Test Bank for Varcarolis Canadian Psychiatric Mental Health Nursing, 3rd Edition

TEST BANK Varcarolis's Canadian Psychiatric Mental Health Nursing Cheryl L. Pollard, and Sonya L. Jakubec 3rd Edition extra per year? Table of Contents Chapter 01 Mental Health and Mental Illness 1 Chapter 02 Historical Overview of Psychiatric Mental Health Nursing 13 Chapter 03 Overview of Psychiatric Mental Health Nursing Care Within Various Settings 19 Chapter 04 Relevant Theories and Therapies for Nursing Practice 32 Chapter 05 Understanding Responses to Stress 47 Chapter 06 The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing 58 Chapter 07 Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health Nursing Practice 72 Chapter 08 Cultural Implications for Psychiatric Mental Health Nursing A Critical Cultural Perspective 87 Chapter 09 Therapeutic Relationships 98 Chapter 10 Communication and the Clinical Interview 112 Chapter 11 Psychotropic Drugs 123 Chapter 12 Anxiety and Related Disorders 137 Chapter 13 Depressive Disorders 162 Chapter 14 Bipolar Disorders 179 Chapter 15 Schizophrenia Spectrum and Other Psychotic Disorders 198 Chapter 16 Eating and Feeding Disorders 215 Chapter 17 Neurocognitive Disorders 226 Chapter 18 Psychoactive Substance Use and Treatment 241 Chapter 19 Personality Disorders 254 Chapter 20 Sleep–Wake Disorders 267 Chapter 21 Crisis and Disaster 277 Chapter 22 Suicide and Nonsuicidal Self-Injury 288 Chapter 23 Anger, Aggression, and Violence 299 Chapter 24 Interpersonal Violence Child, Older Person, and Intimate Partner Abuse 311 Chapter 25 Sexual Assault 320 Chapter 26 Sexuality and Gender 329 Chapter 27 Disorders of Children and Adolescents 340 Chapter 28 Psychosocial Needs of the Older Person 351 Chapter 29 Recovery, Survivorship, and Public Mental Health Approaches 366 Chapter 30 Psychological Needs of Patients With Medical Conditions 379 Chapter 31 Care for the Dying and for Those Who Grieve 390 Chapter 32 Forensic Psychiatric Nursing 404 Chapter 33 Therapeutic Groups 416 Chapter 34 Family Interventions 430 Chapter 35 Integrative and Complimentary Therapies 444 Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition (Pollard, 2023) Chapter 01: Mental Health and Mental Illness Pollard: Varcarolis’s Canadian Psychiatric Mental Health Nursing: A Clinical Approach, 3rd Edition MULTIPLE CHOICE 1. Which of the following is considered an Advanced Practice Intervention? a. Conducting mental health assessments (MSA) b. Prescribing psychotropic medication c. Establishing therapeutic relationships d. Individualizing nursing care plans ANS: B Registered nurses and registered psychiatric nurses can further their education at a baccalaureate level or at the graduate level (master’s doctorate) and become qualified to practise psychiatric mental health nursing at two levels – basic and advanced – developing on their education preparation. Prescriptive privileges are granted to master’s-prepared Nurse Practitioners (NPs) as they have taken additional advanced courses on prescribing medication. Appropriate use of diagnostic tests must be completed as well as having hospital admitting privileges. Establishing therapeutic relationship, conducting mental health assessments (MSAs), and individualizing nursing care plans are foundational psychiatric nursing skills. Therefore, they are considered Basic-Level Interventions. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment 2. Which has been identified as a priority for national plans and strategies in psychiatric mental health nursing in Canada? a. Decrease in the aging population b. Increase in cultural diversity c. Role of the advanced practice nurse d. Shortage of physicians in rural and urban areas ANS: B In early phases of strategic development, the Mental Health Commission of Canada identified cultural diversity as a priority for national plans and strategies. Increasing cultural diversity within Canada warrants deeper attention to culturally safe care and concern for the mental health consequences of colonization and racism. An aging population and shortage of physicians are important to future trends. The role of the advanced practice nurse is continuing to evolve in psychiatric mental health nursing in Canada. