FULL TEST BANK
TEST BANK FOR VARCAROLIS’ ESSENTIALS OF
PSYCHIATRIC MENTAL HEALTH NURSING 5TH
EDITION BY CHYLLIA D FOSBRE
PRINTED PDF | ORIGINAL DIRECTLY FROM THE PUBLISHER | 100%
VERIFIED ANSWERS | DOWNLOAD IMMEDIATELY AFTER THE ORDER
, Table of content
Chapter 1. Science and the Therapeutic Use of Self in Psychiatric-Mental
Health Nursing
Chapter 2. Mental Health and Mental Illness
Chapter 3. Theories and Therapies
Chapter 4. Biological Basis for Understanding Psychopharmacology
Chapter 5. Settings for Psychiatric Care
Chapter 6. Legal and Ethical Basis for Practice
Chapter 7. The Nursing Process in Psychiatric-Mental Health Nursing
Chapter 8. Communication Skills:: Medium for All Nursing Practice
Chapter 9. Therapeutic Relationships and the Clinical Interview
Chapter 10. Trauma and Stress-Related Disorders and Dissociative
Disorders
Chapter 11. Anxiety, Anxiety Disorders, and Obsessive-Compulsive and
Related Disorders
Chapter 12. Somatic Symptom Disorders
Chapter 13. Personality Disorders
Chapter 14. Eating Disorders
Chapter 15. Mood Disorders: Depression
Chapter 16. Bipolar Spectrum Disorders
Chapter 17. Schizophrenia Spectrum Disorders and Other Psychotic
Disorders
Chapter 18. Neurocognitive Disorders
Chapter 19. Substance-Related and Addictive Disorders
Chapter 20. Crisis and Mass Disaster
Chapter 21. Child, Partner, and Elder Violence
Chapter 22. Sexual Violence
Chapter 23. Suicidal Thoughts and Behaviors
Chapter 24. Anger, Aggression, and Violence
Chapter 25. Care for the Dying and Those Who Grieve
Chapter 26. Children and Adolescents
Chapter 27. Adults Chapter
28. Older Adults
,Chapter 01: Science and the Therapeutic Use of Self in Psychiatric Mental Health
Nursing
Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communication
Approach to Evidence-Based Care, 5th Edition
MULTIPLE CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient
living in the community and diagnosed with serious and persistent mental illness? Within 3
months, the patient will demonstrate what behavior?
a. Denying suicidal ideation
b. Reporting a sense of well-being
c. Taking medications as prescribed
d. Attending clinic appointments on time
ANSWER: B
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
role performance. The goal of recovery is to empower 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 rather than recovery.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING
PROCESS: Outcomes Identification MEDSC:
NCLEX: HEALTH Promotion and Maintenance
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a
divorce. Select the NURSE’s most caring comment.
a. “Let’s discuss healthy means of coping when you have suicidal feelings.”
b. “I understand why you’re so depressed. When 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?”
ANSWER: A
The NURSE’s 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
nothelpful for therapeutic interventions.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Psychosocial Integrity
3. In the shift-change report, an off-going NURSE criticizes a patient who wears extremely
heavymakeup. Which comment by the NURSE who receives the report best demonstrates
advocacy?
a. “This is a psychiatric hospital, so we expect our patients to behave bizarrely.”
b. “Let’s all show acceptance of this patient by wearing lots of makeup too.”
c. “Your comments are inconsiderate and inappropriate. Keep the report objective.”
d. “Our patients need our help to learn behaviors that will help them get along in
society.”
ANSWER: D
Accepting patients’ needs for self-expression and seeking to teach skills that will contribute to
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, their well-being demonstrate respect and are important parts of advocacy. The on-coming
NURSE needs to take action to ensure that others 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 each other.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Safe, Effective Care
Environment
4. A NURSE assesses a newly admitted patient diagnosed with major depressive disorder.
Whichstatement is an example of “attending”?
a. “We all have stress in life. Being in a psychiatric hospital is not 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 better after we get some antidepressant medication started for you.”
d. “I’d like to sit with you for a while, so you may feel more comfortable talking with
me.”
ANSWER: D
Attending is a technique that demonstrates the NURSE’s commitment to the relationship
and reduces feelings of isolation. This technique shows respect for the patient and
demonstratescaring. Generalizations, probing, and false reassurances are nontherapeutic.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Psychosocial Integrity
5. A patient shows the NURSE an article from the Internet about a HEALTH problem. Which
characteristic of the website’s address most alerts the NURSE that the site may have biased
andprejudiced information?
a. Address ends in “.org.”
b. Address ends in “.com.”
c. Address ends in “.gov.”
d. Address ends in “.net.”
