Test Bank For Essentials of Psychiatric Mental Health Nursing 8th Edition Concepts of Care in Evidence Based Practice 8th Edition Morgan Townsend | 9780803676787 | Chapter 1-32 |All Chapters with Answers and Rationals

Essentials of Psychiatric Mental Health Nursing 8th
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Edition Concepts of Care in Evidence - Based
Practice 8th Edition Morgan Townsend

Chapter 1. Mental Health and Mental ni ni ni ni ni ni




IllnessMultiple Choice ni




1. A nurse is assessing a client who is experiencing occasional feelings of sadness because
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of therecent death of a beloved pet. The clients appetite, sleep patterns, and daily routine
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have not changed. How should the nurse interpret the clients behaviors?
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1. The clients behaviors demonstrate mental illness in the form of depression.
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2. The clients behaviors are extensive, which indicates the presence of mental illness.
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3. The clients behaviors are not congruent with cultural norms.
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4. The clients behaviors demonstrate no functional impairment, indicating no mental i
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llness.

ANS: 4 ni




Rationale: The nurse should assess that the clients daily functioning is not impaired. Th
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e clientwho experiences feelings of sadness after the loss of a pet is responding within nor
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mal expectations. Without significant impairment, the clients distress does not indicate
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a mental illness.
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Cognitive Level: Analysis Int ni ni ni




egrated Process: ni




Assessment

2. At what point should the nurse determine that a client is at risk for developing a
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mentalillness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
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2. When maladaptive responses to stress are coupled with interference in daily f
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unctioning.
3. When a client communicates significant distress.
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4. When a client uses defense mechanisms as ego protection.
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ANS: 2 ni




Rationale: The nurse should determine that the client is at risk for mental illness when
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,responsesto stress are maladaptive and interfere with daily functioning. The DSM-
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5 indicates that in orderto be diagnosed with a mental illness, daily functioning must be
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significantly impaired. The clients ability to communicate distress would be considered
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a positive attribute.
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Cognitive Level: Application ni ni ni




Integrated Process: ni




Assessment

3. A nurse is assessing a set of 15-year-
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old identical twins who respond very differently to stress.One twin becomes anxious an
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d irritable, and the other withdraws and cries. How should the nurse explain these diff
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erent stress responses to the parents?
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1. Reactions to stress are relative rather than absolute; individual responses to stress v
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ary.
2. It is abnormal for identical twins to react differently to similar stressors.
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3. Identical twins should share the same temperament and respond similarly to stress.
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4. Environmental influences to stress weigh more heavily than genetic influences. ni ni ni ni ni ni ni ni ni

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ANS: 1 ni



Rationale: The nurse should explain to the parents that, although the twins have identic
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al DNA,there are several other factors that affect reactions to stress. Mental health is a st
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ate of being thatis relative to the individual client. Environmental influences and tempe
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rament can affect stress reactions.
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Cognitive Level: Application ni ni ni




Integrated Process: ni




Implementation

4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
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1. A Jewish, female social worker.
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2. A Baptist, homeless male.
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3. A Catholic, black male.
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4. A Protestant, Swedish business executive.
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ANS: 1 ni




Rationale: The nurse should anticipate that the client of Jewish culture would place a hi
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gh importance on preventative health care and would consider mental health as equally
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important asphysical health. Women are also more likely to seek treatment for mental h
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ealth problems than men.
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Cognitive Level: ni




ApplicationIntegrated Proces ni




s: Planning
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5. A psychiatric nurse intern states, This clients use of defense mechanisms should be e
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liminated.Which is a correct evaluation of this nurses statement? ni ni ni ni ni ni ni ni




1. Defense mechanisms can be appropriate responses to stress and need not be
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eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety
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and shouldalways be eliminated.
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3. Defense mechanisms, used by individuals with weak ego integrity, should be
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discouraged andnot eliminated. ni ni




4. Defense mechanisms cause disintegration of the ego and should be fostered and e
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ncouraged.

ANS: 1 ni

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ANS: 1 ni



Rationale: The nurse should determine that defense mechanisms can be appropriate du
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ring timesof stress. The client with no defense mechanisms may have a lower tolerance f
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or stress, thus leading to anxiety disorders. Defense mechanisms should be confronted w
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hen they impede the client from developing healthy coping skills.
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Cognitive Level: ni




Application Integrated ni n




Process: Evaluation
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6. During an intake assessment, a nurse asks both physiological and psychosocial q
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uestions. Theclient angrily responds, Im here for my heart, not my head problems.
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Which is the nurses best response?
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1. Its just a routine part of our assessment. All clients are asked these same questions.
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2. Why are you concerned about these types of questions?
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3. Psychological factors, like excessive stress, have been found to affect medical
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conditions.
4. We can skip these questions, if you like. It isnt imperative that we complete this s
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ection.