manage complex
therapies.”
d. “We do not have to treat patients with as much pain and suffering as other
specialties do. We only talk about mental health.”
ANS: B
Two domains relate specifically to psychiatric mental health nursing: behavioural, including
communication, coping, and education; and safety, covering crisis and risk management. The
therapeutic nurse–patient relationship, therapeutic communication, critical thinking, and clinical
judgement are central nursing concepts for psychiatric mental health nursing practice. Psychiatric
mental health nurses work with a broad population of patients in diverse settings to promote optimal
mental health. While there are safety protocols in place within mental health environments, it is not
correct to say the environment is safer than another discipline. Nurse-to-patient ratios may be different
based on observation levels within mental health, but they are not significantly lower. Telepsychiatry
is the use of secured telecommunication connections enabling psychiatric assessments, or consultations
but is not used to manage complex therapies. Psychosocial pain and suffering are as real as physical
pain and suffering.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
17. Which mental disorder is the most prevalent in Canada?
a. Schizophrenia and psychosis
b. Bipolar disorder
c. Attention-deficit disorder
d. Major depressive episode
ANS: D
In accordance with current statistics major depressive episode is the most prevalent mental disorder in
Canada with the prevalence over 12 months of 4.7% and a lifetime prevalence of 11.3%. Attention
deficit disorder has a prevalence over 12 months of 2.6%. Bipolar disorder has a prevalence over 12
months of 1.5% and 2.6% of lifetime prevalence. Schizophrenia and psychosis have a prevalence over
12 months of 1.3%.
8
3rd Edition (Jakubec & Pollard) | Verified Q&A | ISBN 9780323778794
Chapter 01: Mental Health and Mental Illness
Pollard: Varcarolis’s Canadian Psychiatric Mental Health Nursing: A Clinical Approach, 3rd
Edition
MULTIPLE CHOICE
1. Which of the following is considered an Advanced Practice
Intervention?
a. Conducting mental health assessments (MSA)
b. Prescribing psychotropic medication
c. Establishing therapeutic relationships
d. Individualizing nursing care plans
ANS: B
Registered nurses and registered psychiatric nurses can further their
education at a baccalaureate levelor at the graduate level (master’s
doctorate) and become qualified to practise psychiatric mental health
nursing at two levels – basic and advanced – developing on their
education preparation. Prescriptive privileges are granted to master’s-
prepared Nurse Practitioners (NPs) as they have taken additional advanced courses on prescribing
medication. Appropriate use of diagnostic tests must be completed aswell as having hospital admitting
privileges. Establishing therapeutic relationship, conducting mental health assessments (MSAs), and
individualizing nursing care plans are foundational psychiatric nursing skills. Therefore, they are
considered Basic-Level Interventions.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment
2. Which has been identified as a priority for national plans and strategies in psychiatric mental health
nursing in Canada?
a. Decrease in the aging population
b. Increase in cultural diversity
c. Role of the advanced practice nurse
d. Shortage of physicians in rural and urban areas
ANS: B
In early phases of strategic development, the Mental Health Commission of Canada identified cultural
diversity as a priority for national plans and strategies. Increasing cultural diversity within Canada
warrants deeper attention to culturally safe care and concern for the mental health consequences of
colonization and racism. An aging population and shortage of physicians are important to future
trends. The role of the advanced practice nurse is continuing to evolve in psychiatric mental health
nursing in Canada.
, DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
3. Which serves as the official guide for diagnosing psychiatric disorders?
a. International Classification of Diseases (ICD-11)
b. Diagnostic and Statistical Manual of Mental Disorders (DSM)
c. A behavioural health reference manual
, d. NurseOne online
ANS: B
The first Diagnostic and Statistical Manual of Mental Disorders (DSM) was published by the
American Psychiatric Association in 1952. Its purpose was to provide clinicians, educators, and
researchers with a common framework to understand and communicate about mental disorders. With a
common understanding about mental disorders, researchers and clinicians could work together in their
attempts to improve care for people with mental illness. The current DSM-5 serves as the official guide
for diagnosing psychiatric disorders. The International Classification of Diseases (ICD) sets the global
health information standard for mortality and morbidity statistics. Clinicians and researchers use this
classification system to define diseases, study disease patterns, monitor outcomes, and subsequently
allocate resources based on the prevalence of disease. The Canadian Institute for Health Information
developed an enhanced version of the previous version, ICD-10 referred to as the ICD 10-CA period
that version extends beyond defining and classifying diseases to describe conditions and situations that
are not diseases, including for example, risk factors to health and psychosocial circumstances. A
behavioral health reference manual and NurseOne online are not used as official guides for diagnosis.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment MSC: Client Needs: Safe Effective Care Environment
4. When locating the description and diagnostic criteria for anxiety disorders, which resource would have
the most complete information?
a. Nursing Outcomes Classification (NOC)
b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
d. International Statistical Classification of Diseases and Related Health Problems
(ICD-10)
ANS: B
The DSM-5 details the diagnostic criteria for psychiatric clinical conditions and is the official guide for
diagnosing psychiatric disorders. The other references are good resources but do not define the
diagnostic criteria.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment
5. Which individual is demonstrating the highest level of resilience?
a. An individual repressing their stressors who is having a difficult time coping with
activities of daily living (ADLs)
b. An individual who is in a depressed state after the death of their spouse
c. An individual who lives in a shelter for 2 years after their home is destroyed by a
fire
d. An individual who navigates and negotiates resources to support their well-being
ANS: D
3
, A characteristic of mental health increasingly being promoted as essential to the recovery process is
resilience. Resilience is a process and outcome of complex, cultural systems, rather than as an
individual capacity to overcome adversity. In this way, when exposed to adversity, one’s resilience
depends on the navigation and negotiation of resources that can support well-being. Resilience is
closely associated with the process of adapting and helps people facing tragedies, loss, trauma, and
severe stress. An individual who is repressing their stressors may need support for developing coping
strategies. It is important for the individual who is in a depressed state after the death of their spouse to
navigate and negotiate resources that can support their well-being (e.g., grief support or counselling).
An individual living in a shelter needs immediate support and assistance when entering the shelter to
navigate services and supports. Shelters are short-term resources.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Psychosocial Integrity
6. A multidisciplinary team is working with two groups of patients diagnosed with depression. One group
of patients receives supportive interventions and psychotropic medication (e.g., antidepressants). The
other group receives only psychotropic medication. Outcomes are measured for each group. Which is
being studied?
a. Incidence
b. Prevalence
c. Comorbidity
d. Clinical epidemiology
ANS: D
Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if
there is no treatment and the problem is left to run its course) of an illness, studies of diagnostic
screening tests, and observational and experimental studies of interventions used to treat people with
the illness or symptoms. Prevalence refers to numbers of new cases. Comorbidity refers to having
more than one mental disorder at a time. Incidence refers to the number of new cases of mental
disorders in a healthy population within a given period.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
7. A category 5 tornado occurred in a community of 400 people, resulting in destruction of many homes
and businesses. In the 2 years after this disaster, 140 individuals were diagnosed with post-traumatic
stress disorder (PTSD). Which term best applies to these newly diagnosed individuals?
a. Prevalence
b. Comorbidity
c. Incidence
d. Clinical epidemiology
ANS: C
4
, Incidence refers to the number of new cases of mental disorders in a healthy population within a given
period of time. Prevalence describes the total number of cases, new and existing, in a given population
during a specific period of time, regardless of when they became ill. Clinical epidemiology is a broad
field that addresses what happens after people with illnesses are seen by clinical care providers.
