,Chapter 01: Mental Health and Mental Illness
#d #d #d #d #d #d
Halter: Varcarolis’ Foundations of Psychiatric-
#d #d #d #d
Mental Health Nursing: A Clinical Approach, 10th Edition
#d #d #d #d #d #d #d
MULTIPLE CHOICE #d
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
#d #d #d #d #d #d #d #d #d #d #d #d
a. Conducting a mental health assessment. #d #d #d #d
b. Prescribing psychotropic medication. #d #d
c. Establishing a therapeutic relationship. #d #d #d
d. Individualizing a nursing care plan. #d #d #d #d
ANS: # d B
In most states, prescriptive privileges are granted to master’s-
#d #d #d #d #d #d #d #d
prepared nurse practitioners and clinical nurse specialists who have taken special courses on
#d #d #d #d #d #d #d #d #d #d #d #d #d
prescribing medication. The nurse prepared at the basic level is permitted to perform mental
#d #d #d #d #d #d #d #d #d #d #d #d #d
health assessments, establish relationships, and provide individualized care planning.
#d #d #d #d #d #d #d #d #d
PTS: # d # d 1 DIF: Cognitive Level: Understand (Comprehension) #d #d #d
TOP: # d Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursi
#d #d #d #d #d #d #d #d #d #d #d #d #d
ng skills.” Select the best response by the mental health nurse.
#d #d #d #d #d #d #d #d #d #d
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-
#d #d #d #d #d #d #d #d #d
to- client ratios must be better because of the nature of the clients’ problems.”
#d #d #d #d #d #d #d #d #d #d #d #d #d
b. “Psychiatric nurses use complex communication skills as well as critical thinkin
#d #d #d #d #d #d #d #d #d #d
g to solve multidimensional problems. I am challenged by those situations.”
#d #d #d #d #d #d #d #d #d #d
c. “That’s a misconception. Psychiatric nurses frequently use high technolog
#d #d #d #d #d #d #d #d
y monitoring equipment and manage complex intravenous therapies.”
#d #d #d #d #d #d #d
d. “Psychiatric nurses do not have to deal with as much pain and suffering
#d #d #d #d #d #d #d #d #d #d #d #d #d
as medical–surgical nurses do. That appeals to me.”
#d #d #d #d #d #d #d
ANS: # d B
The practice of psychiatric nursing requires a different set of skills than medical–
#d #d #d #d #d #d #d #d #d #d #d #d
surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help
#d #d #d #d #d #d #d #d #d #d #d #d #d
clients with medical as well as mental health problems, reflecting the holistic perspective th
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ese nurses must have. Nurse–
#d #d #d #d
client ratios and workloads in psychiatric settings have increased, just like other specialties.
#d #d #d #d #d #d #d #d #d #d #d #d #
Psychiatric nursing involves clinical practice, not just documentation.
d #d #d #d #d #d #d #d
Psychosocial pain and suffering are as real as physical pain and suffering.
#d #d #d #d #d #d #d #d #d #d #d
PTS: # d # d 1 DIF: Cognitive Level: Apply (Application) #d #d #d
TOP: # d Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed w
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ith mental illness, a group of nurses write letters to their elected representatives in opposit
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ion to the legislation. Which role have the nurses fulfilled?
#d #d #d #d #d #d #d #d #d
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice #d
, ANS: # d C
An advocate defends or asserts another’s cause, particularly when the other person lacks th
#d #d #d #d #d #d #d #d #d #d #d #d #d
e ability to do that for self. Examples of individual advocacy include helping clients unders
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
tand their rights or make decisions. On a community scale, advocacy includes political acti
#d #d #d #d #d #d #d #d #d #d #d #d #d
vity, public speaking, and publication in the interest of improving the human condition. Sin
#d #d #d #d #d #d #d #d #d #d #d #d #d
ce funding is necessary to deliver quality programming for persons with mental illness, the l
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
etter-
#dwriting campaign advocates for that cause on behalf of clients who are unable to articulate
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #
dtheir own needs. #d #d
PTS: # d # d 1 DIF: Cognitive Level: Understand (Comprehension) #d #d #d
TOP: # d Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
4. A family has a long history of conflicted relationships among the members. Which fami
#d #d #d #d #d #d #d #d #d #d #d #d #d
ly member’s comment best reflects a mentally healthy perspective?
