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Chapter 1. Examination and Diagnosis of the Psychiatric Patient
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Multiple Choice v #
Identify the choice that best completes the statement or answers the question.
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1. A nurse is assessing a client who is experiencing occasional fee v# v# v# v# v# v# v# v# v# v# v
lings of sadness because of the recent death of a beloved pet. The client’s appetite, sle
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ep patterns, and daily routine have not changed. How should the nurse inter
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pret the client’s behaviors?
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The client’s behaviors demonstrate mental illne
1.
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ss in the form of depression.
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The client’s behaviors are extensive, which indi
2.
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cates the presence of mental illness.
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The client’s behaviors are not congruent with c
3.
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ultural norms. v #
The client’s behaviors demonstrate no functio n
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4. al impairment, indicating no mental
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illness.
2. At what point should the nurse determine that a client is at risk v# v# v# v# v# v# v# v# v# v# v# v# v
# for developing a mental illness?
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When thoughts, feelings, and behaviors are
1.
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not reflective of the DSM-5 criteria. v# v# v# v# v#
When maladaptive responses to stress are coupl v# v# v# v# v# v# v#
2. ed with interference in daily v# v# v# v#
functioning.
When a client communicates significant
3.
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distress.
When a client uses defense mechanisms as
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ego protection. v#
3. A nurse is assessing a set of 15-year- v# v# v# v# v# v# v#
old identical twins who respond very differently to stress. One twin becomes anxiou
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s and irritable, and the other withdraws and cries. How should the nurse explain the
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se different stress responses to the parents?
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Reactions to stress are relative rather than absol v# v# v# v# v# v# v# v#
1. ute; individual responses to stress v# v# v# v#
vary.
It is abnormal for identical twins to react differe
2.
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ntly to similar stressors. v# v# v#
PlusBay.Plus
, Identical twins should share the same temperam
3.
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ent and respond similarly to stress.
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Environmental influences to stress weigh mo
4.
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re heavily than genetic influences.
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4. Which client should the nurse anticipate to be most
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# receptive to psychiatric treatment?
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1. A Jewish, female social worker. v# v# v# v#
2. A Baptist, homeless male. v# v# v#
3. A Catholic, black male. v# v# v #
4. A Protestant, Swedish business executive. v# v # v# v #
5. A psychiatric nurse intern states, “This client’s use of defense
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mechanisms should be eliminated.” Which is a correct evaluation of this nurse’s state
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ment?
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Defense mechanisms can be appropriate respon v# v# v# v# v# v#
1. ses to stress and need not be v# v# v# v# v# bn
eliminated.
Defense mechanisms are a maladaptive attem v# v# v# v# v# v#
2. pt of the ego to manage anxiety and v# v# v# v# v# v# v#
should always be eliminated. v# v# v#
Defense mechanisms, used by individuals wit v# v# v# v# v# v#
3. h weak ego integrity, should be v# v# v# v# v #
discouraged and not eliminated. v# v # v#
Defense mechanisms cause disintegration of t
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4. he ego and should be fostered and
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encouraged.
6. During an intake assessment, a nurse asks both physiological
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and psychosocial questions. The client angrily responds, “I’m here for my heart, no
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t my head problems.” Which is the nurse’s best response?
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“It is just a routine part of our assessment. All c v# v# v# bn v# v# v# v# v# v# v#
1. lients are asked these same v# v# v# v #
questions.”
“Why are you concerned about these types of q
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uestions?”
“Psychological factors, like excessive stress, ha v# v# v# v# v# v#
3. ve been found to affect medical v# v# v# v# bn
conditions.”
PlusBay.Plus
, “We can skip these questions, if you like. It i
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4. sn’t imperative that we complete this
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section.”
7. An employee uses the defense mechanism of displacement wh
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# en the boss openly disagrees with suggestions. What behavior would be expected fro
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# m this employee?
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1. The employee assertively confronts the boss. v# v # v # v # v #
The employee leaves the staff meeting to wor
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k out in the gym. v# v# v# v#
3. The employee criticizes a coworker. v# v# v# v#
4. The employee takes the boss out to lunch. v# v# v# v# v# v# v#
8. A fourth- v#
grade boy teases and makes jokes about a cute girl in his class. This behavior shoul
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d be identified by a nurse as indicative of which defense mechanism?
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1. Displacement
2. Projection
3. Reaction formation v #
4. Sublimation
9. Which nursing statement about the concept of neurosis is most accurate?
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An individual experiencing neurosis is unawa v# v# v# v# v# v
1. re that he or she is experiencing # v# v# v# v# v# v#
distress.
An individual experiencing neurosis feels hel
2.
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pless to change his or her situation. v# v# v# v# v# v#
An individual experiencing neurosis is aware v# v# v# v# v# v#
3. of the psychological causes of his or v# v# v# v# v# v#
her behavior. v#
An individual experiencing neurosis has a lo
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ss of contact with reality. v# v# v# v#
10. Which nursing statement regarding the concept of psychosis is most
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accurate?
Individuals experiencing psychoses are aware t
1.
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hat their behaviors are maladaptive.
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Individuals experiencing psychoses experien
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ce little distress.
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PlusBay.Plus