,Fortinash: Psychiatric Mental Health Nursing, 5th Edition Chapter 01:
m m m m m m m m
Psychiatric Nursing: Theory, Principles, and Trends
m m m m m m
MULTIPLECHOICE
1. Which understanding is the basis for the nursing actions focused on minimizing
m m m m m m m m m m m
mental health promotion of families with chronically mentally ill
m m m m m m m m m
mmembers?
a Family members are at an increased risk for mental illness.
m m m m m m m m m
b. The mental health care system is not prepared to deal with family crises.
m m m m m m m m m m m m
c. Family members are seldom prepared to cope with a chronically ill
m m m m m m m m m m
individual.
m
d. The chronically mentally ill receive care best when delivered in a formal
m m m m m m m m m m m
setting.
m
ANS: A m
v m v m
When families live with a dominant member who has a persistent and severe
m m m m m m m m m m m m
m mental disorder the outcomes are often expressed as family members who are at increased riskfor
m m m m m m m m m m m m m m v
mphysical and mental illnesses. The remaining options are not necessarily true.
m m m m m m m m m m
DIF: Cognitive Level: Application REF: Page 3 m m m
2. Which nursing activity shows the nurse actively engaged in the primary prevention
m m m m m m m m m m m
ofmental disorders?
m m
a Providing a patient, whose m m m m depression is m m well m managed, m with
medication on tim
m m m
b. Making regular follow-up visitsto a new mother at risk for post-partum
m m m m m m m m m m m
depression
m
c. Providingthefamily ofapatient,diagnosedwithdepression,information on suicide
m m m m m m m m m m m
prevention
m
d. Assistingapatientwhohas obsessivecompulsivetendenciesprepareand practice for
m m m m m m m m m
a job interview
m m m
ANS: B
Primary prevention helps toreduce the occurrence of mental disorders bystaying
m m m m m m m m m m m
involvedwitha patient. Providingmedicationand informationon existingillnesses are
m m m m m m m m m m m m
examples of secondary prevention which helps to reduce the prevalence of mental
m m m m m m m m m m m m
disorders. Assisting a mentally ill patient with preparation for a job interview is tertiary
m m m m m m m m m m m m m m
prevention since it involves rehabilitation.
m m m m m
DIF: Cognitive Level: Application REF: Page 4 m m m
3. Whichinterventionreflects attention beingfocusedon thepatient’s intentions
m m m m m m m m m
regarding his diagnosis of severe depression?
m m m m m m
a Being placed on suicide precautions
m m m m
b. Encouraging visits m m by his family members
m m m
c. Receiving a combination of m m m m m medications m m to address m m m m his m emotional m needs
d. Being asked to decide where he will attend his prescribed therapy
m m m m m m m m m m
sessions
m
ANS: D m v m
A primary factor in patient treatment includes consideration of thepatient’s intentions regarding his
m m m m m m m m m m m m m
m or her own care. Patients are central to the process that determines their care as
m m m m m m m m m m m m m m
mtheir abilities allow. Under the guidance of PMH nurses and other mental health
m m m m m m m m m m m m
mpersonnel, patients are encouraged to make decisions and to actively engage
m m m m m m m m m m
m in their own treatment plans to meet their needs. The remaining options are focused
m m m m m m m m m m m m m
on
mspecificsof the determined plan of care. m m m m m
DIF: Cognitive Level: Application REF: Page 5 m m m
,4. Whenapatient’sfamily askswhytheirchronically mentallyilladultchildis being
m m m m m m m m m m m m
discharged to a community-based living facility, the nurse responds:
m m m m m m m m m
a “It is a way to meet the need for social support.”
m m m m m m m m m m
b. “It is too expensive to keep stabilized patients in acute care settings.”
m m m m m m m m m m m
c. “This type of facility will provide the specialized care that is needed.”
m m m m m m m m m m m
d. “Being out in the community will help provide hope and purpose for
m m m m m m m m m m m
living.” m
ANS: D m v m
Hospitalizationmay be necessary foracute care, but, when patients are stabilized, they
m m m m m m m m m m m m
move into community-based, patient-centered settings or are discharged home with
m m m m m m m m m m
continued outpatient treatment in the community. Concentrated efforts are made to
m m m m m m m m m m m
reduce the patient’s sick role by providing opportunities forthe development of a
m m m m m m m m m m m m m
purposeful life and instilling hope for each patient’s future. Although social support is
m m m m m m m m m m m m m
important, such aliving arrangement isnotthe only waytoachieve it.Although acute
m m m m m m m m m m m m m m m
care is expensive, it is not the major concern when determining long-term care options.