#d #d #d #d #d #d #d #d
a. “I’ve made mistakes but everyone else in this family has also.”
#d #d #d #d #d #d #d #d #d #d
b. “I remember joy and mutual respect from our early years together.”
#d #d #d #d #d #d #d #d #d #d
c. “I will make some changes in my behavior for the good of the family.”
#d #d #d #d #d #d #d #d #d #d #d #d #d
d. “It’s best for me to move away from my family. Things will never change.”
#d #d #d #d #d #d #d #d #d #d #d #d #d
ANS: # d C
The correct response demonstrates the best evidence of a healthy recognition of the import
#d #d #d #d #d #d #d #d #d #d #d #d #d
ance of relationships. Mental health includes rational thinking, communication skills, learni
#d #d #d #d #d #d #d #d #d #d
ng, emotional growth, resilience, and self-
#d #d #d #d #d
esteem. Recalling joy from earlier in life may be healthy, but the correct response shows a
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #d #d
higher level of mental health. The other incorrect responses show blaming and avoidance.
#d #d #d #d #d #d #d #d #d #d #d #d
PTS: # d # d 1 DIF: Cognitive Level: Analyze (Analysis) #d #d #d
TOP: # d Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
#d #d # d #d #d #d
5. Which assessment finding most clearly indicates that a client may be experiencing a ment
#d #d #d #d #d #d #d #d #d #d #d #d #d
al illness?
#d
a. reporting occasional sleeplessness and anxiety. #d #d #d #d
b. reporting a consistently sad, discouraged, and hopeless mood.
#d #d #d #d #d #d #d
c. being able to describe the difference between “as if” and “for real.”
#d #d #d #d #d #d #d #d #d #d #d
d. experiencing difficulty making a decision about whether to change jobs. #d #d #d #d #d #d #d #d #d
ANS: # d B
The correct response describes a mood alteration, which reflects mental illness. The distracte
#d #d #d #d #d #d #d #d #d #d #d #d
rs describe behaviors that are mentally healthy or within the usual scope of human experien
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ce.
PTS: # d # d 1 DIF: Cognitive Level: Apply (Application) #d #d #d
TOP: # d Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
#d #d # d #d #d #d
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” w
#d #d #d #d #d #d #d #d #d #d #d
as achieved for an adult client?
#d #d #d #d #d
a. being willing to work towards achieving ideals and meeting demands.
#d #d #d #d #d #d #d #d #d
b. behaving without considering the consequences of personal actions.
#d #d #d #d #d #d #d
c. aggressively meeting personal needs without considering the rights of others.
#d #d #d #d #d #d #d #d #d
d. seeking help from others to avoid assuming responsibility for major areas of o
#d #d #d #d #d #d #d #d #d #d #d #d
wn life. #d
, ANS: # d A
Mental health is a state of well-
#d #d #d #d #d #d
being in which individuals reach their own potential, cope with the normal stresses of life,
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #
dwork productively, and contribute to the community. Mental health provides people with t
#d #d #d #d #d #d #d #d #d #d #d #d
he capacity for rational thinking, communication skills, learning, emotional growth, resilien
#d #d #d #d #d #d #d #d #d #d
ce, and self-
#d #d
esteem. The correct response describes an adaptive, healthy behavior. The distracters descr
#d #d #d #d #d #d #d #d #d #d #d
ibe maladaptive behaviors.
#d #d
PTS: # d # d 1 DIF: Cognitive Level: Apply (Application) #d #d #d
TOP: # d Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
#d #d # d #d #d #d
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. W
#d #d #d #d #d #d #d #d #d #d #d #d #d
hich resource should the nurse consult to determine criteria used to establish this diagnosis?
