TEST BANK FOR Foundations of Psychiatric Mental Health Nursing 6th Edition By Halter & Varcarolis

TEST BANK FOR Foundations of Psychiatric Mental Health Nursing 6th Edition By Halter & Varcarolis Exam (elaborations) TEST BANK FOR Foundations of Psychiatric Mental Health Nursing 6th Edition By Halter & Varcarolis Varcarolis: Foundations of Psychiatric Mental Health Nursing, 6th Edition Chapter 01: Mental Health and Mental Illness 1. A new staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice nurse to perform which additional interventions? d. Prescribe psychotropic medication 2. Two nursing students discuss their career plans after graduation. One student wants to enter psychiatric nursing. The other asks, “Why would you want to be a psychiatric nurse? The only thing they do is talk. You’ll lose all your skills.” Select the best response. b. “Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations.” 3. A new bill introduced in Congress would reduce funding for care of persons with mental illness. Groups of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled? a. Advocacy 4. An informal group of patients discusses their perceptions of nursing care. Which comment best indicates a patient perceived the nurse was caring? “My nurse: d. spends time listening to me talk about my problems. That helps me feel like I’m not alone.” 5. Which finding best indicates that a patient has a mental illness? The patient: b. reports mood is consistently sad, discouraged, and hopeless. 6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was achieved? A patient: a. sees self as approaching ideals and capable of meeting demands. 7. A nurse encounters an unfamiliar psychiatric disorder on a new patient’s admission form. To determine criteria used to establish this diagnosis, the nurse should consult which resource? a. Diagnostic and Statistical Manual of Mental Disorders 8. Which documentation of diagnosis would a nurse expect in a psychiatric treatment setting? d. I Major Depression II Avoidant Personality Disorder III Hypertension IV Home destroyed by hurricane last year V 80 ANS: D 9. A nurse explains the multiaxial DSM-IV-TR to a psychiatric technician and includes information that it: c. classifies problems in multiple areas of functioning. 10. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have the most complete information? c. Diagnostic and Statistical Manual of Mental Disorders 11. Which comment most clearly shows a speaker views mental illness with stigma? b. “Most people with mental illness are unmotivated.” 12. Complete this analogy. NANDA : clinical judgment :: NIC : _________________ b. nursing actions 13. A college student said, “Most of the time I’m happy and feel good about myself. I have learned that what I get out of something is proportional to the effort I put into it.” Which number on this mental health continuum should the nurse select? Mental Illness Mental Health 1 2 3 4 5 e. 5 14. A newly admitted patient is uncommunicative about recent life events. The nurse suspects marital and economic problems, but the social worker’s assessment is not yet available. Select the nurse’s best action. d. Refer to axis IV of the DSM-IV-TR in the medical record. 15. The Diagnostic and Statistical Manual of Mental Disorders classifies: d. mental disorders people have. 16. A nurse participating in a community health fair is asked, “What is the most prevalent mental disorder in the United States?” Select the nurse’s best response. d. Alzheimer’s disease 17. In the majority culture of the United States, which individual has the greatest risk to be labeled mentally ill? One who: a. describes hearing God’s voice speaking. 18. A patient’s relationships are intense and unstable. The patient initially idealizes the significant other and then devalues them, resulting in frequent feelings of emptiness. This patient will benefit from interventions to develop which aspect of mental health? d. Fulfilling relationships 19. A patient is depressed, mute, and motionless. According to family members, the patient has refused to bathe or eat for a week. The patient’s global assessment of functioning score is: d. 10 20. Which belief will best support a nurse’s efforts to provide patient advocacy during a multidisciplinary patient care planning session? d. Assessment findings in mental disorders reflect a person’s cultural patterns. 21. A nurse is part of a multidisciplinary team working with groups of depressed patients. Half the patients receive supportive interventions and antidepressant medication. The other half receives only medication. The team measures outcomes for each group. Which type of study is evident? b. Clinical epidemiology 22. The spouse of a patient with schizophrenia says, “I don’t understand how nurturing or toilet training in childhood has anything to do with this incredibly disabling illness.” Which response by the nurse will best help the spouse understand this disorder? d. “New findings show that this condition more likely has biological rather than psychological origins.” 23. A 40-year-old who lives with parents and works at an unchallenging job says, “I’m as happy as anyone else, even though I don’t socialize much outside of work. My work is routine, but when new things come up, my boss explains things a few times to make sure I catch on. At home, my parents make decisions for me, and I go along with their ideas.” The nurse should identify interventions to improve this patient’s: a. self-concept. 