Psychiatric Mental Health Nursing 9th
Edition Sheila Videbeck Complete
Chapters 2026
Chapter 1: Foundations of Psychiatric-Mental Health Nursing
1. A nursing student asks the instructor to explain the primary focus of psychiatric-
mental health nursing. Which statement by the instructor is most accurate?
A. “The focus is exclusively on medication management for diagnosed mental
disorders.”
B. “The focus is promoting mental health through assessment, diagnosis, and
treatment of human responses to mental health problems.”
C. “The focus is limited to providing long-term inpatient care for individuals with
chronic mental illness.”
D. “The focus is conducting psychological testing and formulating psychiatric
diagnoses independently.”
Correct Answer: B
Rationale: Psychiatric-mental health nursing focuses on the diagnosis and
treatment of human responses to actual or potential mental health problems. It
uses a holistic nursing approach that includes promoting mental health,
preventing mental illness, and managing symptoms and functional deficits. Option
A is incorrect because the role encompasses psychosocial interventions, milieu
therapy, and health teaching, not solely medication management. Option C is
incorrect as psychiatric nursing occurs across a continuum of settings, including
community, outpatient, and crisis services. Option D is incorrect because
psychiatric diagnoses and psychological testing are performed by psychiatrists and
psychologists; nurses use nursing diagnoses and implement therapeutic
interventions.
,2. The nurse is reviewing the standards of practice for psychiatric-mental health
nursing. Which activity reflects the standard of “planning”?
A. Collecting data about the patient’s sleep patterns and mood fluctuations.
B. Identifying a nursing diagnosis of Ineffective Coping related to situational crisis.
C. Developing a care plan with the patient that includes a goal to attend two group
activities daily.
D. Evaluating the patient’s progress toward reducing anxiety as evidenced by
lower self-reported stress scores.
Correct Answer: C
Rationale: The standard of planning involves developing an individualized plan of
care with the patient that prescribes strategies and alternatives to attain expected
outcomes. Option C demonstrates collaborative goal setting. Option A reflects the
assessment standard. Option B reflects the diagnosis standard. Option D reflects
the evaluation standard. These distinctions align with the nursing process as
defined by the ANA’s Scope and Standards of Psychiatric-Mental Health Nursing.
3. During the 19th century, a shift toward humane treatment of individuals with
mental illness was known as:
A. The Community Mental Health Movement
B. Moral Treatment
C. Deinstitutionalization
D. The Recovery Model
Correct Answer: B
Rationale: Moral treatment was a 19th-century movement emphasizing kindness,
meaningful activity, and a structured environment, led by figures like Philippe
Pinel and Dorothea Dix. The Community Mental Health Movement (A) emerged in
the 1960s. Deinstitutionalization (C) refers to the shift from long-term hospitals to
community-based care. The Recovery Model (D) is a contemporary framework
focusing on empowerment and hope, not a 19th-century movement.
,Chapter 2: Neurobiologic Theories and Psychopharmacology
4. A patient with depression is prescribed a selective serotonin reuptake inhibitor
(SSRI). The nurse explains that this medication works by:
A. Blocking the reuptake of both serotonin and norepinephrine.
B. Inhibiting monoamine oxidase, leading to increased neurotransmitter levels.
C. Selectively blocking the reabsorption of serotonin in the synaptic cleft.
D. Blocking dopamine receptors in the mesolimbic pathway.
Correct Answer: C
Rationale: SSRIs selectively inhibit the reuptake of serotonin at the presynaptic
neuron, increasing serotonin availability in the synapse. Option A describes SNRIs.
Option B describes MAOIs. Option D describes first-generation antipsychotics. This
reflects core psychopharmacology knowledge.
5. A patient taking risperidone develops fever, muscle rigidity, altered
consciousness, and autonomic instability. The nurse suspects:
A. Acute dystonia
B. Neuroleptic malignant syndrome (NMS)
C. Akathisia
D. Tardive dyskinesia
Correct Answer: B
Rationale: NMS is a rare but life-threatening idiosyncratic reaction to
antipsychotics, characterized by hyperthermia, severe muscle rigidity, autonomic
dysfunction, and fluctuating level of consciousness. Acute dystonia (A) involves
muscle spasms, not fever. Akathisia (C) is subjective restlessness without fever.
