Test Bank For Davis Advantage for Townsend’s
b6 b6 b6 b6 b6 b6
b6 Essentials of Psychiatric Mental Health Nursing
b6 b6 b6 b6 b6
9th Edition Karyn Morgan
b6 b6 b6
Chapters 1 - 32 | Complete
b6 b6 b6 b6 b6 b6
,TABLE OF CONTENTS b6 b6
INTRODUCTION TO PSYCHIATRIC MENTAL HEALTH CONCEPTS b6 b6 b6 b6 b6
1. Mental Health and Mental Illness
b6 b6 b6 b6 b6
2. Biological Implications
b6 b6
3. Ethical and Legal Issues
b6 b6 b6 b6
4. Psychopharmacology
b6
II. PSYCHIATRIC MENTAL HEALTH NURSING INTERVENTIONS
b6 b6 b6 b6 b6
5. Relationship Development and Therapeutic Communication
b6 b6 b6 b6 b6
6. The Nursing Process in Psychiatric/Mental Health Nursing
b6 b6 b6 b6 b6 b6 b6
7. Psychosocial Interventions and Spiritual Care
b6 b6 b6 b6 b6
8. Intervention in Groups
b6 b6 b6
9. Crisis Intervention
b6 b6
10. The Recovery Model
b6 b6 b6
11. Suicide Prevention
b6 b6
III. CARE OF PATIENTS WITH PSYCHIATRIC DISORDERS
b6 b6 b6 b6 b6 b6
12. Caring for Patients with Mental Illness and Substance Use Disorders in General Practice Settings
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
13. Neurocognitive Disorders
b6 b6
14. Substance Use and Addiction Disorders
b6 b6 b6 b6 b6
15. Schizophrenia Spectrum and Other Psychotic Disorders
b6 b6 b6 b6 b6 b6
16. Depressive Disorders
b6 b6
17. Bipolar and Related Disorders
b6 b6 b6 b6
18. Anxiety, Obsessive-Compulsive, and Related Disorders
b6 b6 b6 b6 b6
19. Trauma- and Stressor-Related Disorders
b6 b6 b6 b6
20. Somatic Symptom and Dissociative Disorders
b6 b6 b6 b6 b6
21. Eating Disorders
b6 b6
22. Personality Disorders
b6 b6
IV. PSYCHIATRIC MENTAL HEALTH NURSING OF SPECIAL POPULATIONS
b6 b6 b6 b6 b6 b6 b6
23. Children and Adolescents
b6 b6 b6
24. The Aging Individual
b6 b6 b6
25. Survivors of Abuse or Neglect
b6 b6 b6 b6 b6
26. Community Mental Health Nursing
b6 b6 b6 b6
27. The Bereaved Individual
b6 b6 b6
28. Military Families
b6 b6
V. ONLINE CHAPTERS
b6 b6
29. Concepts of Personality Development
b6 b6 b6 b6
30. Complementary and Integrative Therapies
b6 b6 b6 b6
31. Cultural Concepts Relevant to Psychiatric Mental Health Nursing
b6 b6 b6 b6 b6 b6 b6 b6
32. Issues Related to Human Sexuality and Gender Dysphoria
b6 b6 b6 b6 b6 b6 b6 b6 b6
,Chapter 1. Mental Health and Mental b6 b6 b6 b6 b6
b6 IllnessMultiple Choice 6
b b6
1. A nurse is assessing a client who is experiencing occasional feelings of sadness because
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
of therecent death of a beloved pet. The clients appetite, sleep patterns, and daily routine
b6 b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
have not changed. How should the nurse interpret the clients behaviors?
