WWW.THENURSINGMASTERY.COM
,Chapter 01: Science and the Therapeutic Use of Self in Psychiatric Mental Health
L L L L L L L L L L L L
Nursing
L
Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communication
L L L L L L L L
Approach to Evidence-Based Care, 4th Edition
L L L L L L
MULTIPLE CHOICE L
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient
L L L L L L L L L L L L L L L
living in the community and diagnosed with serious and persistent mental illness? Within 3
L L L L L L L L L L L L L L
months, the patient will demonstrate what behavior?
L L L L L L L
a. Denying suicidal ideation L L
b. Reporting a sense of well-being L L L L
c. Taking medications as prescribed L L L
d. Attending clinic appointments on time L L L L
ANS: B L
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
L L L L L L L L
role performance. The goal of recovery is to empower the individual with mental illness to
L L L L L L L L L L L L L L L
achieve a sense of meaning and satisfaction in life and to function at the highest possible level
L L L L L L L L L L L L L L L L L
of wellness. The incorrect options focus on the classic medical model rather than recovery.
L L L L L L L L L L L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Outcomes Identification
L L L L L
MSC: NCLEX: Health Promotion and Maintenance
L L L L L L
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a
L L L L L L L L L L L L L L
divorce. Select the nurse’s most caring comment.
L L L L L L L
a. “Let’s discuss healthy means of coping when you have suicidal feelings.”
L L L L L L L L L L
b. “I understand why you’re so depressed. When I got divorced, I was devastated
L L L L L L L L L L L L
too.” L
c. “You should forget about your marriage and move on with your life.”
L L L L L L L L L L L
d. “How did you get so depressed that hospitalization was necessary?”
L L L L L L L L L
ANS: A L
The nurse’s communication should evidence caring and a commitment to work with the
L L L L L L L L L L L L
patient. This commitment lets the patient know the nurse will help. Probing and advice are not
L L L L L L L L L L L L L L L L
helpful for therapeutic interventions.
L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Implementation
L MSC: NCLEX: Psychosocial Integrity L L L L L
3. In the shift-change report, an off-going nurse criticizes a patient who wears extremely heavy
L L L L L L L L L L L L L
L makeup. Which comment by the nurse who receives the report best demonstrates advocacy?
L L L L L L L L L L L L
a. “This is a psychiatric hospital, so we expect our patients to behave bizarrely.”
L L L L L L L L L L L L
b. “Let’s all show acceptance of this patient by wearing lots of makeup too.”
L L L L L L L L L L L L
c. “Your comments are inconsiderate and inappropriate. Keep the report objective.”
L L L L L L L L L
d. “Our patients need our help to learn behaviors that will help them get along in
L L L L L L L L L L L L L L
society.” L
WWW.THENURSINGMASTERY.COM
, ANS: D L
Accepting patients’ needs for self-expression and seeking to teach skills that will contribute to
L L L L L L L L L L L L L
their well-being demonstrate respect and are important parts of advocacy. The on-coming
L L L L L L L L L L L L
nurse needs to take action to ensure that others are not prejudiced against the patient. Humor
L L L L L L L L L L L L L L L L
can be appropriate within the privacy of a shift report but not at the expense of respect for
L L L L L L L L L L L L L L L L L L
patients. Judging the off-going nurse in a critical way will create conflict. Nurses must show
L L L L L L L L L L L L L L L
compassion for each other.
L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Implementation
L MSC: NCLEX: Safe, Effective Care Environment L L L L L L L
4. A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which
L L L L L L L L L L L L
L statement is an example of “attending”? L L L L L
a. “We all have stress in life. Being in a psychiatric hospital is not the end of the
L L L L L L L L L L L L L L L L
L world.”
b. “Tell me why you felt you had to be hospitalized to receive treatment for your
L L L L L L L L L L L L L L
L depression.”
c. “You will feel better after we get some antidepressant medication started for you.”
L L L L L L L L L L L L
d. “I’d like to sit with you for a while, so you may feel more comfortable talking with
L L L L L L L L L L L L L L L L
L me.”
ANS: D L
Attending is a technique that demonstrates the nurse’s commitment to the relationship and
L L L L L L L L L L L L
reduces feelings of isolation. This technique shows respect for the patient and demonstrates
L L L L L L L L L L L L L
caring. Generalizations, probing, and false reassurances are nontherapeutic.
L L L L L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Implementation
L MSC: NCLEX: Psychosocial Integrity L L L L L
5. A patient shows the nurse an article from the Internet about a health problem. Which
L L L L L L L L L L L L L L
characteristic of the website’s address most alerts the nurse that the site may have biased and
L L L L L L L L L L L L L L L
prejudiced information?
