L L L L L L L L
Chapter 1 L
1. The nurse is assessing the factors contributing to the well-
L L L L L L L L L
being of a newly admitted client. Which of the following
L L L L L L L L L
would the nurse identify as having a positive impact onthe
L L L L L L L L L L
Lindividual's mental health? L L
A) Not needing others for companionship L L L L
B) The ability to effectively manage stress L L L L L
C) A family history of mental illness
L L L L L
D) Striving for total self-reliance L L L
LAns: B L
Feedback:
Individual factors influencing mental health include L L L L L
Lbiologic makeup, autonomy, independence, self-esteem,
L L L L
capacity for growth, vitality, ability to find meaning in life,
L L L L L L L L L L
emotional resilience or hardiness, sense of belonging,
L L L L L L L
reality orientation, and coping or stress management
L L L L L L L
abilities. Interpersonal factors such as intimacy and a
L L L L L L L L
Lbalance of separateness and connectedness are both needed
L L L L L L L
for good mental health, and therefore ahealthy person would need others for
L L L L L L L L L L L
companionship. A family history of mental illnesscould relate to the biologic makeup
L L L L L L L L L L L L
of an individual, which may have a negative impacton an individual's mental health, as
L L L L L L L L L L L L L L
well as a negative impact on an individual's interpersonal and socialñcultural factors of
L L L L L L L L L L L L L
Lhealth. Total self-reliance is not possible, and a positive social/cultural factor is access
L L L L L L L L L L L L
to adequate resources.
L L L
2. Which of the following statements about mental illness are true? Select all that apply.
L L L L L L L L L L L L L
A) Mental illness can cause significant distress, impaired functioning, or both.
L L L L L L L L L
B) Mental illness is only due to social/cultural factors. L L L L L L L
C) Social/cultural factors that relate to mental illness include excessive dependency L L L L L L L L L
on or withdrawal from relationships.
L L L L L
D) Individuals suffering from mental illness are usually able to cope effectively with L L L L L L L L L L L
daily life. L L
E) Individuals suffering from mental illness may experience dissatisfaction with L L L L L L L L
relationships and self.
L L L
Ans: A, D, E L L L
Feedback:
Mental illness can cause significant distress, impaired functioning, or both. Mental
L L L L L L L L L L
illness may be related to individual, interpersonal, or social/cultural factors. Excessive
L L L L L L L L L L L
dependency on or withdrawal from relationships are interpersonal factors that relate to
L L L L L L L L L L L L
mental illness. Individuals suffering from mental illness can feel overwhelmed with
L L L L L L L L L L L
daily life. Individuals suffering from mental illness may experience dissatisfaction with
L L L L L L L L L L L
relationships and self.
L L L
,3. Which of the following are true regarding mental health and mental illness?
L L L L L L L L L L L
A) Behavior that may be viewed as acceptable in one culture is always unacceptable L L L L L L L L L L L L
in other cultures. L L L
B) It is easy to determine if a person is mentally healthy or mentally ill.
L L L L L L L L L L L L L
C) In most cases, mental health is a state of emotional, psychological, and social
L L L L L L L L L L L L
wellness evidenced by satisfying interpersonal relationships, effective behavior
L L L L L L L L
and coping, positive self-concept, and emotional stability.
L L L L L L L
D) Persons who engage in fantasies are mentally ill. L L L L L L L
Ans: C
L L
Feedback:
What one society may view as acceptable and appropriate behavior, another society may
L L L L L L L L L L L L
see that as maladaptive, and inappropriate. Mental health and mental illness are difficult
L L L L L L L L L L L L L
to define precisely. In most cases, mental health is a state of emotional, psychological,
L L L L L L L L L L L L L L
and social wellness evidenced by satisfying interpersonal relationships, effective
L L L L L L L L L
behavior and coping, positive self-concept, and emotional stability. Persons who engage
L L L L L L L L L L L
in fantasies may be mentally healthy, but the inability to distinguish reality from fantasy
L L L L L L L L L L L L L L
is an individual factor that may contribute to mental illness.
L L L L L L L L L L
4. A client grieving the recent loss of her husband asks if she is becoming mentally ill
L L L L L L L L L L L L L L L
because she is so sad. The nurse's best response would be,
L L L L L L L L L L L
A) ìYou may have a temporary mental illness because you are experiencing so much
L L L L L L L L L L L L
pain.î L
B) ìYou are not mentally ill. This is an expected reaction to the loss you have
L L L L L L L L L L L L L L
experienced.î L
C) ìWere you generally dissatisfied with your relationship before your husband's
L L L L L L L L L
death?î L
D) ìTry not to worry about that right now. You never know what the future brings.î
L L L L L L L L L L L L L L
Ans: B
L L
Feedback:
Mental illness includes general dissatisfaction with self, ineffective relationships,
L L L L L L L L
ineffective coping, and lack of personal growth. Additionally the behavior must not be
L L L L L L L L L L L L L
culturally expected. Acute grief reactions are expected and therefore not considered
L L L L L L L L L L L
mental illness. False reassurance or overanalysis does not accurately address the client's
L L L L L L L L L L L L
concerns.
