Test Bank for Davis Advantage for Townsend's Psychiatric
Mental Health Nursing, 11th Edition by Karyn I. Morgan All
Chapters included LATEST
7. One of the goals of a therapeutic milieu is for clients to become more independent
and accept self-responsibility. Which of the following approaches by staff best
encourages the fulfillment of this goal?
a. Including client input and decisions into the treatment plan
b. Insisting that each client take a turn leading a group activity
c. Making decisions for the client regarding plans for treatment
d. Requiring that the client bathe, dress, and attend breakfast on time each morning - A
8. A client is admitted to the inpatient psychiatric unit, appears anxious, and states, "I've
never been on a unit like this before." Which of these actions by the nurse is a priority
for beginning to establish a therapeutic milieu?
a. Instruct the client to remain in his room until he feels less anxious.
b. Orient the client to the physical surroundings, milieu rules, and activities.
c. Offer to medicate the client with antianxiety medication.
d. Instruct the client not to worry because he will only be on the unit for a few days. - B
9. A client approaches the nurse and says, "I'm sick of the rules on this unit about not
touching each other. I'm an adult and if I want to give one of the ladies a massage, it's
my own business." Which of these responses best incorporates milieu therapy
principles?
a. "If you don't follow the established rules, you will be put in seclusion."
b. "You don't make the rules, so just do as you're told."
c. "Why are you on this unit?"
d. "Let me try to explain why these rules are important for everyone's safety." - D
10. A group of clients in a long-term psychiatric hospital setting complains to the nurse
that they feel like there's not much to do during the day. One client says, "It seems like
we're just sitting around watching TV all day." Which of these actions by the nurse best
supports a therapeutic milieu?
a. Instruct clients that the milieu is intentionally designed to provide for relaxation and
minimal structured activities.
b. Suggest that the clients organize some games and activities for their peers.
c. Instruct these clients that they should be focusing on getting better rather than
complaining.
d. Explore with clients and IDT members activities that would create more structure and
support treatment goals. - D
ANS: C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of
Recent Experiences and the
,Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a
year-score total of 500
or more, indicates high stress in a clients life. However, positive coping mechanisms
and strong social support
can limit susceptibility to stress-related illnesses. - 1. A client has experienced the death
of a close family member and at the same time becomes unemployed. This situation
has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How
should
the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological
illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates
no significant threat of
stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated
without knowledge of
coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
2. A physically and emotionally healthy client has just been fired. During a routine office
visit he states to a
nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art
degree. How should the
nurse characterize the clients appraisal of the job loss stressor?
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging - ANS: D
The client perceives the situation of job loss as a challenge and an opportunity for
growth.
3. Which client statement should alert a nurse that a client may be responding
maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist. - ANS: A
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve
stress. It can prevent
learning appropriate coping skills and can prevent access to needed support systems.
, 4. A nursing student finds that she comes down with a sinus infection toward the end of
every semester. When
this occurs, which stage of stress is the student most likely experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage - ANS: C
At the stage of exhaustion, the students exposure to stress has been prolonged and
adaptive energy has been
depleted. Diseases of adaptation occur more frequently in this stage.
5. A school nurse is assessing a female high school student who is overly concerned
about her appearance. The
clients mother states, Thats not something to be stressed about! Which is the most
appropriate nursing
response?
A. Teenagers! They dont know a thing about real stress.
B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, you cant experience psychological well-
being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
- ANS: D
Stress can be physical or psychological in nature. A perceived threat to self-esteem can
be as stressful as a
physiological change.
6. A bright student confides in the school nurse about conflicts related to attending
college or working to add
needed financial support to the family. Which coping strategy is most appropriate for the
nurse to recommend
to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling - ANS: B
The student must assess his or her situation and determine the best course of action.
Problem-solving training, by providing structure and objectivity, can assist in decision
making.
7. An unemployed college graduate is experiencing severe anxiety over not finding a
teaching position and has
difficulty with independent problem-solving. During a routine physical examination, the
graduate confides in
the clinic nurse. Which is the most appropriate nursing intervention?