m m m m m m m m m m m m m m
Community-based facilities are not the only option for specialized care. DIF: m m m m m m m m m m
Cognitive Level: Application
m REF: Page 5 m m m
5. What is the best explanation to offer when the mother of a chronically ill
m m m m m m m m m m m m m
teenage patient asks, “Underwhatcircumstances wouldhebeconsideredincompetent?”
m m m m m m m m m m m
a. “When youcanprovidethe courtwithenough evidence toshowthat he is notable to
m m m m m m m m m m m m m m m m
care for himself safely.”
m m m m
b. “It is not likely that someone his age would be determined to be
m m m m m m m m m m m m
incompetent regardless of his mental condition.”
m m m m m m
c. “He would have to engage in behavior that would result in harm to himself
m m m m m m m m m m m m m
or to someone else; like you or his siblings.”
m m m m m m m m m
d. “If the illness becomes so severe that his judgment is impaired to the point
m m re m m m m m m m m m m m
whe the decisions he makes are harmful to himself or to others.”
m m m m m m m m m m m m
ANS: D m v m
Whenapersonis unable to cognitively process information or to make decisions
m m m m m m m m m m m m
about his or her own welfare, the person may be determined to be mentally
m m m m m m m m m m m m m m
incompetent.
m
Providing self-care is not the only criteria considered. Age is not a factor considered. The
m m m m m m m m m m m m m m
decision is often based on the potential for such behavior.
m m m m m m m m m m
DIF: Cognitive Level: Application REF: Page 6 m m m
6. Which psychiatric m m m nursing intervention m m shows an understanding m m m of integrated care?
m m
a. A chronically abused
m m m m woman m is m assessed for m m anxiety.
b. A manic patient is taken to the gym to use the exercise equipment.
m m m m m m m m m m m m
c. The older adult diagnosed with depression is monitored for suicidal
m m m m m m m m m
ideations.
s.
m
d. A teenager who refuses to obey the unit’s rules is not allow to play
m m m m m m m m m m m m m
The video
majority of health disciplines now recognize that mental disorders and
m
ANS:
m m m m m m m m m m
physical illnesses are closely linked. The presence of a mental disorder increases
m
v m v
A
m m m m m m m m m m m m
the risk for the development of physical illnesses andvice versa.
m
m m m m m m m m m
Assessing achronically abused individual for m m m
manxiety call should attention to the psychiatric disorder that could developfromthe
m m m m m m m m m m m m
abuse. The remaining options showinterventions that areappropriate for the mental
m m m m m m m m m m m m
disorder.
m
DIF: Cognitive Level: Application REF: Page 6 m m m
7. What reason does the nurse give the patient for the emphasis
m m m m m m m m m m m and attention m
mbeing
, paid to the recovery phase of their treatment plan?
m m m m m m m m
a Recovery care, evenwhenintensive, is less expensivethan acute psychiatric care.
m m m m m m m m m m m
b. Effectiverecoverycareislikelytoresultinfewerrelapsesandsubsequent hospitalizations.
m m m m m m m m m m m m
c. Planning for recovery care is time consuming and involves dealing with many complicated
m m m m m m m m m m m m
details. m
d. Recovery care is usually done on an outpatient basis and so is generally better accepted by
m m m m m m m m m m m m m m m
patients. m
ANS: B
Much attention is paid to recovery care since effective recovery care helps improve
m m m m m m m m m
patient outcomes and thus minimize subsequent hospitalizations. Recovery care is not necessarily
m m m m m m m m m m m m
less expensive than acute care. Although effective recovery care planning may be
m m m m m m m
time consuming and detail oriented, that is not the reason for implementing it.
m m m m m m m m m m m m
Recovery care is not necessarily well accepted by patients.
m m m m m m m m m
DIF: Cognitive Level: Application REF: Page 7 m m m
8. The nurse is attending a neighborhood meeting where a half-way
m m m m m m m m m
house is being proposed for the neighborhood when a member of the
m m m m m m m m m m m m
community states,
m m
“Wedon’twant the facility; we especially don’t want violent people living near us.”
