v
ForPsychiatricMental HealthNursing9thEdition y v
Chapter1
1. Thenurseisassessingthefactorscontributingtothewell-
y
beingofanewlyadmittedclient.Whichofthefollowing
v
wouldthenurseidentifyashavingapositiveimpactonthe
v y
individual'smentalhealth?
v
A) Notneedingothersforcompanionship
B) Theabilitytoeffectivelymanagestress
C) Afamilyhistoryofmentalillness
D) Strivingfortotalself-reliance
Ans: B
v v
Feedback:
Individualfactorsinfluencingmentalhealthincludebiologic y
makeup,autonomy,independence,self-esteem,capacityfor
v
growth,vitality,abilitytofindmeaninginlife,emotional
v
resilienceorhardiness,senseofbelonging,reality
v
orientation,andcopingorstressmanagement abilities.
v y
Interpersonalfactorssuchasintimacyandabalanceof
separatenessandconnectednessarebothneeded
v y y
forgoodmentalhealth,andthereforeahealthypersonwouldneedothersfor y y v
companionship.Afamilyhistoryofmentalillnesscouldrelatetothebiologicmakeupofan
v y
individual,whichmayhaveanegativeimpactonanindividual'smentalhealth,aswellasa
v y y v
negativeimpacton anindividual'sinterpersonaland socialñculturalfactorsofhealth.Total
v y y y v
self-relianceisnotpossible,andapositivesocial/culturalfactorisaccesstoadequate
v y y y y
resources.
v
2. Whichofthefollowingstatementsaboutmentalillnessaretrue?Selectallthatapply. y y
A) Mentalillnesscancausesignificantdistress,impairedfunctioning,orboth.y y y y
B) Mentalillnessisonlyduetosocial/culturalfactors.
y y y
C) Social/culturalfactorsthatrelatetomentalillnessincludeexcessivedependencyon y y
orwithdrawalfromrelationships.
v
D) Individualssufferingfrommentalillnessareusuallyabletocopeeffectivelywith y y
dailylife. v
E) Individualssufferingfrommentalillnessmayexperiencedissatisfactionwith y
relationshipsandself.
v
Ans:A,D,E y
Feedback:
Mentalillnesscancausesignificantdistress,impairedfunctioning,orboth.Mentalillness
y
mayberelatedtoindividual,interpersonal,orsocial/culturalfactors.Excessive
v
dependencyonorwithdrawalfromrelationshipsareinterpersonalfactorsthatrelateto
v
mentalillness.Individualssuffering frommentalillnesscanfeeloverwhelmedwithdaily
v y y
life.Individualssufferingfrommentalillnessmayexperiencedissatisfactionwith
v y
relationshipsandself.
v
,3. Whichofthefollowingaretrueregardingmentalhealthandmentalillness?
y y y y y
A) Behaviorthatmaybeviewedasacceptableinonecultureisalwaysunacceptablein y y y
othercultures.
v
B) Itiseasytodetermineifapersonismentallyhealthyormentallyill.
y
C) Inmostcases,mentalhealthisastateofemotional,psychological,andsocial y v
wellnessevidencedbysatisfyinginterpersonalrelationships,effectivebehavior
v y y
andcoping,positiveself-concept,andemotionalstability.
v
D) Personswhoengageinfantasiesarementallyill.
y y y
Ans: C
v v
Feedback:
Whatonesocietymayviewasacceptableandappropriatebehavior,anothersocietymaysee
vthatasmaladaptive,andinappropriate.Mentalhealthandmentalillnessaredifficulttodefine
y y y
vprecisely.Inmostcases,mentalhealthisastateofemotional,psychological,andsocial v
vwellnessevidencedbysatisfyinginterpersonalrelationships,effectivebehaviorandcoping, y v
vpositiveself-concept,andemotionalstability.Personswhoengageinfantasiesmaybe y
v mentallyhealthy,buttheinabilitytodistinguish realityfromfantasyisanindividualfactor y v
vthatmaycontributetomentalillness.
4. Aclientgrievingtherecentlossofherhusbandasksifsheisbecomingmentallyill
y y y y y y y
becausesheissosad.Thenurse'sbestresponsewouldbe,
v
A) ìYoumayhaveatemporarymentalillnessbecauseyouareexperiencingsomuch
y y y
pain.î v
B) ìYouarenotmentallyill.Thisisanexpectedreactiontothelossyouhave y y y
experienced.îv
C) ìWereyougenerallydissatisfiedwithyourrelationshipbeforeyourhusband's y y
death?î v
D) ìTrynottoworryaboutthatrightnow.Youneverknowwhatthefuturebrings.îAns:y y y y
B v
Feedback:
Mentalillnessincludesgeneraldissatisfactionwithself,ineffectiverelationships,
y
ineffectivecoping,andlackofpersonalgrowth.Additionallythebehaviormustnot
v y y
beculturallyexpected.Acutegriefreactionsareexpectedandthereforenotconsidered
v y y y y
mentalillness.Falsereassuranceoroveranalysisdoesnotaccuratelyaddressthe
v
client'sconcerns.