Comorbidity refers to having more than one mental disorder at a time.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Planning| Nursing Process: Outcome Identification
MSC: Client Needs: Safe Effective Care Environment
8. Which individual is considered to have positive attributes of mental health?
a. An individual who can laugh and play
b. An individual who is unable to experience joy
c. An individual who has a difficult time managing interpersonal conflict
d. An individual who has limited insight and judgement
ANS: A
Mental health is described as more than merely the absence of mental disorders or disabilities.
Laughing and play are considered positive attributes of mental health. Individuals who are unable to
experience joy, who have a difficult time managing interpersonal conflict, and who have limited
insight and judgement may require further support, enhanced coping strategies and promotion of
positive mental health from mental health clinicians.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
9. Which report highlighted the importance of issues related to mental health and mental illness in
Canada?
a. The ERB Report
b. The ERG Report
c. The EDD Report
d. The EPP Report
ANS: D
Published in 1988, Mental Health for Canadians: Striking a Balance, commonly called the Epp
Report, highlighted the importance of issues related to mental health and mental illness in Canada. It
proposed seven guiding principles for the development of public policies to support mental health.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Planning| Nursing Process: Outcome Identification
MSC: Client Needs: Health Promotion and Maintenance
10. Which of the following indicates reflection and discovery of resilience?
a. Why do I not have the inner strength I once did?
b. How have I gotten through difficult times?
c. Why doesn’t anything ever go right for me?
d. Why do people always make me feel this way?
ANS: B
5
, When reflecting on resilience questions should be framed in a positive way. An individual asking,
“How have I gotten through difficult times?” demonstrates a positive reflection and an attempt to
discover progression through difficult times, thus indicating resilience. Questions relating to, “Why do
I not have the inner strength I once did,” “Why doesn’t anything ever go right for me,” and “Why do
people always make me feel this way” are not framed in a positive way. The distractors, are not related
to inner strength, competence, optimism, flexibility, and the ability to cope effectively when faced with
adversity.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
11. Which is a standard measure for mental health?
a. The Epp Report
b. The Diagnostic and Statistical Manual for Mental Disorders (DSM)
c. There is no standard measure for mental health
d. Nature versus nurture
ANS: C
There is no standard measure for mental health, in part because it is culturally defined and is based on
interpretations of effective functioning according to societal norms. One approach to differentiating
mental health from mental illness is to consider what a particular culture regards as acceptable or
unacceptable behavior. The Epp Report highlights the importance of issues related to mental health
and mental illness in Canada but is not a standard measure. The DSM serves as the official guide for
diagnosing psychiatric disorders. Nature versus nurture is not a standard measure for mental health.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
12. Which is currently the most accepted explanation for mental illness?
a. Biological Model
b. Diathesis-Stress Model
c. Psychological Model
d. Sociological Model
ANS: B
Currently, the Diathesis-Stress Model, in which diathesis represents biological predisposition and
stress represents environmental stress or trauma, is the most accepted explanation for mental illness.
This nature-plus-nurture model asserts that most psychiatric disorders result from a combination of
genetic vulnerability and negative environmental stressors. Biological, Psychological, and Sociological
models only have a specific focus, which leads to segregation and isolation of people. Singularly these
models are not identified as causative factors for mental illness.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment
13. Crisis and risk management are considered which of the following?
a. Nursing Outcomes Classification (NOC)
b. Nursing Diagnoses
6
, c. Evidence-Informed Practice
d. Nursing Interventions Classification (NIC)
ANS: D
Crisis and risk management are considered to be part of the Nursing Interventions Classifications
(NIC) are another tool used to standardize, define, and measure nursing care. There are seven domains:
basic physiological, complex physiological, behavioural, safety, family, health system, and
community. Two domains relate specifically to psychiatric nursing behavioural, including
communication, coping, and education, and safety, covering crisis and risk management. The Nursing
Outcome Classification (NOC) provides a comprehensive list of standardized outcomes, definitions,
and measures to describe patient outcomes influenced by nursing practice. A nursing diagnosis is a
clinical judgement about individual, family, or community responses to actual or potential health
problems and life processes. Evidence-Informed Practice is care based on the collection, interpretation,
and integration of valid, important, and applicable patient-reported, clinician-observed, and research-
derived evidence.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
14. A college student is struggling with depressive symptoms and is identifying feeling overwhelmed. The
counsellor at the college working with the student, seeks support, assessment, and follow-up from a
psychiatrist at the local hospital using a secure video connection. This is an example of which of the
following?