ANSWER: B
Financial influences on a site are a clue that the information may be biased. “.com” at the end
of the address indicates that the site is a commercial one. “.gov” indicates that the site is
maintained by a government 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.
DIFFICULTY: 1 COGNITIVE LEVEL:
COMPREHENSION (Understanding) TOPIC: NURSING PROCESS:
EvaluationMEDSC: 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; however, I read a descriptive research study that says that this approach
does notwork. I plan to stop calling patients by name.” Which statement is the best
appraisal of thisNURSE’s comment?
a. One descriptive research study rarely provides enough evidence to change practice.
WWW.THENURSINGMASTERY.COM
, b. Staff NURSES apply new research findings only with the help from clinical
NURSEspecialists.
c. New research findings should be incorporated into clinical algorithms before using
them in practice.
d. The NURSE misinterpreted the results of the study. Classic tenets of practice do
notchange.
ANSWER: A
Descriptive research findings provide evidence for practice but must be viewed in relation to
other studies before practice changes. One study is not enough. Descriptive studies are low on
the hierarchy of evidence. Clinical algorithms use flowcharts to manage problems and do not
specify one response to a clinical problem. Classic tenets of practice should change as
research findings provide evidence for change.
DIFFICULTY: 1 COGNITIVE LEVEL: Analysis
(Analyzing) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: HEALTH Promotion and Maintenance
7. Two nursing students discuss career plans after graduation. One student wants to enter
psychiatric nursing. The other student asks, “Why would you want to be a psychiatric
NURSE?All they do is talk. You will lose your skills.” Select the best response by the
student interested in psychiatric nursing.
a. “Psychiatric NURSES’ practice in safer environments than other specialties
andNURSE-to-patient ratios are better because of the nature of patients’
problems.”
b. “Psychiatric NURSES use complex communication skills, as well as critical
thinking,to solve multidimensional problems. I’m challenged by those situations.”
c. “I think I will be good in the mental HEALTH field. I do not like clinical
rotations inschool, so I do not want to continue them after I graduate.”
d. “Psychiatric NURSES do not have to deal with as much pain and
suffering asmedical-surgical NURSES. That appeals to me.”
ANSWER: B
The practice of psychiatric nursing requires a different set of skills than medical-surgical
nursing, although substantial overlap does exist. Psychiatric NURSES must be able to help
patients with medical and mental HEALTH problems, reflecting the holistic perspective
these NURSES must have. NURSE–patient ratios and workloads in psychiatric settings
have increased,similar to other specialties. Psychiatric nursing involves clinical practice, not
simply documentation. Psychosocial pain is real and can cause as much suffering as physical
pain.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Safe, Effective Care
Environment
8. Which research evidence would most influence a group of NURSES to change their practice?
a. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway
ANSWER: B
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, Research findings are graded using a hierarchy of evidence. A systematic review of
randomized controlled trials is level A and provides the strongest evidence for changing
practice. Expert committee recommendations and descriptive studies lend less powerful and
influential evidence. A critical pathway is not evidence; it incorporates research findings after
they have been analyzed.
DIFFICULTY: 1 COGNITIVE LEVEL:
COMPREHENSION (Understanding) TOPIC: NURSING PROCESS:
PlanningMEDSC: NCLEX: Safe, Effective Care Environment
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with
mental illnesses. A group of NURSES write letters to their elected representatives in
oppositionto the legislation. Which role have the NURSES fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-based practice
ANSWER: A
An advocate defends or asserts another’s cause, particularly when the other person lacks the
ability to do that for him or herself. Examples of individual advocacy include helping patients
understand their rights or make decisions. On a community scale, advocacy includes political
activity, public speaking, and publication in the interest of improving the individuals with
mental illness; the letter-writing campaign advocates for that cause on behalf of patients who
are unable to articulate their own needs.
DIFFICULTY: 1 COGNITIVE LEVEL: COMPREHENSION (Understanding)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Safe, Effective Care
Environment
10. An informal group of patients discuss their perceptions of nursing care. Which comment best
indicates a patient’s perception that his or her NURSE is caring?
a. “My NURSE always asks me which type of juice I want to help me swallow
mymedication.”
b. “My NURSE explained my treatment plan to me and asked for my ideas about
how tomake it better.”
c. “My NURSE told me that if I take all the medicines the doctor prescribes, I will
getdischarged soon.”
d. “My NURSE spends time listening to me talk about my problems. That helps me
feellike I’m not alone.”