L
,5. The nurse consults the DSM for which of the following purposes?
L L L L L L L L L L L
A) To devise a plan of care for a newly admitted client
L L L L L L L L L L
B) To predict the client's prognosis of treatment outcomes
L L L L L L L
C) To document the appropriate diagnostic code in the client's medical record
L L L L L L L L L L
D) To serve as a guide for client assessment
L L L L L L L L L
Ans: D L
Feedback:
The DSM provides standard nomenclature, presents defining characteristics, and
L L L L L L L L
Lidentifies underlying causes of mental disorders. It does not provide care plans or
L L L L L L L L L L L L
Lprognostic outcomes of treatment. Diagnosis of mental illness is not within the
L L L L L L L L L L L
Lgeneralist RN's scope of practice, so documenting the code in the medical record would
L L L L L L L L L L L L L
Lbe inappropriate.
L
6. Which would be a reason for a student nurse to use the DSM?
L L L L L L L L L L L L L
A) Identifying the medical diagnosis L L L
B) Treat clients L
C) Evaluate treatments L
D) Understand the reason for the admission and the nature of psychiatric illnesses.
L L L L L L L L L L L L L
Ans: D L
Feedback:
Although student nurses do not use the DSM to diagnose clients, they will find it a
L L L L L L L L L L L L L L L
helpful resource to understand the reason for the admission and to begin building
L L L L L L L L L L L L L
knowledge about the nature of psychiatric illnesses. Identifying the medical diagnosis,
L L L L L L L L L L L
treating, and evaluating treatments are not a part of the nursing process.
L L L L L L L L L L L L
7. The legislation enacted in 1963 was largely responsible for which of the following shifts
L L L L L L L L L L L L L
in care for the mentally ill?
L L L L L L
A) The widespread use of community-based services
L L L L L
B) The advancement in pharmacotherapies L L L
C) Increased access to hospitalization L L L
D) Improved rights for clients in long-term institutional care L L L L L L L
Ans: A
L L
Feedback:
The Community Mental Health Centers Construction Act of 1963 accomplished the
L L L L L L L L L L
release of individuals from long-term stays in state institutions, the decrease in
L L L L L L L L L L L L
admissions to hospitals, and the development of community-based services as an
L L L L L L L L L L L
alternative to hospital care.
L L L L
, 8. Which one of the following is a result of federal legislation?
L L L L L L L L L L
A) Making it easier to commit people for mental health treatment against their will.
L L L L L L L L L L L L
B) Making it more difficult to commit people for mental health treatment against
L L L L L L L L L L L
their will.
L L
C) State mental institutions being the primary source of care for mentally ill persons.
L L L L L L L L L L L L
D) Improved care for mentally ill persons. L L L L L
Ans: B
L L
Feedback:
Commitment laws changed in the early 1970s, making it more difficult to commit
L L L L L L L L L L L L
people for mental health treatment against their will. Deinstitutionalization
L L L L L L L L L
accomplished the release of individuals from long-term stays in state institutions.
L L L L L L L L L L L
Deinstitutionalization also had negative effects in that some mentally ill persons are
L L L L L L L L L L L L
subjected to the revolving door effect, which may limit care for mentally ill persons.
L L L L L L L L L L L L L L
9. The goal of the 1963 Community Mental Health Centers Act was to
L L L L L L L L L L L
A) ensure patients' rights for the mentally ill. L L L L L L
B) deinstitutionalize state hospitals. L L
C) provide funds to build hospitals with psychiatric units. L L L L L L L
D) treat people with mental illness in a humane fashion.
L L L L L L L L
Ans: B
L L
Feedback:
The 1963 Community Mental Health Centers Act intimated the movement toward
L L L L L L L L L L
treating those with mental illness in a less restrictive environment. This legislation
L L L L L L L L L L L L
resulted in the shift of clients with mental illness from large state institutions to care
L L L L L L L L L L L L L L L
based in the community. Answer choices A, C, and D were not purposes of the 1963
L L L L L L L L L L L L L L L L
Community Mental Health Centers Act.
L L L L L
10. The creation of asylums during the 1800s was meant to
L L L L L L L L L
A) improve treatment of mental disorders. L L L L
B) provide food and shelter for the mentally ill. L L L L L L L
C) punish people with mental illness who were believed to be possessed.
L L L L L L L L L L
D) remove dangerous people with mental illness from the community.
L L L L L L L L
Ans: B
L L
Feedback:
The asylum was meant to be a safe haven with food, shelter, and humane treatment for the
L L L L L L L L L L L L L L L L
mentally ill. Asylums were not used to improve treatment of mental disorders or to punish
L L L L L L L L L L L L L L L
mentally ill people who were believed to be possessed. The asylum was not created to
L L L L L L L L L L L L L L L
remove the dangerously mentally ill from the community.
L L L L L L L L