TestBank_Varcarolis_Essentials_of_Psychiatric_Mental_Health

Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 2 Chapt a 01: Practicing the Science and the Art of Psychiatric Nursing MULTIPLE CHOICE 1. Which outcome, focused on recov ay, would be expected in the plan of care for a patient living in the community and diagnosed with s aious and p asistent mental illness? Within 3 months, the patient will: a. deny suicidal ideation. b. report a sense of well -being. c. take medications as prescribed. d. attend clinic appointments on time. ANS: B Recov ay emphasizes managing symptoms, reducing psychosocial disability, and improving role paformance. The goal of recov ay is to empow a the individual with mental illness to achieve a sense of meaning and satisfaction in life and to function at the highest possible level of wellness. The incorrect options focus on the classic medical model rath a than recov ay. DIF: Cognitive Level: Application (Applying) REF: 2 TOP: Nursing Process: Outcomes Identification MSC: NCLEX: Health Promotion and Maintenance 2. In the shift -change report, an off -going nurse criticizes a patient who wears heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy? a. This is a psychiatric hospital. Craz iness is what we are all about. b. Lets all show acceptance of this patient by wearing lots of makeup too. c. Your comments are inconsid aate and inappropriate. Keep the report objective. d. Our patients need our help to learn behaviors that will help them get a long in society. ANS: D Accepting patients needs for self -expression and seeking to teach skills that will contribute to their well -being demonstrate respect and are important parts of advocacy. The oncoming nurse needs to take action to ensure that oth as are not prejudiced against the patient. Humor can be appropriate within the privacy of a shift report but not at the expense of respect for patients. Judging the off -going nurse in a critical way will create conflict. Nurses must show compassion for eac h oth a. DIF: Cognitive Level: Application (Applying) REF: 8 TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 3. A nurse assesses a newly admitted patient diagnosed with major depressive disord a. Which statement is an exa mple of attending? a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world. b. Tell me why you felt you had to be hospitalized to receive treatment for your depression. c. You will feel bett a afta we get some antidepressant med ication started for you. d. Id like to sit with you a while so you may feel more comfortable talking with me. ANS: D Attending is a technique that demonstrates the nurses commitment to the relationship and reduces feelings of isolation. This technique shows respect for the patient and demonstrates caring. Gen aalizations, probing, and false reassurances are non -thaapeutic. DIF: Cognitive Level: Application (Applying) REF: 8 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 4. A patien t is hospitalized for depression and suicidal ideation aft a their spouse asks for a divorce. Select the nurses most caring comment. a. Lets discuss some means of coping oth a than suicide when you have these feelings. b. I und astand why youre so depressed. W hen I got divorced, I was devastated too. c. You should forget about your marriage and move on with your life. d. How did you get so depressed that hospitalization was necessary? Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varca rolis) 3 ANS: A The nurses communication should evidence caring and a commitment to work with the patient. This commitment lets the patient know the nurse will help. Probing and advice are not helpful or th aapeutic int aventions. DIF: Cognitive Level: Application (Applying) REF: 6 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 5. A patient shows the nurse an article from the Int anet about a health problem. Which charact aistic of the web sites address most alats the nurse that the site may have biased and prejudiced information? a. Address ends in .org. b. Address ends in .com. c. Address ends in .gov. d. Address ends in .net. ANS: B Financial influences on a site are a clue that the information may be biased. .c om at the end of the address indicates that the site is a comm acial one. .gov indicates that the site is maintained by a gov anment entity. .org indicates that the site is nonproprietary; the site may or may not have reliable information, but it does not profit from its activities. .net can have multiple meanings. DIF: Cognitive Level: Comprehension (Und astanding) REF: 5 TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance 6. A nurse says, When I was in school, I learned to call upset patients by name to get their attention; howev a, I read a descriptive research study that says that this approach does not work. I plan to stop calling patients by name. Which statement is the best appraisal of this nurses comment? a. One descriptive research study rarely provides enough evidence to change practice. b. Staff nurses apply new research findings only with th e help from clinical nurse specialists. c. New research findings should be incorporated into clinical algorithms before using them in practice. d. The nurse misint apreted the results of the study. Classic tenets of practice do not change. ANS: A Descriptive r esearch findings provide evidence for practice but must be viewed in relation to otha studies before practice changes. One study is not enough. Descriptive studies are low on the hi aarchy of evidence. Clinical algorithms use flow charts to manage proble ms and do not specify one response to a clinical problem. Classic tenets of practice should change as research findings provide evidence for change. DIF: Cognitive Level: Analysis (Analyzing) REF: 3 TOP: Nursing Process: Evaluation MSC: NCLEX: Health Pro motion and Maintenance 7. Two nursing students discuss care a plans aft a graduation. One student wants to ent a psychiatric nursing. The oth a student asks, Why would you want to be a psychiatric nurse? All they do is talk. You will lose your skills. Sel ect the best response by the student int aested in psychiatric nursing. a. Psychiatric nurses practice in saf a environments than oth a specialties. Nurse -to-patient ratios must be bett a because of the nature of patients problems. b. Psychiatric nurses use co mplex communication skills, as well as critical thinking, to solve multidimensional problems. Im challenged by those situations. c. I think I will be good in the mental health field. I do not like clinical rotations in school, so I do not want to continue them aft a I graduate. d. Psychiatric nurses do not have to deal with as much pain and suff aing as medical surgical nurses. That appe als to me. ANS: B The practice of psychiatric nursing requires a diff aent set of skills than medical surgical nursing, although substantial ov alap does exist. Psychiatric nurses must be able to help patients with medical and mental health problems, refl ecting the holistic p aspective these nurses must have. Nurse -patient ratios and workloads in psychiatric settings have increased, similar to oth a specialties. Psychiatric nursing involves clinical practice, Test Bank: Essentials of Psychiatric Mental Hea lth Nursing (3rd Edition by Varcarolis) 4 not simply documentation. Psychosocial pain is real and can cause as much suff aing as physical pain. DIF: Cognitive Level: Application (Applying) REF: 3 TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effe ctive Care Environment 8. Which research evidence would most influence a group of nurses to change their practice? a. Expat committee report of recommendations for practice b. Systematic review of randomized controlled trials c. Nonexp aimental descriptive study d. Critical pathway ANS: B