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
1. The clients behaviors demonstrate mental illness in the form of depression.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. The clients behaviors are extensive, which indicates the presence of mental illness.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
3. The clients behaviors are not congruent with cultural norms.
b6 b6 b6 b6 b6 b6 b6 b6
4. The clients behaviors demonstrate no functional impairment, indicating no mental illness.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
ANSWER: 4 b6
Rationale: The nurse should assess that the clients daily functioning is not impaired. The
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
clientwho experiences feelings of sadness after the loss of a pet is responding within
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
normal expectations. Without significant impairment, the clients distress does not indicate a
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
mental illness.
b6 b6
Cognitive Level: Analysis b6 b6
Integrated Process:
b6 b6
Assessment
b6
2. At what point should the nurse determine that a client is at risk for developing a
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
mentalillness?
b6 6
b
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. When maladaptive responses to stress are coupled with interference in daily functioning.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
3. When a client communicates significant distress.
b6 b6 b6 b6 b6
4. When a client uses defense mechanisms as ego protection.
b6 b6 b6 b6 b6 b6 b6 b6
ANSWER: 2 b6
Rationale: The nurse should determine that the client is at risk for mental illness when
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
responsesto stress are maladaptive and interfere with daily functioning. The DSM-5
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
indicates that in orderto be diagnosed with a mental illness, daily functioning must be
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
significantly impaired. The clients ability to communicate distress would be considered a
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
positive attribute.
b6 b6
Cognitive Level: Application b6 b6
Integrated Process:
b6 b6
Assessment
b6
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently to
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
stress.One twin becomes anxious and irritable, and the other withdraws and cries. How
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
should the nurse explain these different stress responses to the parents?
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
1. Reactions to stress are relative rather than absolute; individual responses to stress vary.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. It is abnormal for identical twins to react differently to similar stressors.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
3. Identical twins should share the same temperament and respond similarly to stress.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
4. Environmental influences to stress weigh more heavily than genetic influences. b6 b6 b6 b6 b6 b6 b6 b6 b6
, ANSWER: 1 b6
Rationale: The nurse should explain to the parents that, although the twins have identical
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
DNA,there are several other factors that affect reactions to stress. Mental health is a state
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
of being thatis relative to the individual client. Environmental influences and temperament
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
can affect stress reactions.
b6 b6 b6 b6
Cognitive Level: Application b6 b6
Integrated Process:
b6 b6
Implementation
b6
4. Which client should the nurse anticipate to be most receptive to psychiatric
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
treatment?1. A Jewish, female social worker.
b6 b6 b6 b6 b6 b6 b6
2. A Baptist, homeless male.
b6 b6 b6
3. A Catholic, black male.
b6 b6 b6
4. A Protestant, Swedish business executive.
b6 b6 b6 b6
ANSWER: 1 b6
Rationale: The nurse should anticipate that the client of Jewish culture would place a high
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
importance on preventative health care and would consider mental health as equally
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
important asphysical health. Women are also more likely to seek treatment for mental
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
health problems than men.
b6 b6 b6 b6
Cognitive Level: b6
ApplicationIntegrated
b6 b6
Process: Planning
b6 b6
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
eliminated.Which is a correct evaluation of this nurses statement?
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
1. Defense mechanisms can be appropriate responses to stress and need not be eliminated.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
andshouldalways be eliminated.
b6 6
b b6 b6
3. Defense mechanisms, used by individuals with weak ego integrity, should be
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
discouragedandnot eliminated.
b6 b6 b6
4. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
ANSWER: 1 b6
Rationale: The nurse should determine that defense mechanisms can be appropriate during
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
timesof stress. The client with no defense mechanisms may have a lower tolerance for
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
stress, thus leading to anxiety disorders. Defense mechanisms should be confronted when
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
they impede the client from developing healthy coping skills.
b6 b6 b6 b6 b6 b6 b6 b6 b6
Cognitive Level: Application b6 b6
Integrated Process:
b6 b6
Evaluation
b6
6. During an intake assessment, a nurse asks both physiological and psychosocial questions.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
Theclient angrily responds, Im here for my heart, not my head problems. Which is the
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
nurses best response?
b6 b6 b6
1. Its just a routine part of our assessment. All clients are asked these same questions.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. Why are you concerned about these types of questions?