m m m m m m m m m m m m
The response by the nurse that best addresses the public’s concern is:
m m m m m m m m m m m
a. “In truth,most individuals with psychiatric disorderare passive and withdrawn
m m m m m m m m m m
and pose little threat to those around them.”
m m m m m m m m
b. “Thementally illseldom behave in themannerthey areportrayed by movies;
m m m m m m m m m m m m
they are people just like the rest of us.”
m m m m m m m m m
c. “Patients with psychiatric disorder are so well medicated that they do not
m m m m m m m m m m m y
displa violentbehaviors.”
m m m
d. “The mentally ill deserve a safe, comfortable place to live among people
m m m m m m m m m m m
who truly care for them.”
m m m m m
ANS: A m
v m v m
A major reason for the existence of the stigma placed on persons with mental
m m m m m m m m m m m m m
m illness islackof knowledge. The main fear is of violence, although only asmall
m m m m m m m m m m m m m m
m percentage of patients with mental illness display this behavior. Providing the public with
m m m m m m m m m m m m
m accurate
informationcanhelp reduce stigma.The remaining options donot directlyaddress theconcerns
m m m m m m m m m m m m m
mstated.
DIF: Cognitive Level: Application REF: Pages 13-14 m m
9. Which activity shows that a therapeutic alliance has been established between
m m m m m m m m m m
thenurse and patient?
m m m
a. The nurserespects thepatient’sright to privacy when visitors are spending tim
m m m m m m m m m m m m e
with the patient.
m m m
b. The patient is eagerly attending all group sessions and working independently
m m m m m m m m m m n
m
oidentifying their personal stressors.
m m m m
c. The patient is freely describing their feelings related to the physical and
m m m m m m m m m m m
emotional trauma they experienced as a child with the nurse.
m m m m m m m m m m
d. The nurse dutifully administers thepatient’s medications on time and withappropriate
m m m m m m m m m m m
knowledge of the potential side effects.
m m m m m m
ANS: C m
v m v m
A primary aspect of working with patients in any setting and particularly in the
m m m m m m m m m m m m m
m m m m m m m m
Psychiatric Nursing: Theory, Principles, and Trends
m m m m m m
MULTIPLECHOICE
1. Which understanding is the basis for the nursing actions focused on minimizing
m m m m m m m m m m m
mental health promotion of families with chronically mentally ill
m m m m m m m m m
mmembers?
a Family members are at an increased risk for mental illness.
m m m m m m m m m
b. The mental health care system is not prepared to deal with family crises.
m m m m m m m m m m m m
c. Family members are seldom prepared to cope with a chronically ill
m m m m m m m m m m
individual.
m
d. The chronically mentally ill receive care best when delivered in a formal
m m m m m m m m m m m
setting.
m
ANS: A m
v m v m
When families live with a dominant member who has a persistent and severe
m m m m m m m m m m m m
m mental disorder the outcomes are often expressed as family members who are at increased riskfor
m m m m m m m m m m m m m m v
mphysical and mental illnesses. The remaining options are not necessarily true.
m m m m m m m m m m
DIF: Cognitive Level: Application REF: Page 3 m m m
2. Which nursing activity shows the nurse actively engaged in the primary prevention
m m m m m m m m m m m
ofmental disorders?
m m
a Providing a patient, whose m m m m depression is m m well m managed, m with
medication on tim
m m m
b. Making regular follow-up visitsto a new mother at risk for post-partum
m m m m m m m m m m m
depression
m
c. Providingthefamily ofapatient,diagnosedwithdepression,information on suicide
m m m m m m m m m m m
prevention
m
d. Assistingapatientwhohas obsessivecompulsivetendenciesprepareand practice for
m m m m m m m m m
a job interview
m m m
ANS: B
Primary prevention helps toreduce the occurrence of mental disorders bystaying
m m m m m m m m m m m
involvedwitha patient. Providingmedicationand informationon existingillnesses are
m m m m m m m m m m m m
examples of secondary prevention which helps to reduce the prevalence of mental
m m m m m m m m m m m m
disorders. Assisting a mentally ill patient with preparation for a job interview is tertiary
m m m m m m m m m m m m m m
prevention since it involves rehabilitation.