#d #d #d #d #d #d #d #d #d #d #d #d #d
a. International Statistical Classification of Diseases and Related Health Problem
#d #d #d #d #d #d #d #d
s (ICD-10)
#d
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
#d #d #d #d #d #d #d #d #d
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
#d #d #d #d #d #d #d
d. A behavioral health reference manual
#d #d #d #d
ANS: # d C
The DSM- #d
V gives the criteria used to diagnose each mental disorder. It is the official guideline for diag
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #d #d
nosing psychiatric disorders. The distracters may not contain diagnostic criteria for a psychi
#d #d #d #d #d #d #d #d #d #d #d #d
atric illness. #d
PTS: # d # d 1 DIF: Cognitive Level: Understand (Comprehension) #d #d #d
TOP: # d Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resour
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ce would have the most complete information?
#d #d #d #d #d #d
a. Nursing Outcomes Classification (NOC) #d #d #d
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
#d #d #d #d #d #d #d #d #d
d. ICD-10
ANS: # d B
The DSM- #d
V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline
#d #d #d #d #d #d #d #d #d #d #d #d #d
for diagnosing psychiatric disorders. The other references are good resources but do not def
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ine the diagnostic criteria.
#d #d #d
PTS: # d # d 1 DIF: Cognitive Level: Understand (Comprehension) #d #d #d
TOP: # d Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
9. Which individual behavior demonstrates resilience?
#d #d #d #d
a. Repress stressors associated with a divorce. #d #d #d #d #d
b. Continuing to grieve the death of a spouse for 5 years. #d #d #d #d #d #d #d #d #d #d
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire.
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #d
d. Taking a temporary job to maintain financial stability after loss of a permane
#d #d #d #d #d #d #d #d #d #d #d #d
nt job.#d
ANS: # d D
#d #d #d #d #d #d
Halter: Varcarolis’ Foundations of Psychiatric-
#d #d #d #d
Mental Health Nursing: A Clinical Approach, 10th Edition
#d #d #d #d #d #d #d
MULTIPLE CHOICE #d
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
#d #d #d #d #d #d #d #d #d #d #d #d
a. Conducting a mental health assessment. #d #d #d #d
b. Prescribing psychotropic medication. #d #d
c. Establishing a therapeutic relationship. #d #d #d
d. Individualizing a nursing care plan. #d #d #d #d
ANS: # d B
In most states, prescriptive privileges are granted to master’s-
#d #d #d #d #d #d #d #d
prepared nurse practitioners and clinical nurse specialists who have taken special courses on
#d #d #d #d #d #d #d #d #d #d #d #d #d
prescribing medication. The nurse prepared at the basic level is permitted to perform mental
#d #d #d #d #d #d #d #d #d #d #d #d #d
health assessments, establish relationships, and provide individualized care planning.
#d #d #d #d #d #d #d #d #d
PTS: # d # d 1 DIF: Cognitive Level: Understand (Comprehension) #d #d #d
TOP: # d Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursi
#d #d #d #d #d #d #d #d #d #d #d #d #d
ng skills.” Select the best response by the mental health nurse.
#d #d #d #d #d #d #d #d #d #d
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-
#d #d #d #d #d #d #d #d #d
to- client ratios must be better because of the nature of the clients’ problems.”
#d #d #d #d #d #d #d #d #d #d #d #d #d
b. “Psychiatric nurses use complex communication skills as well as critical thinkin
#d #d #d #d #d #d #d #d #d #d
g to solve multidimensional problems. I am challenged by those situations.”
#d #d #d #d #d #d #d #d #d #d
c. “That’s a misconception. Psychiatric nurses frequently use high technolog
#d #d #d #d #d #d #d #d
y monitoring equipment and manage complex intravenous therapies.”