L L
a. Address ends in “.org.” L L L
b. Address ends in “.com.” L L L
c. Address ends in “.gov.” L L L
d. Address ends in “.net.” L L L
ANS: B L
Financial influences on a site are a clue that the information may be biased. “.com” at the end of
L L L L L L L L L L L L L L L L L L
the address indicates that the site is a commercial one. “.gov” indicates that the site is
L L L L L L L L L L L L L L L L
maintained by a government entity. “.org” indicates that the site is nonproprietary; the site
L L L L L L L L L L L L L
may or may not have reliable information, but it does not profit from its activities. “.net” can
L L L L L L L L L L L L L L L L L
have multiple meanings.
L L L
DIF: Cognitive Level: Comprehension (Understanding) L L L TOP: Nursing Process: Evaluation L L L
MSC: NCLEX: Health Promotion and Maintenance
L L L L L L
6. A nurse says, “When I was in school, I learned to call upset patients by name to get their
L L L L L L L L L L L L L L L L L L
attention; however, I read a descriptive research study that says that this approach does not
L L L L L L L L L L L L L L L
work. I plan to stop calling patients by name.” Which statement is the best appraisal of this
L L L L L L L L L L L L L L L L L
nurse’s comment?
L L
a. One descriptive research study rarely provides enough evidence to change practice.
L L L L L L L L L L
WWW.THENURSINGMASTERY.COM
, b. Staff nurses apply new research findings only with the help from clinical nurse
L L L L L L L L L L L L
specialists.
L
c. New research findings should be incorporated into clinical algorithms before using
L L L L L L L L L L
them in practice.
L L L
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not
L L L L L L L L L L L L L
change.
L
ANS: A L
Descriptive research findings provide evidence for practice but must be viewed in relation to
L L L L L L L L L L L L L
other studies before practice changes. One study is not enough. Descriptive studies are low on
L L L L L L L L L L L L L L L
the hierarchy of evidence. Clinical algorithms use flowcharts to manage problems and do not
L L L L L L L L L L L L L L
specify one response to a clinical problem. Classic tenets of practice should change as research
L L L L L L L L L L L L L L L
findings provide evidence for change.
L L L L L
DIF: Cognitive Level: Analysis (Analyzing) L L L TOP: Nursing Process: Evaluation L L L
MSC: NCLEX: Health Promotion and Maintenance
L L L L L L
7. Two nursing students discuss career plans after graduation. One student wants to enter
L L L L L L L L L L L L
psychiatric nursing. The other student asks, “Why would you want to be a psychiatric nurse?
L L L L L L L L L L L L L L L
All they do is talk. You will lose your skills.” Select the best response by the student
L L L L L L L L L L L L L L L L L
interested in psychiatric nursing.
L L L L
a. “Psychiatric nurses’ practice in safer environments than other specialties and L L L L L L L L L
nurse-to-patient ratios are better because of the nature of patients’ problems.”
L L L L L L L L L L L
b. “Psychiatric nurses use complex communication skills, as well as critical thinking, L L L L L L L L L L
to solve multidimensional problems. I’m challenged by those situations.”
L L L L L L L L L
c. “I think I will be good in the mental health field. I do not like clinical rotations in
L L L L L L L L L L L L L L L L L
school, so I do not want to continue them after I graduate.”
L L L L L L L L L L L L
d. “Psychiatric nurses do not have to deal with as much pain and suffering as L L L L L L L L L L L L L
medical-surgical nurses. That appeals to me.”
L L L L L L
ANS: B L
The practice of psychiatric nursing requires a different set of skills than medical-surgical
L L L L L L L L L L L L
nursing, although substantial overlap does exist. Psychiatric nurses must be able to help
L L L L L L L L L L L L L
patients with medical and mental health problems, reflecting the holistic perspective these
L L L L L L L L L L L L
nurses must have. Nurse–patient ratios and workloads in psychiatric settings have increased,
L L L L L L L L L L L L
similar to other specialties. Psychiatric nursing involves clinical practice, not simply
L L L L L L L L L L L
documentation. Psychosocial pain is real and can cause as much suffering as physical pain.
L L L L L L L L L L L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Implementation
L MSC: NCLEX: Safe, Effective Care Environment
L L L L L L L
8. Which research evidence would most influence a group of nurses to change their practice?
L L L L L L L L L L L L L
a. Expert committee report of recommendations for practice
L L L L L L
b. Systematic review of randomized controlled trials L L L L L
c. Nonexperimental descriptive study L L
d. Critical pathway L
ANS: B L
WWW.THENURSINGMASTERY.COM
,Chapter 01: Science and the Therapeutic Use of Self in Psychiatric Mental Health
L L L L L L L L L L L L
Nursing
L
Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communication
L L L L L L L L
Approach to Evidence-Based Care, 4th Edition
L L L L L L
MULTIPLE CHOICE L
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient
L L L L L L L L L L L L L L L
living in the community and diagnosed with serious and persistent mental illness? Within 3
L L L L L L L L L L L L L L
months, the patient will demonstrate what behavior?
