MULTIPLE CHOICE
1. A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice T T T T T T T
nurse to perform which additional intervention?
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a. Conduct mental health assessments. T T T c. Establish therapeutic relationships. T T
b. Prescribe psychotropic medication. T T d. Individualize nursing care plans. T T T
ANS: B T
In most states, prescriptive privileges are granted to masters-prepared nurse practitioners who have taken
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special courses on prescribing medication. The nurse prepared at the basic level is permitted to perform
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mental health assessments, establish relationships, and provide individualized care planning.
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PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
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REF: 15 TOP: Nursing Process: Implementation
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MSC: Client Needs: Safe, Effective Care Environment
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2. When a nursing student expresses concerns about how mental health nurses lose all their nursing skills,
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thebest response by the mental health nurse is:
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a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios
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must be better because of the nature of the patients problems.
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b. Psychiatric nurses use complex communication skills as well as critical thinking to
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solve multidimensional problems. I am challenged by those situations.
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c. Thats a misconception. Psychiatric nurses frequently use high technology monitoring equipment
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andmanage complex intravenous therapies.
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d. Psychiatric nurses do not have to deal with as much pain and suffering as medical-surgical nurses
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do. That appeals to me.
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ANS: B T
The practice of psychiatric nursing requires a different set of skills than medical-surgical nursing, though
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there is substantial overlap. Psychiatric nurses must be able to help patients with medical as well as mental health
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problems, reflecting the holistic perspective these nurses must have. Nurse-patient ratios and workloads in
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psychiatric settings have increased, just like other specialties. Psychiatric nursing involves clinical practice,
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not just documentation. Psychosocial pain and suffering are as real as physical pain and suffering.
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PTS: 1 DIF: Cognitive Level: Apply (Application)
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REF: 10 TOP: Nursing Process: Implementation
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MSC: Client Needs: Safe, Effective Care
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Environment
3. When a new bill introduced in Congress reduces funding for care of persons with mental illness, a group of
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,nurses writes letters to their elected representatives in opposition to the legislation. Which role have the nurses
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fulfilled?
a. Recovery c. Advocacy
b. Attending d. Evidence-based practice T T
ANS: C T
An advocate defends or asserts anothers cause, particularly when the other person lacks the ability to do
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that for self. Examples of individual advocacy include helping patients understand their rights or make
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decisions. On a community scale, advocacy includes political activity, public speaking, and publication in
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the interest of improving the human condition. Since funding is necessary to deliver quality programming
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for persons with mental illness, the letter- writing campaign advocates for that cause on behalf of
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patients who are unable to articulate their own needs.
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PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
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REF: 16 TOP: Nursing Process: Implementation
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MSC: Client Needs: Safe, Effective Care Environment
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4. Which comment best indicates that a patient perceived the nurse was caring? My nurse:
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a. always asks me which type of juice I want to help me swallow my medication.
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b. explained my treatment plan to me and asked for my ideas about how to make it better.
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c. spends time listening to me talk about my problems. That helps me feel like I am not alone.
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d. told me that if I take all the medicines the doctor prescribes, then I will get discharged sooner.
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ANS: C T
Caring evidences empathetic understanding as well as competency. It helps change pain and suffering into a
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shared experience, creating a human connection that alleviates feelings of isolation. The distracters give
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examples of statements that demonstrate advocacy or giving advice.
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PTS: 1 DIF: Cognitive Level: Apply (Application)
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REF: 7 TOP: Nursing Process: Evaluation
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MSC: Client Needs: Psychosocial Integrity
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5. Which assessment finding most clearly indicates that a patient may be experiencing a mental illness? The
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patient:
a. reports occasional sleeplessness and anxiety.
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b. reports a consistently sad, discouraged, and hopeless mood.
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c. is able to describe the difference between as if and for real.
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,d. perceives difficulty making a decision about whether to change jobs.
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ANS: B T
The correct response describes a mood alteration, which reflects mental illness. The distracters describe
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behaviors that are mentally healthy or within the usual scope of human experience.
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PTS: 1 DIF: Cognitive Level: Apply (Application)
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REF: 2 TOP: Nursing Process: Assessment
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MSC: Client Needs: Psychosocial Integrity
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6. Which finding best indicates that the goal Demonstrate mentally healthy behavior was achieved? A patient:
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a. sees self as capable of achieving ideals and meeting demands.
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b. behaves without considering the consequences of personal actions.
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c. aggressively meets own needs without considering the rights of others.
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d. seeks help from others when assuming responsibility for major areas of own life.
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ANS: A T
The correct response describes an adaptive, healthy behavior. The distracters describe maladaptive behaviors.
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PTS: 1 DIF: Cognitive Level: Apply (Application)
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REF: 2 TOP: Nursing Process: Evaluation
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MSC: Client Needs: Psychosocial Integrity
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7. A nurse encounters an unfamiliar psychiatric disorder on a new patients admission form. Which
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resource should the nurse consult to determine criteria used to establish this diagnosis?
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a. International Statistical Classification of Diseases and Related Health Problems (ICD-10)
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b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
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c. A behavioral health reference manual
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d. Wikipedia T
ANS: B T
The DSM-5 gives the criteria used to diagnose each mental disorder. The distracters may not contain diagnostic
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criteria for a psychiatric illness.
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PTS: 1 DIF: Cognitive Level: Apply (Application)
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, REF: 3 TOP: Nursing Process: Assessment
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MSC: Client Needs: Safe, Effective Care Environment
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8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would
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have the most complete information?
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a. Nursing Outcomes Classification (NOC)
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b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
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c. The ANAs Psychiatric-Mental Health Nursing Scope and Standards of Practice
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d. International Statistical Classification of Diseases and Related Health Problems (ICD-10)
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ANS: B T
The DSM-5 details the diagnostic criteria for psychiatric clinical conditions. The other references are good
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resources but do not define the diagnostic criteria.
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PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
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REF: 10 TOP: Nursing Process: Implementation
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MSC: Client Needs: Safe, Effective Care Environment
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9. Which individual is demonstrating the highest level of resilience? One who:
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a. is able to repress stressors.
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b. becomes depressed after the death of a spouse.
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c. lives in a shelter for two years after the home is destroyed by fire.
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d. takes a temporary job to maintain financial stability after loss of a permanent job.
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ANS: D T
Resilience is closely associated with the process of adapting and helps people facing tragedies, loss,
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trauma, and severe stress. It is the ability and capacity for people to secure the resources they need to support
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their well-being. Repression and depression are unhealthy. Living in a shelter for two years shows a failure
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to move forward after a tragedy. See related audience response question.
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PTS: 1 DIF: Cognitive Level: Apply (Application)
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REF: 3 TOP: Nursing Process: Assessment
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MSC: Client Needs: Psychosocial Integrity
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10. Complete this analogy. NANDA: clinical judgment: NIC:
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a. patient outcomes T c. diagnosis
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