b6 b6 b6 b6 b6 b6 b6 b6
3. Psychological factors, like excessive stress, have been found to affect medical conditions.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
4. We can skip these questions, if you like. It isnt imperative that we complete this section.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
b6 b6 b6 b6 b6 b6
b6 Essentials of Psychiatric Mental Health Nursing
b6 b6 b6 b6 b6
9th Edition Karyn Morgan
b6 b6 b6
Chapters 1 - 32 | Complete
b6 b6 b6 b6 b6 b6
,TABLE OF CONTENTS b6 b6
INTRODUCTION TO PSYCHIATRIC MENTAL HEALTH CONCEPTS b6 b6 b6 b6 b6
1. Mental Health and Mental Illness
b6 b6 b6 b6 b6
2. Biological Implications
b6 b6
3. Ethical and Legal Issues
b6 b6 b6 b6
4. Psychopharmacology
b6
II. PSYCHIATRIC MENTAL HEALTH NURSING INTERVENTIONS
b6 b6 b6 b6 b6
5. Relationship Development and Therapeutic Communication
b6 b6 b6 b6 b6
6. The Nursing Process in Psychiatric/Mental Health Nursing
b6 b6 b6 b6 b6 b6 b6
7. Psychosocial Interventions and Spiritual Care
b6 b6 b6 b6 b6
8. Intervention in Groups
b6 b6 b6
9. Crisis Intervention
b6 b6
10. The Recovery Model
b6 b6 b6
11. Suicide Prevention
b6 b6
III. CARE OF PATIENTS WITH PSYCHIATRIC DISORDERS
b6 b6 b6 b6 b6 b6
12. Caring for Patients with Mental Illness and Substance Use Disorders in General Practice Settings
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
13. Neurocognitive Disorders
b6 b6
14. Substance Use and Addiction Disorders
b6 b6 b6 b6 b6
15. Schizophrenia Spectrum and Other Psychotic Disorders
b6 b6 b6 b6 b6 b6
16. Depressive Disorders
b6 b6
17. Bipolar and Related Disorders
b6 b6 b6 b6
18. Anxiety, Obsessive-Compulsive, and Related Disorders
b6 b6 b6 b6 b6
19. Trauma- and Stressor-Related Disorders
b6 b6 b6 b6
20. Somatic Symptom and Dissociative Disorders
b6 b6 b6 b6 b6
21. Eating Disorders
b6 b6
22. Personality Disorders
b6 b6
IV. PSYCHIATRIC MENTAL HEALTH NURSING OF SPECIAL POPULATIONS
b6 b6 b6 b6 b6 b6 b6
23. Children and Adolescents
b6 b6 b6
24. The Aging Individual
b6 b6 b6
25. Survivors of Abuse or Neglect
b6 b6 b6 b6 b6
26. Community Mental Health Nursing
b6 b6 b6 b6
27. The Bereaved Individual
b6 b6 b6
28. Military Families
b6 b6
V. ONLINE CHAPTERS
b6 b6
29. Concepts of Personality Development
b6 b6 b6 b6
30. Complementary and Integrative Therapies
b6 b6 b6 b6
31. Cultural Concepts Relevant to Psychiatric Mental Health Nursing
b6 b6 b6 b6 b6 b6 b6 b6
32. Issues Related to Human Sexuality and Gender Dysphoria
b6 b6 b6 b6 b6 b6 b6 b6 b6
,Chapter 1. Mental Health and Mental b6 b6 b6 b6 b6
b6 IllnessMultiple Choice 6
b b6
1. A nurse is assessing a client who is experiencing occasional feelings of sadness because
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
of therecent death of a beloved pet. The clients appetite, sleep patterns, and daily routine
b6 b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
have not changed. How should the nurse interpret the clients behaviors?