L L L L L L L
a. Denying suicidal ideation L L
b. Reporting a sense of well-being L L L L
c. Taking medications as prescribed L L L
d. Attending clinic appointments on time L L L L
ANS: B L
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
L L L L L L L L
role performance. The goal of recovery is to empower the individual with mental illness to
L L L L L L L L L L L L L L L
achieve a sense of meaning and satisfaction in life and to function at the highest possible level
L L L L L L L L L L L L L L L L L
of wellness. The incorrect options focus on the classic medical model rather than recovery.
L L L L L L L L L L L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Outcomes Identification
L L L L L
MSC: NCLEX: Health Promotion and Maintenance
L L L L L L
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a
L L L L L L L L L L L L L L
divorce. Select the nurse’s most caring comment.
L L L L L L L
a. “Let’s discuss healthy means of coping when you have suicidal feelings.”
L L L L L L L L L L
b. “I understand why you’re so depressed. When I got divorced, I was devastated
L L L L L L L L L L L L
too.” L
c. “You should forget about your marriage and move on with your life.”
L L L L L L L L L L L
d. “How did you get so depressed that hospitalization was necessary?”
L L L L L L L L L
ANS: A L
The nurse’s communication should evidence caring and a commitment to work with the
L L L L L L L L L L L L
patient. This commitment lets the patient know the nurse will help. Probing and advice are not
L L L L L L L L L L L L L L L L
helpful for therapeutic interventions.
L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Implementation
L MSC: NCLEX: Psychosocial Integrity L L L L L
3. In the shift-change report, an off-going nurse criticizes a patient who wears extremely heavy
L L L L L L L L L L L L L
L makeup. Which comment by the nurse who receives the report best demonstrates advocacy?
L L L L L L L L L L L L
a. “This is a psychiatric hospital, so we expect our patients to behave bizarrely.”
L L L L L L L L L L L L
b. “Let’s all show acceptance of this patient by wearing lots of makeup too.”
L L L L L L L L L L L L
c. “Your comments are inconsiderate and inappropriate. Keep the report objective.”
L L L L L L L L L
d. “Our patients need our help to learn behaviors that will help them get along in
L L L L L L L L L L L L L L
society.” L
WWW.THENURSINGMASTERY.COM
, ANS: D L
Accepting patients’ needs for self-expression and seeking to teach skills that will contribute to
L L L L L L L L L L L L L
their well-being demonstrate respect and are important parts of advocacy. The on-coming
L L L L L L L L L L L L
nurse needs to take action to ensure that others are not prejudiced against the patient. Humor
L L L L L L L L L L L L L L L L
can be appropriate within the privacy of a shift report but not at the expense of respect for
L L L L L L L L L L L L L L L L L L
patients. Judging the off-going nurse in a critical way will create conflict. Nurses must show
L L L L L L L L L L L L L L L
compassion for each other.
L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Implementation
L MSC: NCLEX: Safe, Effective Care Environment L L L L L L L
4. A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which
L L L L L L L L L L L L
L statement is an example of “attending”? L L L L L
a. “We all have stress in life. Being in a psychiatric hospital is not the end of the
L L L L L L L L L L L L L L L L
L world.”
b. “Tell me why you felt you had to be hospitalized to receive treatment for your
L L L L L L L L L L L L L L
L depression.”
c. “You will feel better after we get some antidepressant medication started for you.”
L L L L L L L L L L L L
d. “I’d like to sit with you for a while, so you may feel more comfortable talking with
L L L L L L L L L L L L L L L L
L me.”
ANS: D L
Attending is a technique that demonstrates the nurse’s commitment to the relationship and
L L L L L L L L L L L L
reduces feelings of isolation. This technique shows respect for the patient and demonstrates
L L L L L L L L L L L L L
caring. Generalizations, probing, and false reassurances are nontherapeutic.
L L L L L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Implementation
L MSC: NCLEX: Psychosocial Integrity L L L L L
5. A patient shows the nurse an article from the Internet about a health problem. Which
L L L L L L L L L L L L L L
characteristic of the website’s address most alerts the nurse that the site may have biased and
L L L L L L L L L L L L L L L
prejudiced information?