ANSWER: D
Caring evidences empathic understanding as well as competency. It helps change pain and
suffering into a shared experience, creating a human connection that alleviates feelings of
isolation. The incorrect options give examples of statements that demonstrate advocacy or
giving advice.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: Psychosocial Integrity
WWW.THENURSINGMASTERY.COM
,11. A patient who immigrated to the United States from Honduras was diagnosed with
schizophrenia. The patient took an antipsychotic medication for 3 weeks but showed no
improvement. Which resource should the treatment team consult for information on more
effective medications for this patient?
a. Clinical algorithm
b. Clinical pathway
c. Clinical practice guideline
d. International Statistical Classification of Diseases and Related HEALTH Problems
(ICD)
ANSWER: A
A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches
drawn from large databases of information. These guidelines help the treatment team make
decisions cognizant of an individual patient’s needs, such as ethnic origin, age, or gender. A
clinical pathway is a map of interventions and treatments related to a specific disorder.
Clinical practice guidelines summarize best practices about specific HEALTH problems. The
ICDclassifies diseases.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: Safe, Effective Care Environment
12. A team of NURSES wants to integrate evidence-based practice into a facility’s clinical
pathways.Which step should the team implement first?
a. Acquire findings from published literature.
b. Apply the research findings to clinical practice.
c. Assess the outcomes of using new research findings.
d. Ask questions to identify clinical problems that should be changed.
ANSWER: D
Integrating evidence-based practice is a multistep process rather than a single change event.
The first step is to identify clinical problems that should be changed. Each step must proceed
in order when integrated into a clinical environment.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
PlanningMEDSC: NCLEX: Safe, Effective Care Environment
13. A NURSE consistently strives to demonstrate caring behaviors during interactions with
patients.Which reaction reported by a patient indicates this NURSE is most effective?
a. Feeling less distrustful of others
b. Sensing a connection with others
c. Experiencing only minimal uneasiness about the future
d. Being somewhat encouraged with efforts to improve
ANSWER: B
A patient is likely to respond most to caring with a sense of connectedness with others. The
absence of caring can make patients feel some degree of distrustful, disconnection, unease,
and discouragement.
DIFFICULTY: 1 COGNITIVE LEVEL:
COMPREHENSION (Understanding) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: Psychosocial Integrity
WWW.THENURSINGMASTERY.COM
,MULTIPLE RESPONSE
1. An experienced NURSE says to a new graduate, “When you’ve practiced as long as I have,
youwill instantly know how to take care of psychotic patients.” What is the new graduate’s
best analysis of this comment? (Select all that apply.)
a. The experienced NURSE may have lost sight of patients’ individuality, which
maycompromise the integrity of practice.
b. New research findings must be continually integrated into a NURSE’s
practice toprovide the most effective care.
c. Experience provides mental HEALTH NURSES with the tools and skills
needed foreffective professional practice.
d. Experienced psychiatric NURSES have learned the best ways to care for
psychoticpatients through trial and error.
e. Effective psychiatric NURSES should be continually guided by an intuitive
sense ofpatients’ needs.
ANSWER: A, B
Evidence-based practice involves using research findings to provide the most effective
nursing care. Evidence is continually emerging; therefore, NURSES cannot rely solely
on experience. The effective NURSE also maintains respect for each patient as an
individual.Overgeneralization compromises that perspective. Intuition and trial and
error are unsystematic approaches to care.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: Safe, Effective Care Environment
2. Which patient statements identify qualities of nursing practice with high therapeutic value?
“My NURSE: (Select all that apply.)
a. “The NURSES talk in language I can understand.”
b. “The nursing staff helps me keep track of my medications.”
c. “My NURSE is willing to go to social activities with me.”
d. “The staff lets me do whatever I choose without interfering.”
e. “My NURSES look at me as a whole person with different needs.”
ANSWER: A, B, E
Each correct answer demonstrates caring is an example of appropriate nursing foci:
communicating at a level understandable to the patient, using holistic principles to guide care,
and providing medication supervision. The incorrect options suggest a laissez-faire attitude on
the part of the NURSE when the NURSE should instead provide thoughtful feedback and help
patients test alternative solutions or violate boundaries.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Psychosocial Integrity
WWW.THENURSINGMASTERY.COM
,Chapter 02: Mental HEALTH and Mental Illness
Varcarolis: Essentials of Psychiatric Mental HEALTH Nursing: A
CommunicationApproach to Evidence-Based Care, 5th Edition
MULTIPLE CHOICE
1. An 86 year old, previously healthy and independent, falls after an episode of vertigo. Which
statement made by this patient best demonstrates resilience?
a. “I knew this would happen eventually.”
b. “Attending my weekly water aerobics class is too risky.”
c. “I don’t need that silly walker to get around by myself.”
d. “Maybe some physical therapy will help me with my balance.”
