Test Bank For Davis Advantage for Townsends Essentials of
Psychiatric Mental Health Nursing 9th Edition Karyn Morgan
Chapters 1-32 , 9781719645768 , All Chapters with Answers
and Rationals
1. Which statement about the development of bipolar disorder is from a biochemical perspective?
1. Family studies have shown that if one parent is diagnosed with bipolar disorder, the risk that a child
will have the disorder is about 28%.
2. In bipolar disorder, there may be possible alterations in normal electrolyte transfer across cell
membranes, resulting in elevated levels of intracellular calcium and sodium.
3. Magnetic resonance imaging reveals enlarged third ventricles, subcortical white matter, and
periventricular hyperintensity in those diagnosed with bipolar disorder.
4. Twin studies have indicated a concordance rate among monozygotic twins of 60% to 80%. -
ANSWER: 2. Alterations in normal electrolyte transfer across cell membranes, resulting in elevated
levels of intracellular calcium and sodium, is an example of a biochemical perspective in the
development of bipolar disorder.
2. Which nursing charting entry is documentation of a behavioral symptom of mania?
1. "Thoughts fragmented, flight of ideas noted."
2. "Mood euphoric and expansive. Rates mood a 10/10."
3. "Pacing halls throughout the day. Exhibits poor impulse control."
4."Easily distracted, unable to focus on goals." - ANSWER: 3. When the nurse documents, "Pacing halls
throughout the day. Exhibits poor impulse control," the nurse is charting a behavioral symptom of
mania. Psychomotor activities and uninhibited social and sexual behaviors are classified as behavioral
symptoms.
3. A nurse on an in-patient psychiatric unit receives report at 1500 hours. Which client would need to
be assessed first?
1. A client on one-to-one status because of active suicidal ideations.
2. A client pacing the hall and experiencing irritability and flight of ideas.
3. A client diagnosed with hypomania monopolizing time in the milieu.
4. A client with a history of mania who is to be discharged in the morning. - ANSWER: 2. A client's
behavior of pacing the halls and experiencing irritability should be considered emergent and warrant
immediate attention. Most assaultive behavior that occurs on an in-patient unit is preceded by a
period of increasing hyperactivity. Because of these symptoms, this client would need to be assessed
first.
4. A client diagnosed with cyclothymia is newly admitted to an in-patient psychiatric unit. The client
has a history of irritability and grandiosity and is currently sleeping
2 hours a night. Which nursing diagnoses takes priority?
1. Altered thought processes R/T biochemical alterations.
2. Social isolation R/T grandiosity.
3. Disturbed sleep patterns R/T agitation.
4. Risk for violence: self-directed R/T depressive symptoms. - ANSWER: 3. Disturbed sleep patterns is
defined as a time-limited disruption of sleep amount and quality. Because the client is sleeping only 2
hours a night, the client is meeting the defining characteristics of the nursing diagnosis of disturbed
sleep patterns. This sleep problem is usually due to excessive hyperactivity and agitation.
5. A newly admitted client diagnosed with bipolar I disorder is experiencing a manic episode. Which
nursing diagnosis is a priority at this time?
1. Risk for violence: other-directed R/T poor impulse control.
2. Altered thought process R/T hallucinations.
3. Social isolation R/T manic excitement.
, 4. Low self-esteem R/T guilt about promiscuity. - ANSWER: 1. Risk for violence: other-directed is
defined as behaviors in which an individual demonstrates that he or she can be physically,
emotionally, or sexually harmful to others. Because of poor impulse control, irritability, and
hyperactive psychomotor behaviors experienced during a manic episode, this client is at risk for
violence directed toward others. Keeping everyone in the milieu safe is always a nursing priority.
6. A client diagnosed with bipolar I disorder has a nursing diagnosis of disturbed thought process R/T
biochemical alterations. Based on this diagnosis, which outcome would be appropriate?
1. The client will not experience injury throughout the shift.
2. The client will interact appropriately with others by day 3.
3. The client will be compliant with prescribed medications.
4. The client will distinguish reality from delusions by day 6. - ANSWER: 4. Distinguishing reality from
delusions by day 6 is an appropriate outcome for the nursing diagnosis of disturbed thought process
R/T biochemical alterations. Altered thought processes have improved when the client can distinguish
reality from delusions.
7. The nurse is reviewing expected outcomes for a client diagnosed with bipolar I disorder. Number
the outcomes presented in the order in which the nurse would address them.