#d #d #d #d #d #d #d
d. “Psychiatric nurses do not have to deal with as much pain and suffering
#d #d #d #d #d #d #d #d #d #d #d #d #d
as medical–surgical nurses do. That appeals to me.”
#d #d #d #d #d #d #d
ANS: # d B
The practice of psychiatric nursing requires a different set of skills than medical–
#d #d #d #d #d #d #d #d #d #d #d #d
surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help
#d #d #d #d #d #d #d #d #d #d #d #d #d
clients with medical as well as mental health problems, reflecting the holistic perspective th
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ese nurses must have. Nurse–
#d #d #d #d
client ratios and workloads in psychiatric settings have increased, just like other specialties.
#d #d #d #d #d #d #d #d #d #d #d #d #
Psychiatric nursing involves clinical practice, not just documentation.
d #d #d #d #d #d #d #d
Psychosocial pain and suffering are as real as physical pain and suffering.
#d #d #d #d #d #d #d #d #d #d #d
PTS: # d # d 1 DIF: Cognitive Level: Apply (Application) #d #d #d
TOP: # d Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed w
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ith mental illness, a group of nurses write letters to their elected representatives in opposit
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ion to the legislation. Which role have the nurses fulfilled?
#d #d #d #d #d #d #d #d #d
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice #d
, ANS: # d C
An advocate defends or asserts another’s cause, particularly when the other person lacks th
#d #d #d #d #d #d #d #d #d #d #d #d #d
e ability to do that for self. Examples of individual advocacy include helping clients unders
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
tand their rights or make decisions. On a community scale, advocacy includes political acti
#d #d #d #d #d #d #d #d #d #d #d #d #d
vity, public speaking, and publication in the interest of improving the human condition. Sin
#d #d #d #d #d #d #d #d #d #d #d #d #d
ce funding is necessary to deliver quality programming for persons with mental illness, the l
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
etter-
#dwriting campaign advocates for that cause on behalf of clients who are unable to articulate
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #
dtheir own needs. #d #d
PTS: # d # d 1 DIF: Cognitive Level: Understand (Comprehension) #d #d #d
TOP: # d Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
4. A family has a long history of conflicted relationships among the members. Which fami
#d #d #d #d #d #d #d #d #d #d #d #d #d
ly member’s comment best reflects a mentally healthy perspective?
#d #d #d #d #d #d #d #d
a. “I’ve made mistakes but everyone else in this family has also.”
#d #d #d #d #d #d #d #d #d #d
b. “I remember joy and mutual respect from our early years together.”
#d #d #d #d #d #d #d #d #d #d
c. “I will make some changes in my behavior for the good of the family.”
#d #d #d #d #d #d #d #d #d #d #d #d #d
d. “It’s best for me to move away from my family. Things will never change.”
#d #d #d #d #d #d #d #d #d #d #d #d #d
ANS: # d C
The correct response demonstrates the best evidence of a healthy recognition of the import
#d #d #d #d #d #d #d #d #d #d #d #d #d
ance of relationships. Mental health includes rational thinking, communication skills, learni
#d #d #d #d #d #d #d #d #d #d
ng, emotional growth, resilience, and self-
#d #d #d #d #d
esteem. Recalling joy from earlier in life may be healthy, but the correct response shows a
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #d #d
higher level of mental health. The other incorrect responses show blaming and avoidance.
#d #d #d #d #d #d #d #d #d #d #d #d
PTS: # d # d 1 DIF: Cognitive Level: Analyze (Analysis) #d #d #d
TOP: # d Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
#d #d # d #d #d #d
5. Which assessment finding most clearly indicates that a client may be experiencing a ment
#d #d #d #d #d #d #d #d #d #d #d #d #d
al illness?
#d
a. reporting occasional sleeplessness and anxiety. #d #d #d #d
b. reporting a consistently sad, discouraged, and hopeless mood.
#d #d #d #d #d #d #d
c. being able to describe the difference between “as if” and “for real.”