Mental Health Nursing, 11th Edition by Karyn I. Morgan All
Chapters included LATEST
7. One of the goals of a therapeutic milieu is for clients to become more independent
and accept self-responsibility. Which of the following approaches by staff best
encourages the fulfillment of this goal?
a. Including client input and decisions into the treatment plan
b. Insisting that each client take a turn leading a group activity
c. Making decisions for the client regarding plans for treatment
d. Requiring that the client bathe, dress, and attend breakfast on time each morning - A
8. A client is admitted to the inpatient psychiatric unit, appears anxious, and states, "I've
never been on a unit like this before." Which of these actions by the nurse is a priority
for beginning to establish a therapeutic milieu?
a. Instruct the client to remain in his room until he feels less anxious.
b. Orient the client to the physical surroundings, milieu rules, and activities.
c. Offer to medicate the client with antianxiety medication.
d. Instruct the client not to worry because he will only be on the unit for a few days. - B
9. A client approaches the nurse and says, "I'm sick of the rules on this unit about not
touching each other. I'm an adult and if I want to give one of the ladies a massage, it's
my own business." Which of these responses best incorporates milieu therapy
principles?
a. "If you don't follow the established rules, you will be put in seclusion."
b. "You don't make the rules, so just do as you're told."
c. "Why are you on this unit?"
d. "Let me try to explain why these rules are important for everyone's safety." - D
10. A group of clients in a long-term psychiatric hospital setting complains to the nurse
that they feel like there's not much to do during the day. One client says, "It seems like
we're just sitting around watching TV all day." Which of these actions by the nurse best
supports a therapeutic milieu?
a. Instruct clients that the milieu is intentionally designed to provide for relaxation and
minimal structured activities.
b. Suggest that the clients organize some games and activities for their peers.
c. Instruct these clients that they should be focusing on getting better rather than
complaining.
d. Explore with clients and IDT members activities that would create more structure and
support treatment goals. - D
ANS: C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of
Recent Experiences and the
,Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a
year-score total of 500
or more, indicates high stress in a clients life. However, positive coping mechanisms
and strong social support
can limit susceptibility to stress-related illnesses. - 1. A client has experienced the death
of a close family member and at the same time becomes unemployed. This situation
has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How
should
the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological
illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates
no significant threat of
stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated
without knowledge of
coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
2. A physically and emotionally healthy client has just been fired. During a routine office
visit he states to a
nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art
degree. How should the
nurse characterize the clients appraisal of the job loss stressor?
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging - ANS: D
The client perceives the situation of job loss as a challenge and an opportunity for
growth.
3. Which client statement should alert a nurse that a client may be responding
maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist. - ANS: A
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve
stress. It can prevent
learning appropriate coping skills and can prevent access to needed support systems.
, 4. A nursing student finds that she comes down with a sinus infection toward the end of
every semester. When
this occurs, which stage of stress is the student most likely experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage - ANS: C
At the stage of exhaustion, the students exposure to stress has been prolonged and
adaptive energy has been
depleted. Diseases of adaptation occur more frequently in this stage.
5. A school nurse is assessing a female high school student who is overly concerned
about her appearance. The
clients mother states, Thats not something to be stressed about! Which is the most
appropriate nursing
response?
A. Teenagers! They dont know a thing about real stress.
B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, you cant experience psychological well-
being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
- ANS: D
Stress can be physical or psychological in nature. A perceived threat to self-esteem can
be as stressful as a
physiological change.
6. A bright student confides in the school nurse about conflicts related to attending
college or working to add
needed financial support to the family. Which coping strategy is most appropriate for the
nurse to recommend
to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling - ANS: B
The student must assess his or her situation and determine the best course of action.
Problem-solving training, by providing structure and objectivity, can assist in decision
making.
7. An unemployed college graduate is experiencing severe anxiety over not finding a
teaching position and has
difficulty with independent problem-solving. During a routine physical examination, the
graduate confides in
the clinic nurse. Which is the most appropriate nursing intervention?