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Outcome Evaluation MSC: Client Needs: Safe Effective Care Environment 3. Which serves as the official guide for diagnosing psychiatric disorders? a. International Classification of Diseases (ICD-11) b. Diagnostic and Statistical Manual of Mental Disorders (DSM) c. A behavioural health reference manual 1 | P a g e S - The Marketplace to Buy and Sell your Study Material Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition (Pollard, 2023) 2 | P a g e Downloaded by: TestBankMall | Distribution of this document is illegal Want to earn $1.236 extra per year? d. NurseOne online ANS: B The first Diagnostic and Statistical Manual of Mental Disorders (DSM) was published by the American Psychiatric Association in 1952. Its purpose was to provide clinicians, educators, and researchers with a common framework to understand and communicate about mental disorders. With a common understanding about mental disorders, researchers and clinicians could work together in their attempts to improve care for people with mental illness. The current DSM-5 serves as the official guide for diagnosing psychiatric disorders. The International Classification of Diseases (ICD) sets the global health information standard for mortality and morbidity statistics. Clinicians and researchers use this classification system to define diseases, study disease patterns, monitor outcomes, and subsequently allocate resources based on the prevalence of disease. The Canadian Institute for Health Information developed an enhanced version of the previous version, ICD-10 referred to as the ICD 10-CA period that version extends beyond defining and classifying diseases to describe conditions and situations that are not diseases, including for example, risk factors to health and psychosocial circumstances. A behavioral health reference manual and NurseOne online are not used as official guides for diagnosis. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Safe Effective Care Environment 4. When locating the description and diagnostic criteria for anxiety disorders, which resource would have the most complete information? a. Nursing Outcomes Classification (NOC) b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice d. International Statistical Classification of Diseases and Related Health Problems (ICD-10) ANS: B The DSM-5 details the diagnostic criteria for psychiatric clinical conditions and is the official guide for diagnosing psychiatric disorders. The other references are good resources but do not define the diagnostic criteria. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment 5. Which individual is demonstrating the highest level of resilience? a. An individual repressing their stressors who is having a difficult time coping with activities of daily living (ADLs) b. An individual who is in a depressed state after the death of their spouse c. An individual who lives in a shelter for 2 years after their home is destroyed by a fire d. An individual who navigates and negotiates resources to support their well-being ANS: D S - The Marketplace to Buy and Sell your Study Material Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition (Pollard, 2023) 3 | P a g e Downloaded by: TestBankMall | Distribution of this document is illegal Want to earn $1.236 extra per year? A characteristic of mental health increasingly being promoted as essential to the recovery process is resilience. Resilience is a process and outcome of complex, cultural systems, rather than as an individual capacity to overcome adversity. In this way, when exposed to adversity, one’s resilience depends on the navigation and negotiation of resources that can support well-being. Resilience is closely associated with the process of adapting and helps people facing tragedies, loss, trauma, and severe stress. An individual who is repressing their stressors may need support for developing coping strategies. It is important for the individual who is in a depressed state after the death of their spouse to navigate and negotiate resources that can support their well-being (e.g., grief support or counselling). An individual living in a shelter needs immediate support and assistance when entering the shelter to navigate services and supports. Shelters are short-term resources. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Outcome Evaluation MSC: Client Needs: Psychosocial Integrity 6. A multidisciplinary team is working with two groups of patients diagnosed with depression. One group of patients receives supportive interventions and psychotropic medication (e.g., antidepressants). The other group receives only psychotropic medication. Outcomes are measured for each group. Which is being studied? a. Incidence b. Prevalence c. Comorbidity d. Clinical epidemiology ANS: D Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if there is no treatment and the problem is left to run its course) of an illness, studies of diagnostic screening tests, and observational and experimental studies of interventions used to treat people with the illness or symptoms. Prevalence refers to numbers of new cases. Comorbidity refers to having more than one mental disorder at a time. Incidence refers to the number of new cases of mental disorders in a healthy population within a given period. