Unit I Mental Health Test Bank (All
Answers
1.1 A client has experienced the death of a close family member and at the same time
becomes unemployed. This situation has resulted in a 6-month score of 110 on the
Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological
illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates
no significant threat of stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated
without knowledge of coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
- ANSWER: C
RATIONALE: the Recent Life Changes Questionnaire is an expanded version of the
Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating
Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates
high stress in a client's life. (However, positive coping mechanisms and strong social
support can limit susceptibility to stress-related illnesses.)
1.2. A physically and emotionally healthy client has just been fired. During a routine
office visit he states to a nurse: "Perhaps this was the best thing to happen. Maybe I'll
look into pursuing an art degree." How should the nurse characterize the client's
appraisal of the job loss stressor?
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging - ANSWER: D
RATIONALE: the client perceives the situation of job loss as a challenge and an
opportunity for growth.
1.3. Which client statement should alert a nurse that a client may be responding
maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist. - ANSWER: A
RATIONALE: Reliance on social isolation as a coping mechanism is a maladaptive
method to relieve stress. It can prevent learning appropriate coping skills and can
prevent access to needed support systems.
,1.4. A nursing student finds that she comes down with a sinus infection toward the end
of every semester. When this occurs, which stage of stress is the student most likely
experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage - ANSWER: C
RATIONALE: At the stage of
exhaustion, the student's exposure to stress has been prolonged and adaptive energy
has been depleted. Diseases of adaptation occur more frequently in this stage.
1.5. A school nurse is assessing a female high school student who is overly concerned
about her appearance. The clients mother states, That's not something to be stressed
about! Which is the most appropriate nursing response?
A. Teenagers! They don't know a thing about real stress.
B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, you cant experience psychological well-
being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
- ANSWER: D
RATIONALE: Stress can be physical or psychological in nature. A perceived threat to
self-esteem can be as stressful as a physiological change.
1.6. A bright student confides in the school nurse about conflicts related to attending
college or working to add needed financial support to the family. Which coping strategy
is most appropriate for the nurse to recommend to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling - ANSWER: B
RATIONALE: The student must assess his or her situation and determine the best
course of action. Problem-solving training, by providing structure and objectivity, can
assist in decision making.
1.7. An unemployed college graduate is experiencing severe anxiety over not finding a
teaching position and has difficulty with independent problem-solving. During a routine
physical examination, the graduate confides in the clinic nurse. Which is the most
appropriate nursing intervention?
A. Encourage the student to use the alternative coping mechanism of relaxation
exercises.
B. Complete the problem-solving process for the client.
C. Work through the problem-solving process with the client.
D. Encourage the client to keep a journal. - ANSWER: C
, RATIONALE: During times of high anxiety and stress, clients will need more assistance
in problem-solving and decision making.
1.8. A school nurse is assessing a distraught female high school student who is overly
concerned because her parents can't afford horseback riding lessons. How should the
nurse interpret the student's reaction to her perceived problem?
A. The problem is endangering her well-being.
B. The problem is personally relevant to her.
C. The problem is based on immaturity.
D. The problem is exceeding her capacity to cope. - ANSWER: B
RATIONALE: Psychological stressors to self-esteem and self-image are related to how
the individual perceives the situation or event. Self-image is of particular importance to
adolescents, who feel entitled to have all the advantages that other adolescents
experience.
1.9. Meditation has been shown to be an effective stress management technique. When
meditation is effective, what should a nurse expect to assess?
A. An achieved state of relaxation
B. An achieved insight into one's feelings
C. A demonstration of appropriate role behaviors
D. An enhanced ability to problem-solve - ANSWER: A
RATIONALE: Meditation produces relaxation by creating a special state of
consciousness through focused concentration.
10. A distraught, single, first-time mother cries and asks a nurse, "how can I go to work
if I can't afford childcare?" What is the nurse's initial action in assisting the client with the
problem-solving process?
A. Determine the risks and benefits for each alternative.
B. Formulate goals for resolution of the problem.
C. Evaluate the outcome of the implemented alternative.
D. Assess the facts of the situation. - ANSWER: D
RATIONALE: Before any other steps can be taken, accurate information about the
situation must be gathered and assessed.
1.11. A nursing instructor is asking students about diseases of adaptation and when
they are likely to occur. Which student response indicates that learning has occurred?
