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