ANSWER: D
Resiliency is the ability to recover from or adjust to misfortune and change. The correct
response indicates that the patient is hopeful and thinking positively about ways to adapt to
the vertigo. Saying “I knew this would happen eventually” and discontinuing HEALTHY
activities suggest a hopeless perspective on the HEALTH change. Refusing to use a walker
indicates denial.
DIFFICULTY: 1 COGNITIVE LEVEL: Analysis (Analyzing)
TOPIC: NURSING PROCESS: Assessment MEDSC: NCLEX: Psychosocial Integrity
2. Which basic intervention should a psychiatric mental HEALTH NURSE plan to provide for a
patientdiagnosed with a mood disorder?
a. Sharing clinical expertise to enhance patient treatment
b. Performing individual or group psychotherapy for the patient
c. Using appropriate diagnostic tests to monitor patient condition
d. Conducting stress reduction and HEALTH maintenance classes
ANSWER: D
Conducting stress reduction and HEALTH maintenance classes is the basic intervention that
should be performed by a psychiatric mental HEALTH NURSE. These classes will provide
individualized guidance to patients to prevent or reduce mental illness and improve mental
HEALTH. Community screenings and stress management classes are examples of HEALTH
maintenance classes. Consulting NURSES from other disciplines to share clinical expertise
and enhance patient treatment is an advanced practice psychiatric mental HEALTH nursing
intervention. Performing individual and group psychotherapy and performing diagnostic tests
like blood pressure, etc., are also advanced practice psychiatric mental HEALTH nursing
interventions.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
PlanningMEDSC: NCLEX: Psychosocial Integrity
3. A patient is admitted to the psychiatric hospital. Which assessment finding best indicates that
the patient has a mental illness? The patient:
a. describes coping and relaxation strategies used when feeling anxious.
b. describes mood as consistently sad, discouraged, and hopeless.
c. can perform tasks attempted within the limits of own abilities.
d. reports occasional problems with insomnia.
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, ANSWER: B
A patient who reports having a consistently negative mood is describing a mood alteration
that affects the ability to function optimistically. The incorrect options describe mentally
HEALTHY behaviors and common problems that do not indicate mental illness.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: Assessment MEDSC: NCLEX: Psychosocial Integrity
4. The goal for a patient is to increase resiliency. Which outcome should a NURSE add to the
planof care to be achieved within 3 days?
a. Patient describes feelings associated with loss and stress.
b. Patient meet own needs before considering the rights of others.
c. Patient will identify HEALTHY coping behaviors in response to stressful events.
d. Patient will allow others to assume responsibility for major areas of own life.
ANSWER: C
The patient’s ability to identify HEALTHY coping behaviors indicates adaptive, HEALTHY
behaviorand demonstrates an increased ability to recover from severe stress. Describing
feelings associated with loss and stress does not move the patient toward adaptation. The
remaining options are maladaptive behaviors.
DIFFICULTY: 1 COGNITIVE LEVEL:
Analysis (Analyzing) TOPIC: NURSING
PROCESS: Outcomes IdentificationMEDSC:
NCLEX: Psychosocial Integrity
5. A NURSE at a behavioral HEALTH clinic sees an unfamiliar psychiatric diagnosis on a
patient’sinsurance form. Which resource should the NURSE consult to discern the criteria
used to establish this diagnosis?
a. A psychiatric nursing textbook
b. NANDA International (NANDA-I)
c. A behavioral HEALTH reference manual
d. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
ANSWER: D
The DSM-5 gives the criteria used to diagnose each mental disorder. The NANDA-I focuses on
nursing diagnoses. A psychiatric nursing textbook or behavioral HEALTH reference manual
may not contain diagnostic criteria.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: Analysis | NURSING PROCESS:
DiagnosisMEDSC: NCLEX: Safe, Effective Care Environment
6. A NURSE must assess several new patients at a community mental HEALTH center.
Conclusionsconcerning current functioning should be made on the basis of what factor?
a. The degree of conformity of the individual to society’s norms.
b. The degree to which an individual appears logical and rational.
c. A continuum from mentally HEALTHY to mentally unHEALTHY.
d. The rate of their intellectual and emotional growth.