A. When an individual has limited experience dealing with stress
B. When an individual inherits maladaptive genes
C. When an individual experiences existing conditions that exacerbate stress
D. When an individual's physiological and psychological resources have become
depleted - ANSWER: D
Answers
1.1 A client has experienced the death of a close family member and at the same time
becomes unemployed. This situation has resulted in a 6-month score of 110 on the
Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological
illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates
no significant threat of stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated
without knowledge of coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
- ANSWER: C
RATIONALE: the Recent Life Changes Questionnaire is an expanded version of the
Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating
Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates
high stress in a client's life. (However, positive coping mechanisms and strong social
support can limit susceptibility to stress-related illnesses.)
1.2. A physically and emotionally healthy client has just been fired. During a routine
office visit he states to a nurse: "Perhaps this was the best thing to happen. Maybe I'll
look into pursuing an art degree." How should the nurse characterize the client's
appraisal of the job loss stressor?
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging - ANSWER: D
RATIONALE: the client perceives the situation of job loss as a challenge and an
opportunity for growth.
1.3. Which client statement should alert a nurse that a client may be responding
maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist. - ANSWER: A
RATIONALE: Reliance on social isolation as a coping mechanism is a maladaptive
method to relieve stress. It can prevent learning appropriate coping skills and can
prevent access to needed support systems.
,1.4. A nursing student finds that she comes down with a sinus infection toward the end
of every semester. When this occurs, which stage of stress is the student most likely
experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage - ANSWER: C
RATIONALE: At the stage of
exhaustion, the student's exposure to stress has been prolonged and adaptive energy
has been depleted. Diseases of adaptation occur more frequently in this stage.
1.5. A school nurse is assessing a female high school student who is overly concerned
about her appearance. The clients mother states, That's not something to be stressed
about! Which is the most appropriate nursing response?
A. Teenagers! They don't know a thing about real stress.
B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, you cant experience psychological well-
being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
- ANSWER: D
RATIONALE: Stress can be physical or psychological in nature. A perceived threat to
self-esteem can be as stressful as a physiological change.
1.6. A bright student confides in the school nurse about conflicts related to attending
college or working to add needed financial support to the family. Which coping strategy
is most appropriate for the nurse to recommend to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling - ANSWER: B
RATIONALE: The student must assess his or her situation and determine the best
course of action. Problem-solving training, by providing structure and objectivity, can
assist in decision making.
1.7. An unemployed college graduate is experiencing severe anxiety over not finding a
teaching position and has difficulty with independent problem-solving. During a routine
physical examination, the graduate confides in the clinic nurse. Which is the most
appropriate nursing intervention?
A. Encourage the student to use the alternative coping mechanism of relaxation
exercises.
B. Complete the problem-solving process for the client.
C. Work through the problem-solving process with the client.
D. Encourage the client to keep a journal. - ANSWER: C
, RATIONALE: During times of high anxiety and stress, clients will need more assistance
in problem-solving and decision making.
1.8. A school nurse is assessing a distraught female high school student who is overly
concerned because her parents can't afford horseback riding lessons. How should the
nurse interpret the student's reaction to her perceived problem?
A. The problem is endangering her well-being.
B. The problem is personally relevant to her.
C. The problem is based on immaturity.
D. The problem is exceeding her capacity to cope. - ANSWER: B
RATIONALE: Psychological stressors to self-esteem and self-image are related to how
the individual perceives the situation or event. Self-image is of particular importance to
adolescents, who feel entitled to have all the advantages that other adolescents
experience.
1.9. Meditation has been shown to be an effective stress management technique. When
meditation is effective, what should a nurse expect to assess?
A. An achieved state of relaxation
B. An achieved insight into one's feelings
C. A demonstration of appropriate role behaviors
D. An enhanced ability to problem-solve - ANSWER: A
RATIONALE: Meditation produces relaxation by creating a special state of
consciousness through focused concentration.
10. A distraught, single, first-time mother cries and asks a nurse, "how can I go to work
if I can't afford childcare?" What is the nurse's initial action in assisting the client with the
problem-solving process?
A. Determine the risks and benefits for each alternative.
B. Formulate goals for resolution of the problem.
C. Evaluate the outcome of the implemented alternative.
D. Assess the facts of the situation. - ANSWER: D
RATIONALE: Before any other steps can be taken, accurate information about the
situation must be gathered and assessed.
1.11. A nursing instructor is asking students about diseases of adaptation and when
they are likely to occur. Which student response indicates that learning has occurred?
A. When an individual has limited experience dealing with stress
B. When an individual inherits maladaptive genes
C. When an individual experiences existing conditions that exacerbate stress
D. When an individual's physiological and psychological resources have become
depleted - ANSWER: D