Tardive dyskinesia (D) presents as involuntary choreoathetoid movements, not
acute rigidity and fever. Immediate medical intervention is required for NMS.
6. A patient on lithium therapy reports fine hand tremor, polyuria, and metallic
taste. The nurse should first:
A. Withhold the lithium and notify the prescriber immediately.
, B. Reassure the patient that these are expected side effects at therapeutic levels.
C. Assess for signs of severe toxicity such as coarse tremor and confusion.
D. Administer an anticholinergic medication to reduce the tremor.
Correct Answer: B
Rationale: Fine tremor, polyuria, and metallic taste are common, manageable side
effects of lithium at therapeutic serum levels (0.6–1.2 mEq/L). The nurse should
provide reassurance and encourage adequate hydration. Option A is for toxicity.
Option C is assessment for worsening condition but does not address the
immediate need for teaching. Option D is inappropriate; anticholinergics are not
used for lithium tremor. Careful monitoring and patient education are priorities.
7. A patient with schizophrenia is started on clozapine. Which laboratory test is
essential before initiating therapy and regularly thereafter?
A. Serum creatinine
B. Absolute neutrophil count (ANC)
C. Thyroid-stimulating hormone
D. Serum lithium level
Correct Answer: B
Rationale: Clozapine carries a risk of agranulocytosis, a potentially life-threatening
decrease in white blood cells. The ANC must be monitored at baseline, weekly for
the first 6 months, then biweekly and eventually monthly if stable. Options A, C,
and D are not specific to clozapine monitoring. This critical safety component is
emphasized in Videbeck.
Chapter 3: Psychosocial Theories and Therapies
8. A nurse is interacting with a patient using Peplau’s theory. During the working
phase, the nurse should:
A. Establish rapport and explore the patient’s perceptions of problems.
B. Summarize progress and discuss termination of the relationship.
Edition Sheila Videbeck Complete
Chapters 2026
Chapter 1: Foundations of Psychiatric-Mental Health Nursing
1. A nursing student asks the instructor to explain the primary focus of psychiatric-
mental health nursing. Which statement by the instructor is most accurate?
A. “The focus is exclusively on medication management for diagnosed mental
disorders.”
B. “The focus is promoting mental health through assessment, diagnosis, and
treatment of human responses to mental health problems.”
C. “The focus is limited to providing long-term inpatient care for individuals with
chronic mental illness.”
D. “The focus is conducting psychological testing and formulating psychiatric
diagnoses independently.”
Correct Answer: B
Rationale: Psychiatric-mental health nursing focuses on the diagnosis and
treatment of human responses to actual or potential mental health problems. It
uses a holistic nursing approach that includes promoting mental health,
preventing mental illness, and managing symptoms and functional deficits. Option
A is incorrect because the role encompasses psychosocial interventions, milieu
therapy, and health teaching, not solely medication management. Option C is
incorrect as psychiatric nursing occurs across a continuum of settings, including
community, outpatient, and crisis services. Option D is incorrect because
psychiatric diagnoses and psychological testing are performed by psychiatrists and
psychologists; nurses use nursing diagnoses and implement therapeutic
interventions.
,2. The nurse is reviewing the standards of practice for psychiatric-mental health
nursing. Which activity reflects the standard of “planning”?
A. Collecting data about the patient’s sleep patterns and mood fluctuations.
B. Identifying a nursing diagnosis of Ineffective Coping related to situational crisis.
C. Developing a care plan with the patient that includes a goal to attend two group
activities daily.
D. Evaluating the patient’s progress toward reducing anxiety as evidenced by
lower self-reported stress scores.
Correct Answer: C
Rationale: The standard of planning involves developing an individualized plan of
care with the patient that prescribes strategies and alternatives to attain expected
outcomes. Option C demonstrates collaborative goal setting. Option A reflects the
assessment standard. Option B reflects the diagnosis standard. Option D reflects
the evaluation standard. These distinctions align with the nursing process as
defined by the ANA’s Scope and Standards of Psychiatric-Mental Health Nursing.
