Essentials of Psychiatric Mental Health Nursing 8th Edition Testbank

,Chapter 1. Mental Health and Mental vv vv vv vv vv




vv IllnessMultiple Choice vv




1. A nurse is assessing a client who is experiencing occasional feelings of sadness
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vv because of therecent death of a beloved pet. The clients appetite, sleep patterns,
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vv and daily routine have not changed. How should the nurse interpret the clients
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vv behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
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2. The clients behaviors are extensive, which indicates the presence of mental illness.
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3. The clients behaviors are not congruent with cultural norms.
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4. The clients behaviors demonstrate no functional impairment, indicating no mental
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illness.
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ANS: 4 vv




Rationale: The nurse should assess that the clients daily functioning is not impaired.
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vv The clientwho experiences feelings of sadness after the loss of a pet is responding
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vv within normal expectations. Without significant impairment, the clients distress does
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vv not indicate a mental illness.
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Cognitive Level: Analysis vv vv




vv Integrated Process: vv




Assessment

2. At what point should the nurse determine that a client is at risk for developing
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a mentalillness?
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1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
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,2. When maladaptive responses to stress are coupled with interference in daily
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functioning.
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3. When a client communicates significant distress.
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4. When a client uses defense mechanisms as ego protection.
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ANS: 2 vv




Rationale: The nurse should determine that the client is at risk for mental illness
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vv when responsesto stress are maladaptive and interfere with daily functioning. The
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vv DSM-5 indicates that in orderto be diagnosed with a mental illness, daily functioning
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vv must be significantly impaired. The clients ability to communicate distress would be
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vv considered a positive attribute. vv vv vv




Cognitive Level: Application vv vv




vv Integrated Process: vv




Assessment

3. A nurse is assessing a set of 15-year-old identical twins who respond very
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differently to stress.One twin becomes anxious and irritable, and the other
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vv withdraws and cries. How should the nurse explain these different stress responses
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vv to the parents?
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1. Reactions to stress are relative rather than absolute; individual responses to
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vv stress vary. vv




2. It is abnormal for identical twins to react differently to similar stressors.
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3. Identical twins should share the same temperament and respond similarly to stress.
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4. Environmental influences to stress weigh more heavily than genetic influences. vv vv vv vv vv vv vv vv vv

, ANS: 1 vv




Rationale: The nurse should explain to the parents that, although the twins have
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vv identical DNA,there are several other factors that affect reactions to stress. Mental
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vv health is a state of being thatis relative to the individual client. Environmental
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vv influences and temperament can affect stress reactions.
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Cognitive Level: Application vv vv




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Implementation

4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
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1. A Jewish, female social worker.
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2. A Baptist, homeless male.
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3. A Catholic, black male.
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4. A Protestant, Swedish business executive.
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ANS: 1 vv




Rationale: The nurse should anticipate that the client of Jewish culture would place a
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vv high importance on preventative health care and would consider mental health as
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vv equally important asphysical health. Women are also more likely to seek treatment for
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vv mental health problems than men.
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Cognitive Level: vv




ApplicationIntegrated
Process: Planning
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5. A psychiatric nurse intern states, This clients use of defense mechanisms should
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be eliminated.Which is a correct evaluation of this nurses statement?
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1. Defense mechanisms can be appropriate responses to stress and need not
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be eliminated.
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2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety
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vv and shouldalways be eliminated.
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3. Defense mechanisms, used by individuals with weak ego integrity, should be
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vv discouraged andnot eliminated. vv vv




4. Defense mechanisms cause disintegration of the ego and should be fostered and
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vv encouraged.

ANS: 1 vv