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
1. The clients behaviors demonstrate mental illness in the form of depression.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. The clients behaviors are extensive, which indicates the presence of mental illness.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
3. The clients behaviors are not congruent with cultural norms.
b6 b6 b6 b6 b6 b6 b6 b6
4. The clients behaviors demonstrate no functional impairment, indicating no mental illness.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
ANSWER: 4 b6
Rationale: The nurse should assess that the clients daily functioning is not impaired. The
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
clientwho experiences feelings of sadness after the loss of a pet is responding within
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
normal expectations. Without significant impairment, the clients distress does not indicate a
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
mental illness.
b6 b6
Cognitive Level: Analysis b6 b6
Integrated Process:
b6 b6
Assessment
b6
2. At what point should the nurse determine that a client is at risk for developing a
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
mentalillness?
b6 6
b
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. When maladaptive responses to stress are coupled with interference in daily functioning.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
3. When a client communicates significant distress.
b6 b6 b6 b6 b6
4. When a client uses defense mechanisms as ego protection.
b6 b6 b6 b6 b6 b6 b6 b6
ANSWER: 2 b6
Rationale: The nurse should determine that the client is at risk for mental illness when
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
responsesto stress are maladaptive and interfere with daily functioning. The DSM-5
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
indicates that in orderto be diagnosed with a mental illness, daily functioning must be
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
significantly impaired. The clients ability to communicate distress would be considered a
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
positive attribute.
b6 b6
Cognitive Level: Application b6 b6
Integrated Process:
b6 b6
Assessment
b6
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently to
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
stress.One twin becomes anxious and irritable, and the other withdraws and cries. How
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
should the nurse explain these different stress responses to the parents?
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
1. Reactions to stress are relative rather than absolute; individual responses to stress vary.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. It is abnormal for identical twins to react differently to similar stressors.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
3. Identical twins should share the same temperament and respond similarly to stress.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
4. Environmental influences to stress weigh more heavily than genetic influences. b6 b6 b6 b6 b6 b6 b6 b6 b6
, ANSWER: 1 b6
Rationale: The nurse should explain to the parents that, although the twins have identical
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
DNA,there are several other factors that affect reactions to stress. Mental health is a state
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
of being thatis relative to the individual client. Environmental influences and temperament
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
can affect stress reactions.
b6 b6 b6 b6
Cognitive Level: Application b6 b6
Integrated Process:
b6 b6
Implementation
b6
4. Which client should the nurse anticipate to be most receptive to psychiatric
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
treatment?1. A Jewish, female social worker.
b6 b6 b6 b6 b6 b6 b6
2. A Baptist, homeless male.
b6 b6 b6
3. A Catholic, black male.
b6 b6 b6
4. A Protestant, Swedish business executive.
b6 b6 b6 b6
ANSWER: 1 b6
Rationale: The nurse should anticipate that the client of Jewish culture would place a high
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
importance on preventative health care and would consider mental health as equally
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
important asphysical health. Women are also more likely to seek treatment for mental
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
health problems than men.
b6 b6 b6 b6
Cognitive Level: b6
ApplicationIntegrated
b6 b6
Process: Planning
b6 b6
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
eliminated.Which is a correct evaluation of this nurses statement?
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
1. Defense mechanisms can be appropriate responses to stress and need not be eliminated.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
andshouldalways be eliminated.
b6 6
b b6 b6
3. Defense mechanisms, used by individuals with weak ego integrity, should be
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
discouragedandnot eliminated.
b6 b6 b6
4. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
ANSWER: 1 b6
Rationale: The nurse should determine that defense mechanisms can be appropriate during
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
timesof stress. The client with no defense mechanisms may have a lower tolerance for
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
stress, thus leading to anxiety disorders. Defense mechanisms should be confronted when
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
they impede the client from developing healthy coping skills.
b6 b6 b6 b6 b6 b6 b6 b6 b6
Cognitive Level: Application b6 b6
Integrated Process:
b6 b6
Evaluation
b6
6. During an intake assessment, a nurse asks both physiological and psychosocial questions.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
Theclient angrily responds, Im here for my heart, not my head problems. Which is the
b6 6
b b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
nurses best response?
b6 b6 b6
1. Its just a routine part of our assessment. All clients are asked these same questions.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
2. Why are you concerned about these types of questions?
b6 b6 b6 b6 b6 b6 b6 b6
3. Psychological factors, like excessive stress, have been found to affect medical conditions.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
4. We can skip these questions, if you like. It isnt imperative that we complete this section.
b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6 b6