L L
a. Address ends in “.org.” L L L
b. Address ends in “.com.” L L L
c. Address ends in “.gov.” L L L
d. Address ends in “.net.” L L L
ANS: B L
Financial influences on a site are a clue that the information may be biased. “.com” at the end of
L L L L L L L L L L L L L L L L L L
the address indicates that the site is a commercial one. “.gov” indicates that the site is
L L L L L L L L L L L L L L L L
maintained by a government entity. “.org” indicates that the site is nonproprietary; the site
L L L L L L L L L L L L L
may or may not have reliable information, but it does not profit from its activities. “.net” can
L L L L L L L L L L L L L L L L L
have multiple meanings.
L L L
DIF: Cognitive Level: Comprehension (Understanding) L L L TOP: Nursing Process: Evaluation L L L
MSC: NCLEX: Health Promotion and Maintenance
L L L L L L
6. A nurse says, “When I was in school, I learned to call upset patients by name to get their
L L L L L L L L L L L L L L L L L L
attention; however, I read a descriptive research study that says that this approach does not
L L L L L L L L L L L L L L L
work. I plan to stop calling patients by name.” Which statement is the best appraisal of this
L L L L L L L L L L L L L L L L L
nurse’s comment?
L L
a. One descriptive research study rarely provides enough evidence to change practice.
L L L L L L L L L L
WWW.THENURSINGMASTERY.COM
, b. Staff nurses apply new research findings only with the help from clinical nurse
L L L L L L L L L L L L
specialists.
L
c. New research findings should be incorporated into clinical algorithms before using
L L L L L L L L L L
them in practice.
L L L
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not
L L L L L L L L L L L L L
change.
L
ANS: A L
Descriptive research findings provide evidence for practice but must be viewed in relation to
L L L L L L L L L L L L L
other studies before practice changes. One study is not enough. Descriptive studies are low on
L L L L L L L L L L L L L L L
the hierarchy of evidence. Clinical algorithms use flowcharts to manage problems and do not
L L L L L L L L L L L L L L
specify one response to a clinical problem. Classic tenets of practice should change as research
L L L L L L L L L L L L L L L
findings provide evidence for change.
L L L L L
DIF: Cognitive Level: Analysis (Analyzing) L L L TOP: Nursing Process: Evaluation L L L
MSC: NCLEX: Health Promotion and Maintenance
L L L L L L
7. Two nursing students discuss career plans after graduation. One student wants to enter
L L L L L L L L L L L L
psychiatric nursing. The other student asks, “Why would you want to be a psychiatric nurse?
L L L L L L L L L L L L L L L
All they do is talk. You will lose your skills.” Select the best response by the student
L L L L L L L L L L L L L L L L L
interested in psychiatric nursing.
L L L L
a. “Psychiatric nurses’ practice in safer environments than other specialties and L L L L L L L L L
nurse-to-patient ratios are better because of the nature of patients’ problems.”
L L L L L L L L L L L
b. “Psychiatric nurses use complex communication skills, as well as critical thinking, L L L L L L L L L L
to solve multidimensional problems. I’m challenged by those situations.”
L L L L L L L L L
c. “I think I will be good in the mental health field. I do not like clinical rotations in
L L L L L L L L L L L L L L L L L
school, so I do not want to continue them after I graduate.”
L L L L L L L L L L L L
d. “Psychiatric nurses do not have to deal with as much pain and suffering as L L L L L L L L L L L L L
medical-surgical nurses. That appeals to me.”
L L L L L L
ANS: B L
The practice of psychiatric nursing requires a different set of skills than medical-surgical
L L L L L L L L L L L L
nursing, although substantial overlap does exist. Psychiatric nurses must be able to help
L L L L L L L L L L L L L
patients with medical and mental health problems, reflecting the holistic perspective these
L L L L L L L L L L L L
nurses must have. Nurse–patient ratios and workloads in psychiatric settings have increased,
L L L L L L L L L L L L
similar to other specialties. Psychiatric nursing involves clinical practice, not simply
L L L L L L L L L L L
documentation. Psychosocial pain is real and can cause as much suffering as physical pain.
L L L L L L L L L L L L L L
DIF: Cognitive Level: Application (Applying) L L L
TOP: Nursing Process: Implementation
L MSC: NCLEX: Safe, Effective Care Environment
L L L L L L L
8. Which research evidence would most influence a group of nurses to change their practice?
L L L L L L L L L L L L L
a. Expert committee report of recommendations for practice
L L L L L L
b. Systematic review of randomized controlled trials L L L L L
c. Nonexperimental descriptive study L L
d. Critical pathway L
ANS: B L
WWW.THENURSINGMASTERY.COM