24. The psychiatric nurse addresses axis I of the DSM as the focus of treatment but must also consider physical health problems that may affect treatment. Which axis contains the desired information? b. III 25. Select the best response for the nurse who receives a query from another mental health professional seeking to understand the difference between a DSM-IV-TR diagnosis and a nursing diagnosis. d. “The DSM-IV-TR diagnosis affects the choice of medical treatment, whereas the nursing diagnosis offers a framework for identifying interventions for phenomena a patient is experiencing.” 1. An experienced nurse says to a new graduate, “When you’ve practiced as long as I have, you’ll instantly know how to take care of psychotic patients.” Which information should the new graduate consider when analyzing this comment? You may select more than one answer. a. The experienced nurse may have lost sight of patients’ individuality, which may compromise the integrity of practice. b. New research findings should be integrated continuously into a nurse’s practice to provide the most effective care. 2. A patient asks the nurse, “I read an article online about psychosocial factors that influence depression. What are psychosocial factors?” Examples a nurse could cite to support the premise that a patient’s depression may be influenced by psychosocial factors include: (Select all that apply) a. having a hostile and overinvolved family. c. feeling strong guilt over having an abortion when one’s religion forbids it. d. experiencing the death of a parent a month before the onset of depression. 3. A patient in the emergency department says, “The voices say someone is stalking me. They want to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a threat.” Which aspect(s) of mental health should be of greatest immediate concern to the nurse? Select all that apply. b. Appraisal of reality c. Control over behavior e. Healthy self-concept Varcarolis: Foundations of Psychiatric Mental Health Nursing, 6th Edition Chapter 02: Relevant Theories and Therapies for Nursing Practice Test Bank 1. A 2-year-old child often displays negative behaviors. The parent says, “My child refuses toilet training and shouts ‘No!’ when given directions. What do you think is wrong?” Select the nurse’s best reply. b. “This is normal for your child’s age. The child is striving for independence.” 2. A 26-month-old displays negative behavior, refuses toilet training, and often says, “No!” Which stage of psychosexual development is evident? b. Anal 3. A 26-month-old displays negative behavior, refuses toilet training, and often says, “No!” Which psychosocial crisis is evident? d. Autonomy versus shame and doubt 4. A 4-year-old grabs toys from siblings and says, “I want that now!” The siblings cry, and the child’s parent becomes upset with the behavior. Using Freudian theory, the nurse can interpret this behavior as a product of impulses originating in the: a. id. 5. The parent of a 4-year-old rewards and praises the child for helping a younger sibling, being polite, and using good manners. The nurse supports the use of praise related to these behaviors. These qualities will likely be internalized and become part of the child’s: c. superego. 6. A nurse supports a parent for praising a child behaving in a helpful way. When this child behaves with politeness and helpfulness in adulthood, which feeling will most likely result? d. Self-esteem 7. A patient says, “I never know the answers,” and “My opinion doesn’t count.” The nurse correctly assesses that this patient had difficulty resolving which psychosocial crisis? c. Autonomy versus shame and doubt 8. Which patient statement would lead the nurse to suspect unsuccessful completion of the developmental task of infancy? b. “I’m afraid to allow anyone to really get to know me.” 9. A patient is suspicious and frequently manipulates others. To which psychosexual stage do these traits relate? a. Oral 10. A patient expresses the desire to be cared for by others and often behaves in a helpless fashion. The patient’s needs relate to which stage of psychosexual development? d. Oral 11. A nurse listens to a group of recent retirees. One says, “I volunteer with Meals on Wheels, coach teen sports, and do church visitation.” Another laughs and says, “I’m too busy taking care of myself to volunteer to help others.” Which developmental task do these statements contrast? d. Generativity and self-absorption *12.Although ego defense mechanisms and security operations are unconsciously determined and designed to relieve anxiety, the major difference is: d. security operations address interpersonal relationship activities. 13. A student nurse says, “I don’t need to interact with my patients. I learn what I need to know by observation.” An instructor can best interpret the nursing implications of Sullivan’s theory to this student by responding: b. “Nurses cannot be isolated. We must interact to provide patients with opportunities to practice interpersonal skills.” 14. A psychiatric technician says, “Common sense is the most important part of working with people who have milambien . Theories are just something to fill up textbooks.” The nurse wants to educate the technician by identifying which common use of Sullivan’s theory? c. The structure of the therapeutic milieu of most behavioral health units 15. A nurse uses Maslow’s hierarchy of needs to plan care for a patient with mental illness. Which problem will receive priority? The patient: a. refuses to eat or bathe. 16. Operant conditioning is part of the treatment plan to encourage speech in a child who is nearly mute. Which technique applies? c. Give the child a small treat for speaking. 