ANSWER: C
WWW.THENURSINGMASTERY.COM
TEST BANK FOR VARCAROLIS’ ESSENTIALS OF
PSYCHIATRIC MENTAL HEALTH NURSING 5TH
EDITION BY CHYLLIA D FOSBRE
PRINTED PDF | ORIGINAL DIRECTLY FROM THE PUBLISHER | 100%
VERIFIED ANSWERS | DOWNLOAD IMMEDIATELY AFTER THE ORDER
, Table of content
Chapter 1. Science and the Therapeutic Use of Self in Psychiatric-Mental
Health Nursing
Chapter 2. Mental Health and Mental Illness
Chapter 3. Theories and Therapies
Chapter 4. Biological Basis for Understanding Psychopharmacology
Chapter 5. Settings for Psychiatric Care
Chapter 6. Legal and Ethical Basis for Practice
Chapter 7. The Nursing Process in Psychiatric-Mental Health Nursing
Chapter 8. Communication Skills:: Medium for All Nursing Practice
Chapter 9. Therapeutic Relationships and the Clinical Interview
Chapter 10. Trauma and Stress-Related Disorders and Dissociative
Disorders
Chapter 11. Anxiety, Anxiety Disorders, and Obsessive-Compulsive and
Related Disorders
Chapter 12. Somatic Symptom Disorders
Chapter 13. Personality Disorders
Chapter 14. Eating Disorders
Chapter 15. Mood Disorders: Depression
Chapter 16. Bipolar Spectrum Disorders
Chapter 17. Schizophrenia Spectrum Disorders and Other Psychotic
Disorders
Chapter 18. Neurocognitive Disorders
Chapter 19. Substance-Related and Addictive Disorders
Chapter 20. Crisis and Mass Disaster
Chapter 21. Child, Partner, and Elder Violence
Chapter 22. Sexual Violence
Chapter 23. Suicidal Thoughts and Behaviors
Chapter 24. Anger, Aggression, and Violence
Chapter 25. Care for the Dying and Those Who Grieve
Chapter 26. Children and Adolescents
Chapter 27. Adults Chapter
28. Older Adults
,Chapter 01: Science and the Therapeutic Use of Self in Psychiatric Mental Health
Nursing
Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communication
Approach to Evidence-Based Care, 5th Edition
MULTIPLE CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient
living in the community and diagnosed with serious and persistent mental illness? Within 3
months, the patient will demonstrate what behavior?
a. Denying suicidal ideation
b. Reporting a sense of well-being
c. Taking medications as prescribed
d. Attending clinic appointments on time
ANSWER: B
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
role performance. The goal of recovery is to empower 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 rather than recovery.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING
PROCESS: Outcomes Identification MEDSC:
NCLEX: HEALTH Promotion and Maintenance
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a
divorce. Select the NURSE’s most caring comment.
a. “Let’s discuss healthy means of coping when you have suicidal feelings.”
b. “I understand why you’re so depressed. When 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?”
ANSWER: A
The NURSE’s 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
nothelpful for therapeutic interventions.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Psychosocial Integrity
3. In the shift-change report, an off-going NURSE criticizes a patient who wears extremely
heavymakeup. Which comment by the NURSE who receives the report best demonstrates
advocacy?
a. “This is a psychiatric hospital, so we expect our patients to behave bizarrely.”
b. “Let’s all show acceptance of this patient by wearing lots of makeup too.”
c. “Your comments are inconsiderate and inappropriate. Keep the report objective.”
d. “Our patients need our help to learn behaviors that will help them get along in
society.”
ANSWER: D
Accepting patients’ needs for self-expression and seeking to teach skills that will contribute to
WWW.THENURSINGMASTERY.COM
, their well-being demonstrate respect and are important parts of advocacy. The on-coming
NURSE needs to take action to ensure that others 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 each other.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Safe, Effective Care
Environment
4. A NURSE assesses a newly admitted patient diagnosed with major depressive disorder.
Whichstatement is an example of “attending”?
a. “We all have stress in life. Being in a psychiatric hospital is not 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 better after we get some antidepressant medication started for you.”
d. “I’d like to sit with you for a while, so you may feel more comfortable talking with
me.”
ANSWER: D
Attending is a technique that demonstrates the NURSE’s commitment to the relationship
and reduces feelings of isolation. This technique shows respect for the patient and
demonstratescaring. Generalizations, probing, and false reassurances are nontherapeutic.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Psychosocial Integrity
5. A patient shows the NURSE an article from the Internet about a HEALTH problem. Which
characteristic of the website’s address most alerts the NURSE that the site may have biased
andprejudiced information?
a. Address ends in “.org.”
b. Address ends in “.com.”
c. Address ends in “.gov.”
d. Address ends in “.net.”