1. _____ The client exhibits no evidence of physical injury.
2. _____ The client eats 70% of all finger foods offered.
3. _____ The client is able to access available out-patient resources.
4. _____ The client accepts responsibility for own behaviors. - ANSWER: The outcomes should be
numbered as follows: 1, 2, 4, 3.
8. A client diagnosed with bipolar II disorder has a nursing diagnosis of impaired social interactions
R/T egocentrism. Which short-term outcome is an appropriate expectation for this client problem?
1. The client will have an appropriate one-on-one interaction with a peer by day 4.
2. The client will exchange personal information with peers at lunchtime.
3. The client will verbalize the desire to interact with peers by day 2.
4. The client will initiate an appropriate social relationship with a peer. - ANSWER: 1. A client's having
an appropriate one-on-one interaction with a peer is a successful outcome for the nursing diagnosis
of impaired social interactions. The test taker should note that this outcome is specific, client
centered, positive, realistic, and measurable and includes a time frame.
9. A client seen in the emergency department is experiencing irritability, pressured speech, and
increased levels of anxiety. Which would be the nurse's priority intervention?
1. Place the client on a one-to-one observation to prevent injury.
2. Ask the physician for a psychiatric consultation.
3. Assess vital signs, and complete a physical assessment.
4. Reinforce relaxation techniques to decrease anxiety. - ANSWER: 3. The nurse first should assess
vital signs and complete a physical assessment to rule out a physical cause for the symptoms
presented. Many physical problems manifest in symptoms that seem to be caused by psychological
problems.
10. A client experiencing mania states, "Everything I do is great." Using a cognitive approach, which
nursing response would be most appropriate?
1. "Is there a time in your life when things didn't go as planned?"
2. "Everything you do is great."
3. "What are some other things you do well?"
4."Let's talk about the feelings you have about your childhood." - ANSWER: 1. By asking, "Is there a
time in your life when things didn't go as planned?" the nurse is using a cognitive approach to
challenge the thought processes of the client.
11. A newly admitted client is experiencing a manic episode. The client's nursing diagnosis is
imbalanced nutrition, less than body requirements. Which meal is most appropriate for this client?
1. Chicken fingers and French fries.
2. Grilled chicken and a baked potato.
Psychiatric Mental Health Nursing 9th Edition Karyn Morgan
Chapters 1-32 , 9781719645768 , All Chapters with Answers
and Rationals
1. Which statement about the development of bipolar disorder is from a biochemical perspective?
1. Family studies have shown that if one parent is diagnosed with bipolar disorder, the risk that a child
will have the disorder is about 28%.
2. In bipolar disorder, there may be possible alterations in normal electrolyte transfer across cell
membranes, resulting in elevated levels of intracellular calcium and sodium.
3. Magnetic resonance imaging reveals enlarged third ventricles, subcortical white matter, and
periventricular hyperintensity in those diagnosed with bipolar disorder.
4. Twin studies have indicated a concordance rate among monozygotic twins of 60% to 80%. -
ANSWER: 2. Alterations in normal electrolyte transfer across cell membranes, resulting in elevated
levels of intracellular calcium and sodium, is an example of a biochemical perspective in the
development of bipolar disorder.
2. Which nursing charting entry is documentation of a behavioral symptom of mania?
1. "Thoughts fragmented, flight of ideas noted."
2. "Mood euphoric and expansive. Rates mood a 10/10."
3. "Pacing halls throughout the day. Exhibits poor impulse control."
4."Easily distracted, unable to focus on goals." - ANSWER: 3. When the nurse documents, "Pacing halls
throughout the day. Exhibits poor impulse control," the nurse is charting a behavioral symptom of
mania. Psychomotor activities and uninhibited social and sexual behaviors are classified as behavioral
symptoms.
3. A nurse on an in-patient psychiatric unit receives report at 1500 hours. Which client would need to
be assessed first?
1. A client on one-to-one status because of active suicidal ideations.
2. A client pacing the hall and experiencing irritability and flight of ideas.
3. A client diagnosed with hypomania monopolizing time in the milieu.
4. A client with a history of mania who is to be discharged in the morning. - ANSWER: 2. A client's
behavior of pacing the halls and experiencing irritability should be considered emergent and warrant
immediate attention. Most assaultive behavior that occurs on an in-patient unit is preceded by a
period of increasing hyperactivity. Because of these symptoms, this client would need to be assessed
first.