17. The parent of a child with schizophrenia tearfully asks the nurse, “What could I have done differently to prevent this illness?” Select the nurse’s best response. b. “Schizophrenia is a biological illness resulting from changes in how the brain and nervous system function. You are not to blame for your child’s illness.” 18. A nurse influenced by Peplau’s interpersonal theory works with an anxious, withdrawn patient. Interventions should focus on: d. enhancing the patient’s interactions with others. 19. A patient had psychotherapy weekly for 5 months. The therapist used free association, dream analysis, and facilitated transference to help the patient understand conflicts and foster change. Select the term that applies to this method. c. Psychodynamic psychotherapy 20. Consider a therapist’s statement: “The patient is homosexual but has kept this preference secret. Severe anxiety and depression occur when the patient anticipates family reactions to this sexual orientation.” Which perspective is evident in the speaker? a. Theory of interpersonal relationships 21. A psychotherapist works with an anxious, dependent patient. Which strategy is most consistent with psychoanalytic psychotherapy? c. Focusing on feelings developed by the patient toward the therapist *22.A person says, “I was the only survivor in a small plane crash. Three business associates died. I got depressed and saw a counselor twice a week for 4 weeks. We talked about my feelings related to being a survivor and I’m OK now.” Which type of therapy was used? d. Interpersonal psychotherapy 23. A cognitive strategy the nurse could use to help a dependent patient would be: d. examining the patient’s fears related to being independent. 24. A single parent who is employed full time complains of feelings of inadequacy related to work and family. The parent seeks help from a therapist who specializes in cognitive behavioral therapy. The therapist will treat the parent by: d. helping the parent identify and change faulty thinking. 25. A college student received an invitation to attend the wedding of a close friend who lives across the country. The student is afraid of flying. What type of therapy would the nurse suggest? c. Systematic desensitization 26. A patient would benefit from therapy in which peers as well as staff have a voice in determining patient privileges and psychoeducational topics. Which approach would be best? a. Milieu therapy 27. A patient repeatedly stated, “I’m stupid.” Which statement by the patient shows progress because of cognitive behavioral therapy? a. “Sometimes I do stupid things.” MULTIPLE RESPONSE 1. A patient states, “I’m starting cognitive-behavioral therapy. What can I expect from the sessions?” Which response(s) by the nurse would be appropriate? Select all that apply. a. “The therapist will be active and questioning.” b. “You may be given homework assignments.” d. “The therapist will help you look at ideas and beliefs you have about yourself.” 2. Which comment(s) by an elderly person best indicate successful completion of developmental tasks? Select all that apply. a. “I am proud of my children’s successes in life.” d. “My experiences in the war helped me appreciate the meaning of life.” 3. Which comment(s) by an adult best indicate self-actualization? Select all that apply. a. “I am content with a good book.” d. “It’s important for our country to provide basic health care services for everyone.” e. “When I was lost at sea for 2 days, I gained an understanding of what is important.” . Varcarolis: Foundations of Psychiatric Mental Health Nursing, 6th Edition Chapter 09: Therapeutic Relationships 1. A nurse assesses an elderly patient who was found wandering and confused. The nurse feels sad and reflects, “She’s like my grandmother…so helpless.” Which term best applies to the nurse’s response? c. Countertransference 2. Which statement shows a nurse has empathy for a patient who made a suicide attempt? a. “You must have been very upset to do what you did today.” 3. After several therapeutic encounters with a patient who recently attempted suicide, which behavior should cause the nurse to consider the possibility of countertransference? b. The nurse feels very happy when the patient’s mood begins to lift. 4. How should the nurse respond if a patient says, “Please don’t share information about me with the other people”? b. “I won’t share information with your family or friends without your permission, but I will share information with other staff.” 5. A patient who recently attempted suicide talks with the nurse about wanting to take a walk on hospital grounds. The nurse responds by telling the patient, “I will talk with the psychiatrist on your behalf.” Select the accurate analysis of this interaction. a. The nurse is behaving in an overly helpful way. 6. Termination of a therapeutic nurse-patient relationship has been successful when the nurse: a. discusses with the patient changes that happened during the relationship and evaluates outcomes. 7. Select the desirable outcome for the initial stage of a nurse-patient relationship. The patient will demonstrate behaviors that indicate: b. rapport and trust with the nurse. 8. During which phase of the nurse-patient relationship can a nurse anticipate that patient issues will be explored and resolved? c. Working 9. At what point in the nurse-patient relationship should a nurse first address termination? b. Orientation phase 10. Why should a nurse introduce the matter of a contract during the first session with a new patient? Contracts: b. spell out participation and responsibilities of both parties. 11. A patient frequently asks the nurse for extra snacks, implying more willingness to talk if these items are provided. The nurse should assess this behavior as: d. testing the nurse’s clinical