ANSWER: B
Financial influences on a site are a clue that the information may be biased. “.com” at the end
of the address indicates that the site is a commercial one. “.gov” indicates that the site is
maintained by a government 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.
DIFFICULTY: 1 COGNITIVE LEVEL:
COMPREHENSION (Understanding) TOPIC: NURSING PROCESS:
EvaluationMEDSC: 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; however, I read a descriptive research study that says that this approach
does notwork. I plan to stop calling patients by name.” Which statement is the best
appraisal of thisNURSE’s comment?
a. One descriptive research study rarely provides enough evidence to change practice.
WWW.THENURSINGMASTERY.COM
, b. Staff NURSES apply new research findings only with the help from clinical
NURSEspecialists.
c. New research findings should be incorporated into clinical algorithms before using
them in practice.
d. The NURSE misinterpreted the results of the study. Classic tenets of practice do
notchange.
ANSWER: A
Descriptive research findings provide evidence for practice but must be viewed in relation to
other studies before practice changes. One study is not enough. Descriptive studies are low on
the hierarchy of evidence. Clinical algorithms use flowcharts to manage problems and do not
specify one response to a clinical problem. Classic tenets of practice should change as
research findings provide evidence for change.
DIFFICULTY: 1 COGNITIVE LEVEL: Analysis
(Analyzing) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: HEALTH Promotion and Maintenance
7. Two nursing students discuss career plans after graduation. One student wants to enter
psychiatric nursing. The other student asks, “Why would you want to be a psychiatric
NURSE?All they do is talk. You will lose your skills.” Select the best response by the
student interested in psychiatric nursing.
a. “Psychiatric NURSES’ practice in safer environments than other specialties
andNURSE-to-patient ratios are better because of the nature of patients’
problems.”
b. “Psychiatric NURSES use complex communication skills, as well as critical
thinking,to solve multidimensional problems. I’m challenged by those situations.”
c. “I think I will be good in the mental HEALTH field. I do not like clinical
rotations inschool, so I do not want to continue them after I graduate.”
d. “Psychiatric NURSES do not have to deal with as much pain and
suffering asmedical-surgical NURSES. That appeals to me.”
ANSWER: B
The practice of psychiatric nursing requires a different set of skills than medical-surgical
nursing, although substantial overlap does exist. Psychiatric NURSES must be able to help
patients with medical and mental HEALTH problems, reflecting the holistic perspective
these NURSES must have. NURSE–patient ratios and workloads in psychiatric settings
have increased,similar to other specialties. Psychiatric nursing involves clinical practice, not
simply documentation. Psychosocial pain is real and can cause as much suffering as physical
pain.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Safe, Effective Care
Environment
8. Which research evidence would most influence a group of NURSES to change their practice?
a. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway
ANSWER: B
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, Research findings are graded using a hierarchy of evidence. A systematic review of
randomized controlled trials is level A and provides the strongest evidence for changing
practice. Expert committee recommendations and descriptive studies lend less powerful and
influential evidence. A critical pathway is not evidence; it incorporates research findings after
they have been analyzed.
DIFFICULTY: 1 COGNITIVE LEVEL:
COMPREHENSION (Understanding) TOPIC: NURSING PROCESS:
PlanningMEDSC: NCLEX: Safe, Effective Care Environment
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with
mental illnesses. A group of NURSES write letters to their elected representatives in
oppositionto the legislation. Which role have the NURSES fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-based practice
ANSWER: A
An advocate defends or asserts another’s cause, particularly when the other person lacks the
ability to do that for him or herself. Examples of individual advocacy include helping patients
understand their rights or make decisions. On a community scale, advocacy includes political
activity, public speaking, and publication in the interest of improving the individuals with
mental illness; the letter-writing campaign advocates for that cause on behalf of patients who
are unable to articulate their own needs.
DIFFICULTY: 1 COGNITIVE LEVEL: COMPREHENSION (Understanding)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Safe, Effective Care
Environment
10. An informal group of patients discuss their perceptions of nursing care. Which comment best
indicates a patient’s perception that his or her NURSE is caring?
a. “My NURSE always asks me which type of juice I want to help me swallow
mymedication.”
b. “My NURSE explained my treatment plan to me and asked for my ideas about
how tomake it better.”
c. “My NURSE told me that if I take all the medicines the doctor prescribes, I will
getdischarged soon.”
d. “My NURSE spends time listening to me talk about my problems. That helps me
feellike I’m not alone.”