3. During the 19th century, a shift toward humane treatment of individuals with
mental illness was known as:
A. The Community Mental Health Movement
B. Moral Treatment
C. Deinstitutionalization
D. The Recovery Model
Correct Answer: B
Rationale: Moral treatment was a 19th-century movement emphasizing kindness,
meaningful activity, and a structured environment, led by figures like Philippe
Pinel and Dorothea Dix. The Community Mental Health Movement (A) emerged in
the 1960s. Deinstitutionalization (C) refers to the shift from long-term hospitals to
community-based care. The Recovery Model (D) is a contemporary framework
focusing on empowerment and hope, not a 19th-century movement.
,Chapter 2: Neurobiologic Theories and Psychopharmacology
4. A patient with depression is prescribed a selective serotonin reuptake inhibitor
(SSRI). The nurse explains that this medication works by:
A. Blocking the reuptake of both serotonin and norepinephrine.
B. Inhibiting monoamine oxidase, leading to increased neurotransmitter levels.
C. Selectively blocking the reabsorption of serotonin in the synaptic cleft.
D. Blocking dopamine receptors in the mesolimbic pathway.
Correct Answer: C
Rationale: SSRIs selectively inhibit the reuptake of serotonin at the presynaptic
neuron, increasing serotonin availability in the synapse. Option A describes SNRIs.
Option B describes MAOIs. Option D describes first-generation antipsychotics. This
reflects core psychopharmacology knowledge.
5. A patient taking risperidone develops fever, muscle rigidity, altered
consciousness, and autonomic instability. The nurse suspects:
A. Acute dystonia
B. Neuroleptic malignant syndrome (NMS)
C. Akathisia
D. Tardive dyskinesia
Correct Answer: B
Rationale: NMS is a rare but life-threatening idiosyncratic reaction to
antipsychotics, characterized by hyperthermia, severe muscle rigidity, autonomic
dysfunction, and fluctuating level of consciousness. Acute dystonia (A) involves
muscle spasms, not fever. Akathisia (C) is subjective restlessness without fever.
Tardive dyskinesia (D) presents as involuntary choreoathetoid movements, not
acute rigidity and fever. Immediate medical intervention is required for NMS.
6. A patient on lithium therapy reports fine hand tremor, polyuria, and metallic
taste. The nurse should first:
A. Withhold the lithium and notify the prescriber immediately.
, B. Reassure the patient that these are expected side effects at therapeutic levels.
C. Assess for signs of severe toxicity such as coarse tremor and confusion.
D. Administer an anticholinergic medication to reduce the tremor.
Correct Answer: B
Rationale: Fine tremor, polyuria, and metallic taste are common, manageable side
effects of lithium at therapeutic serum levels (0.6–1.2 mEq/L). The nurse should
provide reassurance and encourage adequate hydration. Option A is for toxicity.
Option C is assessment for worsening condition but does not address the
immediate need for teaching. Option D is inappropriate; anticholinergics are not
used for lithium tremor. Careful monitoring and patient education are priorities.
7. A patient with schizophrenia is started on clozapine. Which laboratory test is
essential before initiating therapy and regularly thereafter?
A. Serum creatinine
B. Absolute neutrophil count (ANC)
C. Thyroid-stimulating hormone
D. Serum lithium level
Correct Answer: B
Rationale: Clozapine carries a risk of agranulocytosis, a potentially life-threatening
decrease in white blood cells. The ANC must be monitored at baseline, weekly for
the first 6 months, then biweekly and eventually monthly if stable. Options A, C,
and D are not specific to clozapine monitoring. This critical safety component is
emphasized in Videbeck.
Chapter 3: Psychosocial Theories and Therapies
8. A nurse is interacting with a patient using Peplau’s theory. During the working
phase, the nurse should:
A. Establish rapport and explore the patient’s perceptions of problems.
B. Summarize progress and discuss termination of the relationship.