m m m m m
DIF: Cognitive Level: Application REF: Page 4 m m m
3. Whichinterventionreflects attention beingfocusedon thepatient’s intentions
m m m m m m m m m
regarding his diagnosis of severe depression?
m m m m m m
a Being placed on suicide precautions
m m m m
b. Encouraging visits m m by his family members
m m m
c. Receiving a combination of m m m m m medications m m to address m m m m his m emotional m needs
d. Being asked to decide where he will attend his prescribed therapy
m m m m m m m m m m
sessions
m
ANS: D m v m
A primary factor in patient treatment includes consideration of thepatient’s intentions regarding his
m m m m m m m m m m m m m
m or her own care. Patients are central to the process that determines their care as
m m m m m m m m m m m m m m
mtheir abilities allow. Under the guidance of PMH nurses and other mental health
m m m m m m m m m m m m
mpersonnel, patients are encouraged to make decisions and to actively engage
m m m m m m m m m m
m in their own treatment plans to meet their needs. The remaining options are focused
m m m m m m m m m m m m m
on
mspecificsof the determined plan of care. m m m m m
DIF: Cognitive Level: Application REF: Page 5 m m m
,4. Whenapatient’sfamily askswhytheirchronically mentallyilladultchildis being
m m m m m m m m m m m m
discharged to a community-based living facility, the nurse responds:
m m m m m m m m m
a “It is a way to meet the need for social support.”
m m m m m m m m m m
b. “It is too expensive to keep stabilized patients in acute care settings.”
m m m m m m m m m m m
c. “This type of facility will provide the specialized care that is needed.”
m m m m m m m m m m m
d. “Being out in the community will help provide hope and purpose for
m m m m m m m m m m m
living.” m
ANS: D m v m
Hospitalizationmay be necessary foracute care, but, when patients are stabilized, they
m m m m m m m m m m m m
move into community-based, patient-centered settings or are discharged home with
m m m m m m m m m m
continued outpatient treatment in the community. Concentrated efforts are made to
m m m m m m m m m m m
reduce the patient’s sick role by providing opportunities forthe development of a
m m m m m m m m m m m m m
purposeful life and instilling hope for each patient’s future. Although social support is
m m m m m m m m m m m m m
important, such aliving arrangement isnotthe only waytoachieve it.Although acute
m m m m m m m m m m m m m m m
care is expensive, it is not the major concern when determining long-term care options.
m m m m m m m m m m m m m m
Community-based facilities are not the only option for specialized care. DIF: m m m m m m m m m m
Cognitive Level: Application
m REF: Page 5 m m m
5. What is the best explanation to offer when the mother of a chronically ill
m m m m m m m m m m m m m
teenage patient asks, “Underwhatcircumstances wouldhebeconsideredincompetent?”
m m m m m m m m m m m
a. “When youcanprovidethe courtwithenough evidence toshowthat he is notable to
m m m m m m m m m m m m m m m m
care for himself safely.”
m m m m
b. “It is not likely that someone his age would be determined to be
m m m m m m m m m m m m
incompetent regardless of his mental condition.”
m m m m m m
c. “He would have to engage in behavior that would result in harm to himself
m m m m m m m m m m m m m
or to someone else; like you or his siblings.”
m m m m m m m m m
d. “If the illness becomes so severe that his judgment is impaired to the point
m m re m m m m m m m m m m m
whe the decisions he makes are harmful to himself or to others.”
m m m m m m m m m m m m
ANS: D m v m
Whenapersonis unable to cognitively process information or to make decisions
m m m m m m m m m m m m
about his or her own welfare, the person may be determined to be mentally
m m m m m m m m m m m m m m
incompetent.
m
Providing self-care is not the only criteria considered. Age is not a factor considered. The
m m m m m m m m m m m m m m
decision is often based on the potential for such behavior.
m m m m m m m m m m
DIF: Cognitive Level: Application REF: Page 6 m m m
6. Which psychiatric m m m nursing intervention m m shows an understanding m m m of integrated care?
m m
a. A chronically abused
m m m m woman m is m assessed for m m anxiety.
b. A manic patient is taken to the gym to use the exercise equipment.
m m m m m m m m m m m m
c. The older adult diagnosed with depression is monitored for suicidal
m m m m m m m m m
ideations.