ANSWER: D
Caring evidences empathic understanding as well as competency. It helps change pain and
suffering into a shared experience, creating a human connection that alleviates feelings of
isolation. The incorrect options give examples of statements that demonstrate advocacy or
giving advice.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: Psychosocial Integrity
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,11. A patient who immigrated to the United States from Honduras was diagnosed with
schizophrenia. The patient took an antipsychotic medication for 3 weeks but showed no
improvement. Which resource should the treatment team consult for information on more
effective medications for this patient?
a. Clinical algorithm
b. Clinical pathway
c. Clinical practice guideline
d. International Statistical Classification of Diseases and Related HEALTH Problems
(ICD)
ANSWER: A
A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches
drawn from large databases of information. These guidelines help the treatment team make
decisions cognizant of an individual patient’s needs, such as ethnic origin, age, or gender. A
clinical pathway is a map of interventions and treatments related to a specific disorder.
Clinical practice guidelines summarize best practices about specific HEALTH problems. The
ICDclassifies diseases.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: Safe, Effective Care Environment
12. A team of NURSES wants to integrate evidence-based practice into a facility’s clinical
pathways.Which step should the team implement first?
a. Acquire findings from published literature.
b. Apply the research findings to clinical practice.
c. Assess the outcomes of using new research findings.
d. Ask questions to identify clinical problems that should be changed.
ANSWER: D
Integrating evidence-based practice is a multistep process rather than a single change event.
The first step is to identify clinical problems that should be changed. Each step must proceed
in order when integrated into a clinical environment.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
PlanningMEDSC: NCLEX: Safe, Effective Care Environment
13. A NURSE consistently strives to demonstrate caring behaviors during interactions with
patients.Which reaction reported by a patient indicates this NURSE is most effective?
a. Feeling less distrustful of others
b. Sensing a connection with others
c. Experiencing only minimal uneasiness about the future
d. Being somewhat encouraged with efforts to improve
ANSWER: B
A patient is likely to respond most to caring with a sense of connectedness with others. The
absence of caring can make patients feel some degree of distrustful, disconnection, unease,
and discouragement.
DIFFICULTY: 1 COGNITIVE LEVEL:
COMPREHENSION (Understanding) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: Psychosocial Integrity
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,MULTIPLE RESPONSE
1. An experienced NURSE says to a new graduate, “When you’ve practiced as long as I have,
youwill instantly know how to take care of psychotic patients.” What is the new graduate’s
best analysis of this comment? (Select all that apply.)
a. The experienced NURSE may have lost sight of patients’ individuality, which
maycompromise the integrity of practice.
b. New research findings must be continually integrated into a NURSE’s
practice toprovide the most effective care.
c. Experience provides mental HEALTH NURSES with the tools and skills
needed foreffective professional practice.
d. Experienced psychiatric NURSES have learned the best ways to care for
psychoticpatients through trial and error.
e. Effective psychiatric NURSES should be continually guided by an intuitive
sense ofpatients’ needs.
ANSWER: A, B
Evidence-based practice involves using research findings to provide the most effective
nursing care. Evidence is continually emerging; therefore, NURSES cannot rely solely
on experience. The effective NURSE also maintains respect for each patient as an
individual.Overgeneralization compromises that perspective. Intuition and trial and
error are unsystematic approaches to care.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
EvaluationMEDSC: NCLEX: Safe, Effective Care Environment
2. Which patient statements identify qualities of nursing practice with high therapeutic value?
“My NURSE: (Select all that apply.)
a. “The NURSES talk in language I can understand.”
b. “The nursing staff helps me keep track of my medications.”
c. “My NURSE is willing to go to social activities with me.”
d. “The staff lets me do whatever I choose without interfering.”
e. “My NURSES look at me as a whole person with different needs.”
ANSWER: A, B, E
Each correct answer demonstrates caring is an example of appropriate nursing foci:
communicating at a level understandable to the patient, using holistic principles to guide care,
and providing medication supervision. The incorrect options suggest a laissez-faire attitude on
the part of the NURSE when the NURSE should instead provide thoughtful feedback and help
patients test alternative solutions or violate boundaries.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: IMPLEMENTATION MEDSC: NCLEX: Psychosocial Integrity
WWW.THENURSINGMASTERY.COM
,Chapter 02: Mental HEALTH and Mental Illness
Varcarolis: Essentials of Psychiatric Mental HEALTH Nursing: A
CommunicationApproach to Evidence-Based Care, 5th Edition
MULTIPLE CHOICE
1. An 86 year old, previously healthy and independent, falls after an episode of vertigo. Which
statement made by this patient best demonstrates resilience?
a. “I knew this would happen eventually.”
b. “Attending my weekly water aerobics class is too risky.”
c. “I don’t need that silly walker to get around by myself.”
d. “Maybe some physical therapy will help me with my balance.”
