ESSENTIALS OF PSYCHIATRIC MENTAL
HEALTH NURSING: CONCEPTS OF CARE IN
EVIDENCE-BASED PRACTICE 8TH EDITION
MORGAN, TOWNSEND TEST BANK
,Chapter 1. Mental Health and Mental Illness Multiple Choice
1. A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent
death of a beloved pet. The clients appetite, sleep patterns, and daily routine have not changed. How
should the nurse interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of mental illness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no mental illness.
ANS: 4
Rationale: The nurse should assess that the clients daily functioning is not impaired. The client who
experiences feelings of sadness after the loss of a pet is responding within normal expectations. Without
significant impairment, the clients distress does not indicate a mental illness.
Cognitive Level: Analysis Integrated Process: Assessment
2. At what point should the nurse determine that a client is at risk for developing a mental illness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
2. When maladaptive responses to stress are coupled with interference in daily functioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
ANS: 2
Rationale: The nurse should determine that the client is at risk for mental illness when responses to
stress are maladaptive and interfere with daily functioning. The DSM-5 indicates that in order to be
diagnosed with a mental illness, daily functioning must be significantly impaired. The clients ability to
communicate distress would be considered a positive attribute.
Cognitive Level: Application Integrated Process: Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently to stress. One
twin becomes anxious and irritable, and the other withdraws and cries. How should the nurse explain
these different stress responses to the parents?
1. Reactions to stress are relative rather than absolute; individual responses to stress vary.
2. It is abnormal for identical twins to react differently to similar stressors.
3. Identical twins should share the same temperament and respond similarly to stress.
4. Environmental influences to stress weigh more heavily than genetic influences.
,Rationale: The nurse should explain to the parents that, although the twins have identical DNA, there
are several other factors that affect reactions to stress. Mental health is a state of being that is relative
to the individual client. Environmental influences and temperament can affect stress reactions.
Cognitive Level: Application Integrated Process: Implementation
4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
1. A Jewish, female social worker.
2. A Baptist, homeless male.
3. A Catholic, black male.
4. A Protestant, Swedish business executive.
ANS: 1
Rationale: The nurse should anticipate that the client of Jewish culture would place a high importance
on preventative health care and would consider mental health as equally important as physical health.
Women are also more likely to seek treatment for mental health problems than men.
Cognitive Level: Application Integrated Process: Planning
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be eliminated.
Which is a correct evaluation of this nurses statement?
1. Defense mechanisms can be appropriate responses to stress and need not be eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should
always be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and
not eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
ANS: 1
Rationale: The nurse should determine that defense mechanisms can be appropriate during times of
stress. The client with no defense mechanisms may have a lower tolerance for stress, thus leading to
anxiety disorders. Defense mechanisms should be confronted when they impede the client from
developing healthy coping skills.
Cognitive Level: Application Integrated Process: Evaluation
6. During an intake assessment, a nurse asks both physiological and psychosocial questions. The client
angrily responds, Im here for my heart, not my head problems. Which is the nurses best response?
1. Its just a routine part of our assessment. All clients are asked these same questions.
2. Why are you concerned about these types of questions?
3. Psychological factors, like excessive stress, have been found to affect medical conditions.
, 4. We can skip these questions, if you like. It isnt imperative that we complete this section.
ANS: 3
Rationale: The nurse should attempt to educate the client on the negative effects of excessive stress on
medical conditions. It is not appropriate to skip physiological and psychosocial questions, as this would
lead to an inaccurate assessment.
Cognitive Level: Application Integrated Process: Implementation
7. An employee uses the defense mechanism of displacement when the boss openly disagrees with
suggestions. What behavior would be expected from this employee?
1. The employee assertively confronts the boss.
2. The employee leaves the staff meeting to work out in the gym.
3. The employee criticizes a coworker.
4. The employee takes the boss out to lunch.
ANS: 3
Rationale: The nurse should expect that the client using the defense mechanism displacement would
criticize a coworker after being confronted by the boss. Displacement refers to transferring feelings from
one target to a neutral or less-threatening target.
Cognitive Level: Analysis Integrated Process: Assessment
8. A fourth-grade boy teases and makes jokes about a cute girl in his class. This behavior should be
identified by a nurse as indicative of which defense mechanism?