s.
m
d. A teenager who refuses to obey the unit’s rules is not allow to play
m m m m m m m m m m m m m
The video
majority of health disciplines now recognize that mental disorders and
m
ANS:
m m m m m m m m m m
physical illnesses are closely linked. The presence of a mental disorder increases
m
v m v
A
m m m m m m m m m m m m
the risk for the development of physical illnesses andvice versa.
m
m m m m m m m m m
Assessing achronically abused individual for m m m
manxiety call should attention to the psychiatric disorder that could developfromthe
m m m m m m m m m m m m
abuse. The remaining options showinterventions that areappropriate for the mental
m m m m m m m m m m m m
disorder.
m
DIF: Cognitive Level: Application REF: Page 6 m m m
7. What reason does the nurse give the patient for the emphasis
m m m m m m m m m m m and attention m
mbeing
, paid to the recovery phase of their treatment plan?
m m m m m m m m
a Recovery care, evenwhenintensive, is less expensivethan acute psychiatric care.
m m m m m m m m m m m
b. Effectiverecoverycareislikelytoresultinfewerrelapsesandsubsequent hospitalizations.
m m m m m m m m m m m m
c. Planning for recovery care is time consuming and involves dealing with many complicated
m m m m m m m m m m m m
details. m
d. Recovery care is usually done on an outpatient basis and so is generally better accepted by
m m m m m m m m m m m m m m m
patients. m
ANS: B
Much attention is paid to recovery care since effective recovery care helps improve
m m m m m m m m m
patient outcomes and thus minimize subsequent hospitalizations. Recovery care is not necessarily
m m m m m m m m m m m m
less expensive than acute care. Although effective recovery care planning may be
m m m m m m m
time consuming and detail oriented, that is not the reason for implementing it.
m m m m m m m m m m m m
Recovery care is not necessarily well accepted by patients.
m m m m m m m m m
DIF: Cognitive Level: Application REF: Page 7 m m m
8. The nurse is attending a neighborhood meeting where a half-way
m m m m m m m m m
house is being proposed for the neighborhood when a member of the
m m m m m m m m m m m m
community states,
m m
“Wedon’twant the facility; we especially don’t want violent people living near us.”
m m m m m m m m m m m m
The response by the nurse that best addresses the public’s concern is:
m m m m m m m m m m m
a. “In truth,most individuals with psychiatric disorderare passive and withdrawn
m m m m m m m m m m
and pose little threat to those around them.”
m m m m m m m m
b. “Thementally illseldom behave in themannerthey areportrayed by movies;
m m m m m m m m m m m m
they are people just like the rest of us.”
m m m m m m m m m
c. “Patients with psychiatric disorder are so well medicated that they do not
m m m m m m m m m m m y
displa violentbehaviors.”
m m m
d. “The mentally ill deserve a safe, comfortable place to live among people
m m m m m m m m m m m
who truly care for them.”
m m m m m
ANS: A m
v m v m
A major reason for the existence of the stigma placed on persons with mental
m m m m m m m m m m m m m
m illness islackof knowledge. The main fear is of violence, although only asmall
m m m m m m m m m m m m m m
m percentage of patients with mental illness display this behavior. Providing the public with
m m m m m m m m m m m m
m accurate
informationcanhelp reduce stigma.The remaining options donot directlyaddress theconcerns
m m m m m m m m m m m m m
mstated.
DIF: Cognitive Level: Application REF: Pages 13-14 m m
9. Which activity shows that a therapeutic alliance has been established between
m m m m m m m m m m
thenurse and patient?
m m m
a. The nurserespects thepatient’sright to privacy when visitors are spending tim
m m m m m m m m m m m m e
with the patient.
m m m
b. The patient is eagerly attending all group sessions and working independently
m m m m m m m m m m n
m
oidentifying their personal stressors.
m m m m
c. The patient is freely describing their feelings related to the physical and
m m m m m m m m m m m
emotional trauma they experienced as a child with the nurse.
m m m m m m m m m m
d. The nurse dutifully administers thepatient’s medications on time and withappropriate
m m m m m m m m m m m
knowledge of the potential side effects.
m m m m m m
ANS: C m
v m v m
A primary aspect of working with patients in any setting and particularly in the
m m m m m m m m m m m m m