v
,5. The nurse consults the DSM for which of the following purposes?
vb v vv
y y y y y b b b b b b b b b b
A) Todeviseaplanofcareforanewlyadmittedclient y
B) To predict theclient'sprognosisoftreatmentoutcomes
v v
C) Todocumenttheappropriatediagnosticcodeintheclient'smedicalrecord y y y
D) To serve as a guide for client assessment
b
b b b b b b b
Ans:D
Feedback:
TheDSMprovides standardnomenclature,presentsdefiningcharacteristics,and identifies y y
underlyingcausesofmentaldisorders.Itdoesnotprovidecareplansorprognosticoutcomes
v y
oftreatment.DiagnosisofmentalillnessisnotwithinthegeneralistRN'sscopeofpractice,so
v y y
documentingthecodeinthemedicalrecordwouldbeinappropriate.
v y y y
6.
vb v v
y y y y
A) Identifyingthemedicaldiagnosis y
B) Treat clients v
C) Evaluatetreatments
D) Understand the reason for the admission and the nature of psychiatric illnesses.
b b b b b b b b b b b b
Ans:D
Feedback:
AlthoughstudentnursesdonotusetheDSMtodiagnoseclients,theywillfindita helpful
y y y y y v
resourcetounderstandthereasonfortheadmissionandtobeginbuildingknowledgeabout
v y y v
thenatureofpsychiatricillnesses.Identifyingthemedicaldiagnosis,treating,and
v
evaluating treatments arenot a partofthenursing process.
v y v y y y
7. Thelegislationenactedin1963waslargelyresponsibleforwhichofthefollowingshiftsin
y y y y y
careforthementallyill?
v
A) Thewidespreaduseofcommunity-basedservices y
B) Theadvancementin pharmacotherapies v
C) Increasedaccesstohospitalization y
D) Improvedrightsforclientsinlong-terminstitutionalcare y
Ans: A v v
Feedback:
TheCommunityMentalHealthCentersConstructionActof1963accomplishedtherelease
v y y
ofindividualsfromlong-termstaysinstateinstitutions,thedecreaseinadmissionsto
v
hospitals,andthedevelopmentofcommunity-basedservices asanalternativetohospital
v y y v
care. v
, 8. Whichoneofthefollowingisaresultoffederallegislation? y y y
A) Makingiteasiertocommitpeopleformentalhealthtreatment againsttheirwill.
y y
B) Makingitmoredifficulttocommitpeopleformentalhealthtreatmentagainsttheir
y y y
will. v
C) Statementalinstitutionsbeingtheprimarysourceofcareformentallyillpersons. y
D) Improvedcareformentallyillpersons. y y
Ans: B
v v
Feedback:
Commitmentlawschangedintheearly1970s,makingitmoredifficult tocommitpeoplefor
v y y y y y y
vmentalhealthtreatment againsttheirwill.Deinstitutionalizationaccomplishedtherelease
y v
vofindividualsfromlong-termstaysinstateinstitutions.Deinstitutionalizationalsohad
vnegativeeffectsinthatsomementallyillpersonsaresubjectedtotherevolvingdooreffect, v
vwhichmaylimitcareformentallyillpersons. y
9. Thegoalofthe1963CommunityMentalHealthCentersActwasto y y v
A) ensurepatients'rightsforthementallyill.
B) deinstitutionalizestatehospitals.
C) providefundstobuildhospitalswithpsychiatricunits. y y
D) treatpeoplewithmentalillnessinahumanefashion.
y y y
Ans: B
v v
Feedback:
The1963CommunityMentalHealthCentersActintimatedthemovementtowardtreating
v y y y
vthosewithmentalillnessinalessrestrictiveenvironment.Thislegislationresultedinthe v
vshiftofclients withmentalillnessfromlargestateinstitutionstocarebasedinthe
y y
v community.AnswerchoicesA,C,andDwerenotpurposesofthe1963CommunityMental y y
Health CentersAct.
v y
10. Thecreationofasylums duringthe1800swasmeantto
y y y
A) improvetreatmentofmentaldisorders. y
B) providefoodandshelter forthementallyill. y y v
C) punishpeoplewithmentalillnesswhowerebelievedtobepossessed. y y y y
D) removedangerouspeoplewithmentalillnessfromthecommunity. y y
Ans: B
v v
Feedback:
Theasylumwasmeanttobeasafehavenwithfood,shelter,andhumanetreatmentforthe
y y y y y
vmentallyill.Asylumswerenotusedtoimprovetreatmentofmentaldisordersortopunish y y
vmentallyillpeoplewhowerebelievedtobepossessed.Theasylumwasnotcreatedtoremove v
vthedangerouslymentallyillfromthecommunity.