1. Displacement
2. Projection
3. Reaction formation
4. Sublimation
ANS: 3
HEALTH NURSING: CONCEPTS OF CARE IN
EVIDENCE-BASED PRACTICE 8TH EDITION
MORGAN, TOWNSEND TEST BANK
,Chapter 1. Mental Health and Mental Illness Multiple Choice
1. A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent
death of a beloved pet. The clients appetite, sleep patterns, and daily routine have not changed. How
should the nurse interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of mental illness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no mental illness.
ANS: 4
Rationale: The nurse should assess that the clients daily functioning is not impaired. The client who
experiences feelings of sadness after the loss of a pet is responding within normal expectations. Without
significant impairment, the clients distress does not indicate a mental illness.
Cognitive Level: Analysis Integrated Process: Assessment
2. At what point should the nurse determine that a client is at risk for developing a mental illness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
2. When maladaptive responses to stress are coupled with interference in daily functioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
ANS: 2
Rationale: The nurse should determine that the client is at risk for mental illness when responses to
stress are maladaptive and interfere with daily functioning. The DSM-5 indicates that in order to be
diagnosed with a mental illness, daily functioning must be significantly impaired. The clients ability to
communicate distress would be considered a positive attribute.
Cognitive Level: Application Integrated Process: Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently to stress. One
twin becomes anxious and irritable, and the other withdraws and cries. How should the nurse explain
these different stress responses to the parents?
1. Reactions to stress are relative rather than absolute; individual responses to stress vary.
2. It is abnormal for identical twins to react differently to similar stressors.
3. Identical twins should share the same temperament and respond similarly to stress.
4. Environmental influences to stress weigh more heavily than genetic influences.
,Rationale: The nurse should explain to the parents that, although the twins have identical DNA, there
are several other factors that affect reactions to stress. Mental health is a state of being that is relative
to the individual client. Environmental influences and temperament can affect stress reactions.
Cognitive Level: Application Integrated Process: Implementation
4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
1. A Jewish, female social worker.
2. A Baptist, homeless male.
3. A Catholic, black male.
4. A Protestant, Swedish business executive.
ANS: 1
Rationale: The nurse should anticipate that the client of Jewish culture would place a high importance
on preventative health care and would consider mental health as equally important as physical health.
Women are also more likely to seek treatment for mental health problems than men.
Cognitive Level: Application Integrated Process: Planning
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be eliminated.
Which is a correct evaluation of this nurses statement?
1. Defense mechanisms can be appropriate responses to stress and need not be eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should
always be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and
not eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
ANS: 1
Rationale: The nurse should determine that defense mechanisms can be appropriate during times of
stress. The client with no defense mechanisms may have a lower tolerance for stress, thus leading to
anxiety disorders. Defense mechanisms should be confronted when they impede the client from
developing healthy coping skills.
Cognitive Level: Application Integrated Process: Evaluation
6. During an intake assessment, a nurse asks both physiological and psychosocial questions. The client
angrily responds, Im here for my heart, not my head problems. Which is the nurses best response?
1. Its just a routine part of our assessment. All clients are asked these same questions.
2. Why are you concerned about these types of questions?
3. Psychological factors, like excessive stress, have been found to affect medical conditions.
, 4. We can skip these questions, if you like. It isnt imperative that we complete this section.
ANS: 3
Rationale: The nurse should attempt to educate the client on the negative effects of excessive stress on
medical conditions. It is not appropriate to skip physiological and psychosocial questions, as this would
lead to an inaccurate assessment.
Cognitive Level: Application Integrated Process: Implementation
7. An employee uses the defense mechanism of displacement when the boss openly disagrees with
suggestions. What behavior would be expected from this employee?
1. The employee assertively confronts the boss.
2. The employee leaves the staff meeting to work out in the gym.
3. The employee criticizes a coworker.
4. The employee takes the boss out to lunch.
ANS: 3
Rationale: The nurse should expect that the client using the defense mechanism displacement would
criticize a coworker after being confronted by the boss. Displacement refers to transferring feelings from
one target to a neutral or less-threatening target.
Cognitive Level: Analysis Integrated Process: Assessment
8. A fourth-grade boy teases and makes jokes about a cute girl in his class. This behavior should be
identified by a nurse as indicative of which defense mechanism?
1. Displacement
2. Projection
3. Reaction formation
4. Sublimation
ANS: 3