#d #d #d #d #d #d #d #d #d #d #d
d. experiencing difficulty making a decision about whether to change jobs. #d #d #d #d #d #d #d #d #d
ANS: # d B
The correct response describes a mood alteration, which reflects mental illness. The distracte
#d #d #d #d #d #d #d #d #d #d #d #d
rs describe behaviors that are mentally healthy or within the usual scope of human experien
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ce.
PTS: # d # d 1 DIF: Cognitive Level: Apply (Application) #d #d #d
TOP: # d Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
#d #d # d #d #d #d
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” w
#d #d #d #d #d #d #d #d #d #d #d
as achieved for an adult client?
#d #d #d #d #d
a. being willing to work towards achieving ideals and meeting demands.
#d #d #d #d #d #d #d #d #d
b. behaving without considering the consequences of personal actions.
#d #d #d #d #d #d #d
c. aggressively meeting personal needs without considering the rights of others.
#d #d #d #d #d #d #d #d #d
d. seeking help from others to avoid assuming responsibility for major areas of o
#d #d #d #d #d #d #d #d #d #d #d #d
wn life. #d
, ANS: # d A
Mental health is a state of well-
#d #d #d #d #d #d
being in which individuals reach their own potential, cope with the normal stresses of life,
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #
dwork productively, and contribute to the community. Mental health provides people with t
#d #d #d #d #d #d #d #d #d #d #d #d
he capacity for rational thinking, communication skills, learning, emotional growth, resilien
#d #d #d #d #d #d #d #d #d #d
ce, and self-
#d #d
esteem. The correct response describes an adaptive, healthy behavior. The distracters descr
#d #d #d #d #d #d #d #d #d #d #d
ibe maladaptive behaviors.
#d #d
PTS: # d # d 1 DIF: Cognitive Level: Apply (Application) #d #d #d
TOP: # d Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
#d #d # d #d #d #d
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. W
#d #d #d #d #d #d #d #d #d #d #d #d #d
hich resource should the nurse consult to determine criteria used to establish this diagnosis?
#d #d #d #d #d #d #d #d #d #d #d #d #d
a. International Statistical Classification of Diseases and Related Health Problem
#d #d #d #d #d #d #d #d
s (ICD-10)
#d
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
#d #d #d #d #d #d #d #d #d
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
#d #d #d #d #d #d #d
d. A behavioral health reference manual
#d #d #d #d
ANS: # d C
The DSM- #d
V gives the criteria used to diagnose each mental disorder. It is the official guideline for diag
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #d #d
nosing psychiatric disorders. The distracters may not contain diagnostic criteria for a psychi
#d #d #d #d #d #d #d #d #d #d #d #d
atric illness. #d
PTS: # d # d 1 DIF: Cognitive Level: Understand (Comprehension) #d #d #d
TOP: # d Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resour
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ce would have the most complete information?
#d #d #d #d #d #d
a. Nursing Outcomes Classification (NOC) #d #d #d
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
#d #d #d #d #d #d #d #d #d
d. ICD-10
ANS: # d B
The DSM- #d
V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline
#d #d #d #d #d #d #d #d #d #d #d #d #d
for diagnosing psychiatric disorders. The other references are good resources but do not def
#d #d #d #d #d #d #d #d #d #d #d #d #d #d
ine the diagnostic criteria.
#d #d #d
PTS: # d # d 1 DIF: Cognitive Level: Understand (Comprehension) #d #d #d
TOP: # d Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
#d #d # d #d #d #d #d #d
9. Which individual behavior demonstrates resilience?
#d #d #d #d
a. Repress stressors associated with a divorce. #d #d #d #d #d
b. Continuing to grieve the death of a spouse for 5 years. #d #d #d #d #d #d #d #d #d #d
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire.
#d #d #d #d #d #d #d #d #d #d #d #d #d #d #d
d. Taking a temporary job to maintain financial stability after loss of a permane
#d #d #d #d #d #d #d #d #d #d #d #d
nt job.#d
ANS: # d D
