Test Bank - Psychiatric Mental Health Nursing by Mary
Townsend (9th Edition, 2017)
TEST BANK
,Chapter 01. The Concept of Stress Adaptation
Multiple Choice
1. A client has experienced the death of a close family member and at the same time becomes unemployed.
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This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should
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the nurse evaluate this client data?
T T T T T
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
T T T T T T T T T T T T T T
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of
T T T T T T T T T T T T T T T T T T
stress-related illness. T
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of
T T T T T T T T T T T T T
coping resources and available supports.
T T T T
D. The client may view these losses as challenges and perceive them as opportunities.
T T T T T T T T T T T T
ANS: C T
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the
T T T T T T T T T T T T T T T T T
Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of
T T T T T T T T T T T T T T T T T
500 or more, indicates high stress in a clients life. However, positive coping mechanisms and strong social
T T T T T T T T T T T T T T T T T
support can limit susceptibility to stress-related illnesses.
T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a
T T T T T T T T T T T T T T T T T T T T
nurse: Perhaps this was the best thing to happen.
T Maybe Ill look into pursuing an art degree. How should the
NURSINGTB.COM T T T T T T T T T T T T T T T T T T
nurse characterize the clients appraisal of the job loss stressor?
T T T T T T T T
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
ANS: D T
The client perceives the situation of job loss as a challenge and an opportunity for growth.
T T T T T T T T T T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
T T T T T T T T T T T T T T T
A. Ive found that avoiding contact with others helps me cope.
T T T T T T T T T
B. I really enjoy journaling; its my private time.
T T T T T T T
C. I signed up for a yoga class this week.
T T T T T T T T
D. I made an appointment to meet with a therapist.
T T T T T T T T
ANS: A T
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent
T T T T T T T T T T T T T T T T T T
learning appropriate coping skills and can prevent access to needed support systems.
T T T T T T T T T T T
,KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
4. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When
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this occurs, which stage of stress is the student most likely experiencing?
T T T T T T T T T T T
A. Alarm reaction stage T T
B. Stage of resistance T T
C. Stage of exhaustion T T
D. Fight-or-flight stage T
ANS: C T
At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy has been
T T T T T T T T T T T T T T T T T T
depleted. Diseases of adaptation occur more frequently in this stage.
T T T T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The
T T T T T T T T T T T T T T T T T T
clients mother states, Thats not something to be stressed about! Which is the most appropriate nursing
T T T T T T T T T T T T T T T T
response?
A. Teenagers! They dont know a thing about real stress. T T T T T T T T
B. Stress occurs only when there is a loss.
T T T T T T T
C. When you are in poor physical condition, yNoU
T uRcaSnIN
t eGxTpBer.C
T ieOncMe psychological well-being.
T T T T T T T T T
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
T T T T T T T T T T T T T
ANS: D T
Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a
T T T T T T T T T T T T T T T T T T T
physiological change. T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
6. A bright student confides in the school nurse about conflicts related to attending college or working to add
T T T T T T T T T T T T T T T T T T
needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend
T T T T T T T T T T T T T T T T T
to the student at this time?
T T T T T
A. Meditation
B. Problem-solving training T
C. Relaxation
D. Journaling
ANS: B T
The student must assess his or her situation and determine the best course of action. Problem-solving training,
T T T T T T T T T T T T T T T T T
by providing structure and objectivity, can assist in decision making.
T T T T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
, 7. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has
T T T T T T T T T T T T T T T T
difficulty with independent problem-solving. During a routine physical examination, the graduate confides in
T T T T T T T T T T T T T
the clinic nurse. Which is the most appropriate nursing intervention?
T T T T T T T T T
A. Encourage the student to use the alternative coping mechanism of relaxation exercises.
T T T T T T T T T T T
B. Complete the problem-solving process for the client.T T T T T T
C. Work through the problem-solving process with the client.
T T T T T T T
D. Encourage the client to keep a journal. T T T T T T
ANS: C T
During times of high anxiety and stress, clients will need more assistance in problem-solving and decision
T T T T T T T T T T T T T T T T
making.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
8. A school nurse is assessing a distraught female high school student who is overly concerned because her
T T T T T T T T T T T T T T T T T
parents cant afford horseback riding lessons. How should the nurse interpret the students reaction to her
T T T T T T T T T T T T T T T T
perceived problem? T
A. The problem is endangering her well-being.
T T T T T
B. The problem is personally relevant to her.
T T T T T T
C. The problem is based on immaturity.
T T T T T
D. The problem is exceeding her capacity to cN
T opUeR.SINGTB.COM T T T T T T T
ANS: B T
Psychological stressors to self-esteem and self-image are related to how the individual perceives the situation or
T T T T T T T T T T T T T T T T
event. Self-image is of particular importance to adolescents, who feel entitled to have all the advantages that
T T T T T T T T T T T T T T T T T
other adolescents experience.
T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
9. Meditation has been shown to be an effective stress management technique. When meditation is effective,
T T T T T T T T T T T T T T T
what should a nurse expect to assess?
T T T T T T
A. An achieved state of relaxation
T T T T
B. An achieved insight into ones feelings
T T T T T
C. A demonstration of appropriate role behaviors
T T T T T
D. An enhanced ability to problem-solve
T T T T
ANS: A T
Meditation produces relaxation by creating a special state of consciousness through focused concentration.
T T T T T T T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
10. A distraught, single, first-time mother cries and asks a nurse, How can I go to work if I cant afford
T T T T T T T T T T T T T T T T T T T T
childcare? What is the nurses initial action in assisting the client with the problem-solving process?