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Outcome Evaluation MSC: Client Needs: Safe Effective Care Environment 7. A category 5 tornado occurred in a community of 400 people, resulting in destruction of many homes and businesses. In the 2 years after this disaster, 140 individuals were diagnosed with post-traumatic stress disorder (PTSD). Which term best applies to these newly diagnosed individuals? a. Prevalence b. Comorbidity c. Incidence d. Clinical epidemiology ANS: C S - The Marketplace to Buy and Sell your Study Material Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition (Pollard, 2023) 4 | P a g e Downloaded by: TestBankMall | Distribution of this document is illegal Want to earn $1.236 extra per year? Incidence refers to the number of new cases of mental disorders in a healthy population within a given period of time. Prevalence describes the total number of cases, new and existing, in a given population during a specific period of time, regardless of when they became ill. Clinical epidemiology is a broad field that addresses what happens after people with illnesses are seen by clinical care providers. Comorbidity refers to having more than one mental disorder at a time. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Planning| Nursing Process: Outcome Identification MSC: Client Needs: Safe Effective Care Environment 8. Which individual is considered to have positive attributes of mental health? a. An individual who can laugh and play b. An individual who is unable to experience joy c. An individual who has a difficult time managing interpersonal conflict d. An individual who has limited insight and judgement ANS: A Mental health is described as more than merely the absence of mental disorders or disabilities. Laughing and play are considered positive attributes of mental health. Individuals who are unable to experience joy, who have a difficult time managing interpersonal conflict, and who have limited insight and judgement may require further support, enhanced coping strategies and promotion of positive mental health from mental health clinicians. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 9. Which report highlighted the importance of issues related to mental health and mental illness in Canada? a. The ERB Report b. The ERG Report c. The EDD Report d. The EPP Report ANS: D Published in 1988, Mental Health for Canadians: Striking a Balance, commonly called the Epp Report, highlighted the importance of issues related to mental health and mental illness in Canada. It proposed seven guiding principles for the development of public policies to support mental health. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Planning| Nursing Process: Outcome Identification MSC: Client Needs: Health Promotion and Maintenance 10. Which of the following indicates reflection and discovery of resilience? a. Why do I not have the inner strength I once did? b. How have I gotten through difficult times? c. Why doesn’t anything ever go right for me? d. Why do people always make me feel this way? ANS: B S - The Marketplace to Buy and Sell your Study Material Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition (Pollard, 2023) 5 | P a g e Downloaded by: TestBankMall | Distribution of this document is illegal Want to earn $1.236 extra per year? When reflecting on resilience questions should be framed in a positive way. An individual asking, “How have I gotten through difficult times?” demonstrates a positive reflection and an attempt to discover progression through difficult times, thus indicating resilience. Questions relating to, “Why do I not have the inner strength I once did,” “Why doesn’t anything ever go right for me,” and “Why do people always make me feel this way” are not framed in a positive way. The distractors, are not related to inner strength, competence, optimism, flexibility, and the ability to cope effectively when faced with adversity. DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 11. Which is a standard measure for mental health? a. The Epp Report b. The Diagnostic and Statistical Manual for Mental Disorders (DSM) c. There is no standard measure for mental health d. Nature versus nurture ANS: C There is no standard measure for mental health, in part because it is culturally defined and is based on interpretations of effective functioning according to societal norms. One approach to differentiating mental health from mental illness is to consider what a particular culture regards as acceptable or unacceptable behavior. The Epp Report highlights the importance of issues related to mental health and mental illness in Canada but is not a standard measure. The DSM serves as the official guide for diagnosing psychiatric disorders. Nature versus nurture is not a standard measure for mental health. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Outcome Evaluation MSC: Client Needs: Safe Effective Care Environment 12. Which is currently the most accepted explanation for mental illness? a. Biological Model b. Diathesis-Stress Model c. Psychological Model d. Sociological Model ANS: B Currently, the Diathesis-Stress Model, in which diathesis represents biological predisposition and stress represents environmental stress or trauma, is the most accepted explanation for mental illness. This nature-plus-nurture model asserts that most psychiatric disorders result from a combination of genetic vulnerability and negative environmental stressors. Biological, Psychological, and Sociological models only have a specific focus, which leads to segregation and isolation of people. Singularly these models are not identified as causative factors for mental illness. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment 13. Crisis and risk management are considered which of the following? a. Nursing Outcomes Classification (NOC) b. Nursing Diagnoses S - The Marketplace to Buy and Sell your Study Material Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition (Pollard, 2023) 6 | P a g e Downloaded by: TestBankMall | Distribution of this document is illegal Want to earn $1.236 extra per year? c. Evidence-Informed Practice d. Nursing Interventions Classification (NIC) ANS: D Crisis and risk management are considered to be part of the Nursing Interventions Classifications (NIC) are another tool used to standardize, define, and measure nursing care. There are seven domains: basic physiological, complex physiological, behavioural, safety, family, health system, and community. Two domains relate specifically to psychiatric nursing behavioural, including communication, coping, and education, and safety, covering crisis and risk management. The Nursing Outcome Classification (NOC) provides a comprehensive list of standardized outcomes, definitions, and measures to describe patient outcomes influenced by nursing practice. A nursing diagnosis is a clinical judgement about individual, family, or community responses to actual or potential health problems and life processes. Evidence-Informed Practice is care based on the collection, interpretation, and integration of valid, important, and applicable patient-reported, clinician-observed, and research-derived evidence. DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Outcome Evaluation MSC: Client Needs: Safe Effective Care Environment 14. A college student is struggling with depressive symptoms and is identifying feeling overwhelmed. The counsellor at the college working with the student, seeks support, assessment, and follow-up from a psychiatrist at the local hospital using a secure video connection. This is an example of which of the following? a. Cultural diversity b. Physical environments c. Telepsychiatry d. Resilience ANS: C Telepsychiatry is also known as telemedicine. In this practice, real-time consultations typically occur in facilities using a secured telecommunication connection to enable psychiatric assessment or consultation. With telepsychiatry, the mental health needs of a greater range of people in a wider range of locations can be met with timely professional assessments and prescribed interventions. The counsellor at the college working with a student and specifically seeking support, assessment, and a follow-up from the psychiatrist in a local hospital using a secure video connection therefore at this time cultural diversity, physical environment, and resilience would not apply. These may be discussed in the assessment with the psychiatrist, student, and counsellor. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: Client Needs: Safe Effective Care Environment 15. An individual diagnosed with schizophrenia has recently been diagnosed with hypertension. Which is correct documentation? a. The individual has a comorbid condition of schizophrenia and hypertension. b. The individual has a diagnosis of schizophrenia and disparity of hypertension. c. The individual has a diagnosis of hypertension secondary to schizophrenia. d. The individual has a diagnosis of schizophrenia. S - The Marketplace to Buy and Sell your Study Material Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition (Pollard, 2023) 7 | P a g e Downloaded by: TestBankMall | Distribution of this document is illegal Want to earn $1.236 extra per year? ANS: A Comorbid conditions are those disorders that occur at the same time as another condition. For example, an individual diagnosed with schizophrenia may also have comorbid hypertension. Hypertension is not a specific disparity of schizophrenia. Hypertension is not diagnosed secondary to schizophrenia. Not acknowledging hypertension in the person at all is incorrect. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 16. A psychiatric mental health nurse is invited to a local college to discuss mental health and mental illness. A student asks about the role of psychiatric mental health nurses. Which is the best response? a. “We practice in safer environments than other specialties. Nurse-to-patient ratios are significantly lower because of the nature of the patients’ concerns.” b. “We work with a broad population of patients in diverse settings. We use therapeutic communication skills, as well as critical thinking to promote optimal mental health.” c. “We frequently use high technology monitoring equipment and manage complex therapies.” d. “We do not have to treat patients with as much pain and suffering as other specialties do. We only talk about mental health.” ANS: B Two domains relate specifically to psychiatric mental health nursing: behavioural, including communication, coping, and education; and safety, covering crisis and risk management. The therapeutic nurse–patient relationship, therapeutic communication, critical thinking, and clinical judgement are central nursing concepts for psychiatric mental health nursing practice. Psychiatric mental health nurses work with a broad population of patients in diverse settings to promote optimal mental health. While there are safety protocols in place within mental health environments, it is not correct to say the environment is safer than another discipline. Nurse-to-patient ratios may be different based on observation levels within mental health, but they are not significantly lower. Telepsychiatry is the use of secured telecommunication connections enabling psychiatric assessments, or consultations but is not used to manage complex therapies. Psychosocial pain and suffering are as real as physical pain and suffering. DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Outcome Evaluation MSC: Client Needs: Safe Effective Care Environment 17. Which mental disorder is the most prevalent in Canada? a. Schizophrenia and psychosis b. Bipolar disorder c. Attention-deficit disorder d. Major depressive episode ANS: D S - The Marketplace to Buy and Sell your Study Material Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition (Pollard, 2023) 8 | P a g e Downloaded by: TestBankMall | Distribution of this document is illegal Want to earn $1.236 extra per year? In accordance with current statistics major depressive episode is the most prevalent mental disorder in Canada with the prevalence over 12 months of 4.7% and a lifetime prevalence of 11.3%. Attention deficit disorder has a prevalence over 12 months of 2.6%. Bipolar disorder has a prevalence over 12 months of 1.5% and 2.6% of lifetime prevalence. Schizophrenia and psychosis have a prevalence over 12 months of 1.3%. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 18. Which of the following is used to define diseases, study disease patterns, monitor outcomes, and subsequently allocate resources based on the prevalence of disease? a. International Classification of Diseases (ICD) b. Diagnostic and Statistical Manual of Mental Disorders (DSM) c. A behavioral health reference manual d. The Canadian Institute for Health Information ANS: B The International Classification of Diseases (ICD) sets the global health information standard for mortality and morbidity statistics. Clinicians and researchers use this classification system to define diseases, study disease patterns, monitor outcomes, and subsequently allocate resources based on the prevalence of disease. The Diagnostic and Statistical Manual of Mental Disorders (DSM) current fifth edition serves as the official guide for diagnosing psychiatric disorders. A behavioural health reference manual and The Canadian Institute for Health Information are not used to define diseases, study disease patterns, monitor outcomes, and subsequently allocate resources based on the prevalence of disease. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Safe Effective Care Environment 19. An individual has a high level of resilience. Which is another characteristic the nurse could expect this individual to have? a. Social support b. Expressiveness c. Aggressiveness d. Depressed affect ANS: A Resilience is more closely connected to social and environmental factors than any individual characteristic. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Nursing Diagnosis MSC: Client Needs: Psychosocial Integrity 20. Mental illness is characterized by alterations in cognition, mood or behaviour, significant distress, and which other key feature? a. Altered social status b. Impaired intellect c. Impaired functioning S - The Marketplace to Buy and Sell your Study Material Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 3rd Edition (Pollard, 2023) 9 | P a g e Downloaded by: TestBankMall | Distribution of this document is illegal Want to earn $1.236 extra per year? d. Personality changes ANS: C Mental health is described as more than merely the absence of mental disorders or disabilities. Mental health is not the same as mental illness. However, poor mental health can lead to mental and physical illness. It is alterations in cognition, mood, or behaviour coupled with significant distress and impaired functioning that characterize mental illness. Mental illness refers to all mental disorders with definable diagnoses. Mental illness impairs functioning – for instance in social, occupational, and daily living. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Nursing Diagnosis MSC: Client Needs: Psychosocial Integrity