4. A client diagnosed with cyclothymia is newly admitted to an in-patient psychiatric unit. The client
has a history of irritability and grandiosity and is currently sleeping
2 hours a night. Which nursing diagnoses takes priority?
1. Altered thought processes R/T biochemical alterations.
2. Social isolation R/T grandiosity.
3. Disturbed sleep patterns R/T agitation.
4. Risk for violence: self-directed R/T depressive symptoms. - ANSWER: 3. Disturbed sleep patterns is
defined as a time-limited disruption of sleep amount and quality. Because the client is sleeping only 2
hours a night, the client is meeting the defining characteristics of the nursing diagnosis of disturbed
sleep patterns. This sleep problem is usually due to excessive hyperactivity and agitation.
5. A newly admitted client diagnosed with bipolar I disorder is experiencing a manic episode. Which
nursing diagnosis is a priority at this time?
1. Risk for violence: other-directed R/T poor impulse control.
2. Altered thought process R/T hallucinations.
3. Social isolation R/T manic excitement.
, 4. Low self-esteem R/T guilt about promiscuity. - ANSWER: 1. Risk for violence: other-directed is
defined as behaviors in which an individual demonstrates that he or she can be physically,
emotionally, or sexually harmful to others. Because of poor impulse control, irritability, and
hyperactive psychomotor behaviors experienced during a manic episode, this client is at risk for
violence directed toward others. Keeping everyone in the milieu safe is always a nursing priority.
6. A client diagnosed with bipolar I disorder has a nursing diagnosis of disturbed thought process R/T
biochemical alterations. Based on this diagnosis, which outcome would be appropriate?
1. The client will not experience injury throughout the shift.
2. The client will interact appropriately with others by day 3.
3. The client will be compliant with prescribed medications.
4. The client will distinguish reality from delusions by day 6. - ANSWER: 4. Distinguishing reality from
delusions by day 6 is an appropriate outcome for the nursing diagnosis of disturbed thought process
R/T biochemical alterations. Altered thought processes have improved when the client can distinguish
reality from delusions.
7. The nurse is reviewing expected outcomes for a client diagnosed with bipolar I disorder. Number
the outcomes presented in the order in which the nurse would address them.
1. _____ The client exhibits no evidence of physical injury.
2. _____ The client eats 70% of all finger foods offered.
3. _____ The client is able to access available out-patient resources.
4. _____ The client accepts responsibility for own behaviors. - ANSWER: The outcomes should be
numbered as follows: 1, 2, 4, 3.
8. A client diagnosed with bipolar II disorder has a nursing diagnosis of impaired social interactions
R/T egocentrism. Which short-term outcome is an appropriate expectation for this client problem?
1. The client will have an appropriate one-on-one interaction with a peer by day 4.
2. The client will exchange personal information with peers at lunchtime.
3. The client will verbalize the desire to interact with peers by day 2.
4. The client will initiate an appropriate social relationship with a peer. - ANSWER: 1. A client's having
an appropriate one-on-one interaction with a peer is a successful outcome for the nursing diagnosis
of impaired social interactions. The test taker should note that this outcome is specific, client
centered, positive, realistic, and measurable and includes a time frame.
9. A client seen in the emergency department is experiencing irritability, pressured speech, and
increased levels of anxiety. Which would be the nurse's priority intervention?
1. Place the client on a one-to-one observation to prevent injury.
2. Ask the physician for a psychiatric consultation.
3. Assess vital signs, and complete a physical assessment.
4. Reinforce relaxation techniques to decrease anxiety. - ANSWER: 3. The nurse first should assess
vital signs and complete a physical assessment to rule out a physical cause for the symptoms
presented. Many physical problems manifest in symptoms that seem to be caused by psychological
problems.
10. A client experiencing mania states, "Everything I do is great." Using a cognitive approach, which
nursing response would be most appropriate?
1. "Is there a time in your life when things didn't go as planned?"
2. "Everything you do is great."
3. "What are some other things you do well?"
4."Let's talk about the feelings you have about your childhood." - ANSWER: 1. By asking, "Is there a
time in your life when things didn't go as planned?" the nurse is using a cognitive approach to
challenge the thought processes of the client.
11. A newly admitted client is experiencing a manic episode. The client's nursing diagnosis is
imbalanced nutrition, less than body requirements. Which meal is most appropriate for this client?
1. Chicken fingers and French fries.
2. Grilled chicken and a baked potato.