T T T T T T T T T T T T T T
Townsend (9th Edition, 2017)
TEST BANK
,Chapter 01. The Concept of Stress Adaptation
Multiple Choice
1. A client has experienced the death of a close family member and at the same time becomes unemployed.
T T T T T T T T T T T T T T T T T
This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should
T T T T T T T T T T T T T T T T T T
the nurse evaluate this client data?
T T T T T
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
T T T T T T T T T T T T T T
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of
T T T T T T T T T T T T T T T T T T
stress-related illness. T
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of
T T T T T T T T T T T T T
coping resources and available supports.
T T T T
D. The client may view these losses as challenges and perceive them as opportunities.
T T T T T T T T T T T T
ANS: C T
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the
T T T T T T T T T T T T T T T T T
Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of
T T T T T T T T T T T T T T T T T
500 or more, indicates high stress in a clients life. However, positive coping mechanisms and strong social
T T T T T T T T T T T T T T T T T
support can limit susceptibility to stress-related illnesses.
T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a
T T T T T T T T T T T T T T T T T T T T
nurse: Perhaps this was the best thing to happen.
T Maybe Ill look into pursuing an art degree. How should the
NURSINGTB.COM T T T T T T T T T T T T T T T T T T
nurse characterize the clients appraisal of the job loss stressor?
T T T T T T T T
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
ANS: D T
The client perceives the situation of job loss as a challenge and an opportunity for growth.
T T T T T T T T T T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
T T T T T T T T T T T T T T T
A. Ive found that avoiding contact with others helps me cope.
T T T T T T T T T
B. I really enjoy journaling; its my private time.
T T T T T T T
C. I signed up for a yoga class this week.
T T T T T T T T
D. I made an appointment to meet with a therapist.
T T T T T T T T
ANS: A T
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent
T T T T T T T T T T T T T T T T T T
learning appropriate coping skills and can prevent access to needed support systems.
T T T T T T T T T T T
,KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
4. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When
T T T T T T T T T T T T T T T T T T T
this occurs, which stage of stress is the student most likely experiencing?
T T T T T T T T T T T
A. Alarm reaction stage T T
B. Stage of resistance T T
C. Stage of exhaustion T T
D. Fight-or-flight stage T
ANS: C T
At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy has been
T T T T T T T T T T T T T T T T T T
depleted. Diseases of adaptation occur more frequently in this stage.
T T T T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The
T T T T T T T T T T T T T T T T T T
clients mother states, Thats not something to be stressed about! Which is the most appropriate nursing
T T T T T T T T T T T T T T T T
response?
A. Teenagers! They dont know a thing about real stress. T T T T T T T T
B. Stress occurs only when there is a loss.
T T T T T T T
C. When you are in poor physical condition, yNoU
T uRcaSnIN
t eGxTpBer.C
T ieOncMe psychological well-being.
T T T T T T T T T
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
T T T T T T T T T T T T T
ANS: D T
Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a
T T T T T T T T T T T T T T T T T T T
physiological change. T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
6. A bright student confides in the school nurse about conflicts related to attending college or working to add
T T T T T T T T T T T T T T T T T T
needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend
T T T T T T T T T T T T T T T T T
to the student at this time?
T T T T T
A. Meditation
B. Problem-solving training T
C. Relaxation
D. Journaling
ANS: B T
The student must assess his or her situation and determine the best course of action. Problem-solving training,
T T T T T T T T T T T T T T T T T
by providing structure and objectivity, can assist in decision making.
T T T T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
, 7. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has
T T T T T T T T T T T T T T T T
difficulty with independent problem-solving. During a routine physical examination, the graduate confides in
T T T T T T T T T T T T T
the clinic nurse. Which is the most appropriate nursing intervention?
T T T T T T T T T
A. Encourage the student to use the alternative coping mechanism of relaxation exercises.
T T T T T T T T T T T
B. Complete the problem-solving process for the client.T T T T T T
C. Work through the problem-solving process with the client.
T T T T T T T
D. Encourage the client to keep a journal. T T T T T T
ANS: C T
During times of high anxiety and stress, clients will need more assistance in problem-solving and decision
T T T T T T T T T T T T T T T T
making.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
8. A school nurse is assessing a distraught female high school student who is overly concerned because her
T T T T T T T T T T T T T T T T T
parents cant afford horseback riding lessons. How should the nurse interpret the students reaction to her
T T T T T T T T T T T T T T T T
perceived problem? T
A. The problem is endangering her well-being.
T T T T T
B. The problem is personally relevant to her.
T T T T T T
C. The problem is based on immaturity.
T T T T T
D. The problem is exceeding her capacity to cN
T opUeR.SINGTB.COM T T T T T T T
ANS: B T
Psychological stressors to self-esteem and self-image are related to how the individual perceives the situation or
T T T T T T T T T T T T T T T T
event. Self-image is of particular importance to adolescents, who feel entitled to have all the advantages that
T T T T T T T T T T T T T T T T T
other adolescents experience.
T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
9. Meditation has been shown to be an effective stress management technique. When meditation is effective,
T T T T T T T T T T T T T T T
what should a nurse expect to assess?
T T T T T T
A. An achieved state of relaxation
T T T T
B. An achieved insight into ones feelings
T T T T T
C. A demonstration of appropriate role behaviors
T T T T T
D. An enhanced ability to problem-solve
T T T T
ANS: A T
Meditation produces relaxation by creating a special state of consciousness through focused concentration.
T T T T T T T T T T T T
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
T T T T T T T T T T T T
Psychosocial Integrity T
10. A distraught, single, first-time mother cries and asks a nurse, How can I go to work if I cant afford
T T T T T T T T T T T T T T T T T T T T
childcare? What is the nurses initial action in assisting the client with the problem-solving process?
T T T T T T T T T T T T T T