a. Cultural diversity
b. Physical environments
c. Telepsychiatry
d. Resilience
ANS: C
Telepsychiatry is also known as telemedicine. In this practice, real-time consultations typically occur
in facilities using a secured telecommunication connection to enable psychiatric assessment or
consultation. With telepsychiatry, the mental health needs of a greater range of people in a wider range
of locations can be met with timely professional assessments and prescribed interventions. The
counsellor at the college working with a student and specifically seeking support, assessment, and a
follow-up from the psychiatrist in a local hospital using a secure video connection therefore at this
time cultural diversity, physical environment, and resilience would not apply. These may be discussed
in the assessment with the psychiatrist, student, and counsellor.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment
15. An individual diagnosed with schizophrenia has recently been diagnosed with hypertension. Which is
correct documentation?
a. The individual has a comorbid condition of schizophrenia and hypertension.
b. The individual has a diagnosis of schizophrenia and disparity of hypertension.
c. The individual has a diagnosis of hypertension secondary to schizophrenia.
d. The individual has a diagnosis of schizophrenia.
ANS: A
7
, Comorbid conditions are those disorders that occur at the same time as another condition. For
example, an individual diagnosed with schizophrenia may also have comorbid hypertension.
Hypertension is not a specific disparity of schizophrenia. Hypertension is not diagnosed secondary to
schizophrenia. Not acknowledging hypertension in the person at all is incorrect.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
16. A psychiatric mental health nurse is invited to a local college to discuss mental health and mental
illness. A student asks about the role of psychiatric mental health nurses. Which is the best response?
a. “We practice in safer environments than other specialties. Nurse-to-patient ratios
are significantly lower because of the nature of the patients’ concerns.”
b. “We work with a broad population of patients in diverse settings. We use
therapeutic communication skills, as well as critical thinking to promote optimal
mental health.”
c. “We frequently use high technology monitoring equipment and manage complex
therapies.”
d. “We do not have to treat patients with as much pain and suffering as other
specialties do. We only talk about mental health.”
ANS: B
Two domains relate specifically to psychiatric mental health nursing: behavioural, including
communication, coping, and education; and safety, covering crisis and risk management. The
therapeutic nurse–patient relationship, therapeutic communication, critical thinking, and clinical
judgement are central nursing concepts for psychiatric mental health nursing practice. Psychiatric
mental health nurses work with a broad population of patients in diverse settings to promote optimal
mental health. While there are safety protocols in place within mental health environments, it is not
correct to say the environment is safer than another discipline. Nurse-to-patient ratios may be different
based on observation levels within mental health, but they are not significantly lower. Telepsychiatry
is the use of secured telecommunication connections enabling psychiatric assessments, or consultations
but is not used to manage complex therapies. Psychosocial pain and suffering are as real as physical
pain and suffering.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Outcome Evaluation
MSC: Client Needs: Safe Effective Care Environment
17. Which mental disorder is the most prevalent in Canada?
a. Schizophrenia and psychosis
b. Bipolar disorder
c. Attention-deficit disorder
d. Major depressive episode
ANS: D
In accordance with current statistics major depressive episode is the most prevalent mental disorder in
Canada with the prevalence over 12 months of 4.7% and a lifetime prevalence of 11.3%. Attention
deficit disorder has a prevalence over 12 months of 2.6%. Bipolar disorder has a prevalence over 12
months of 1.5% and 2.6% of lifetime prevalence. Schizophrenia and psychosis have a prevalence over
12 months of 1.3%.
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