ANSWER: D
Resiliency is the ability to recover from or adjust to misfortune and change. The correct
response indicates that the patient is hopeful and thinking positively about ways to adapt to
the vertigo. Saying “I knew this would happen eventually” and discontinuing HEALTHY
activities suggest a hopeless perspective on the HEALTH change. Refusing to use a walker
indicates denial.
DIFFICULTY: 1 COGNITIVE LEVEL: Analysis (Analyzing)
TOPIC: NURSING PROCESS: Assessment MEDSC: NCLEX: Psychosocial Integrity
2. Which basic intervention should a psychiatric mental HEALTH NURSE plan to provide for a
patientdiagnosed with a mood disorder?
a. Sharing clinical expertise to enhance patient treatment
b. Performing individual or group psychotherapy for the patient
c. Using appropriate diagnostic tests to monitor patient condition
d. Conducting stress reduction and HEALTH maintenance classes
ANSWER: D
Conducting stress reduction and HEALTH maintenance classes is the basic intervention that
should be performed by a psychiatric mental HEALTH NURSE. These classes will provide
individualized guidance to patients to prevent or reduce mental illness and improve mental
HEALTH. Community screenings and stress management classes are examples of HEALTH
maintenance classes. Consulting NURSES from other disciplines to share clinical expertise
and enhance patient treatment is an advanced practice psychiatric mental HEALTH nursing
intervention. Performing individual and group psychotherapy and performing diagnostic tests
like blood pressure, etc., are also advanced practice psychiatric mental HEALTH nursing
interventions.
DIFFICULTY: 1 COGNITIVE LEVEL:
Application (Applying) TOPIC: NURSING PROCESS:
PlanningMEDSC: NCLEX: Psychosocial Integrity
3. A patient is admitted to the psychiatric hospital. Which assessment finding best indicates that
the patient has a mental illness? The patient:
a. describes coping and relaxation strategies used when feeling anxious.
b. describes mood as consistently sad, discouraged, and hopeless.
c. can perform tasks attempted within the limits of own abilities.
d. reports occasional problems with insomnia.
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, ANSWER: B
A patient who reports having a consistently negative mood is describing a mood alteration
that affects the ability to function optimistically. The incorrect options describe mentally
HEALTHY behaviors and common problems that do not indicate mental illness.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: Assessment MEDSC: NCLEX: Psychosocial Integrity
4. The goal for a patient is to increase resiliency. Which outcome should a NURSE add to the
planof care to be achieved within 3 days?
a. Patient describes feelings associated with loss and stress.
b. Patient meet own needs before considering the rights of others.
c. Patient will identify HEALTHY coping behaviors in response to stressful events.
d. Patient will allow others to assume responsibility for major areas of own life.
ANSWER: C
The patient’s ability to identify HEALTHY coping behaviors indicates adaptive, HEALTHY
behaviorand demonstrates an increased ability to recover from severe stress. Describing
feelings associated with loss and stress does not move the patient toward adaptation. The
remaining options are maladaptive behaviors.
DIFFICULTY: 1 COGNITIVE LEVEL:
Analysis (Analyzing) TOPIC: NURSING
PROCESS: Outcomes IdentificationMEDSC:
NCLEX: Psychosocial Integrity
5. A NURSE at a behavioral HEALTH clinic sees an unfamiliar psychiatric diagnosis on a
patient’sinsurance form. Which resource should the NURSE consult to discern the criteria
used to establish this diagnosis?
a. A psychiatric nursing textbook
b. NANDA International (NANDA-I)
c. A behavioral HEALTH reference manual
d. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
ANSWER: D
The DSM-5 gives the criteria used to diagnose each mental disorder. The NANDA-I focuses on
nursing diagnoses. A psychiatric nursing textbook or behavioral HEALTH reference manual
may not contain diagnostic criteria.
DIFFICULTY: 1 COGNITIVE LEVEL: Application (Applying)
TOPIC: NURSING PROCESS: Analysis | NURSING PROCESS:
DiagnosisMEDSC: NCLEX: Safe, Effective Care Environment
6. A NURSE must assess several new patients at a community mental HEALTH center.
Conclusionsconcerning current functioning should be made on the basis of what factor?
a. The degree of conformity of the individual to society’s norms.
b. The degree to which an individual appears logical and rational.
c. A continuum from mentally HEALTHY to mentally unHEALTHY.
d. The rate of their intellectual and emotional growth.
ANSWER: C
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