Test Bank - Davis Advantage for Townsend’s Essentials of Psychiatric Mental Health Nursing 9th Edition Karyn Morgan

TEST BANK FOR DAVIS ADVANTAGE FOR
TOWNSEND’S ESSENTIALS OF PSYCHIATRIC MENTAL
HEALTH NURSING 9TH EDITION KARYN MORGAN.

**Chapter 1: Mental Health and Mental Illness**


A nurse is assessing a client who is feeling occasional sadness after the recent loss of a beloved pet. The
client’s appetite, sleep patterns, and daily routine haven’t changed. How should the nurse interpret the
client’s behaviors?


1. The client’s behaviors show signs of depression.
2. The client’s behaviors are extensive, indicating mental illness.
3. The client’s behaviors don’t align with cultural norms.
4. The client’s behaviors show no functional impairment, suggesting no mental illness.


**Answer:** 4
**Rationale:** The nurse should note that the client’s daily functioning remains intact. Feeling sad after
losing a pet is a normal response, and without significant impairment, this sadness doesn’t point to
mental illness.


**Cognitive Level:** Analysis
**Integrated Process:** Assessment




At what point should the nurse decide that a client is at risk for developing a mental illness?


1. When thoughts, feelings, and behaviors don’t align with DSM-5 criteria.
2. When unhealthy responses to stress interfere with daily life.
3. When a client expresses significant distress.
4. When a client uses defense mechanisms to protect their ego.

,**Answer:** 2
**Rationale:** The nurse should identify a risk for mental illness when a client’s responses to stress are
unhealthy and disrupt daily functioning. According to the DSM-5, significant impairment in daily life is
necessary for a mental illness diagnosis. Being able to communicate distress is actually a positive sign.


**Cognitive Level:** Application
**Integrated Process:** Assessment




A nurse is assessing 15-year-old identical twins who react very differently to stress. One twin gets
anxious and irritable, while the other withdraws and cries. How should the nurse explain these differing
responses to their parents?


i. Reactions to stress are relative; individual responses can vary.
ii. It’s unusual for identical twins to respond differently to the same stressors.
iii. Identical twins should share the same temperament and react similarly.
iv. Environmental factors influence stress responses more than genetics do.




**ANS: 1**
**Rationale:** The nurse should explain to the parents that even though the twins have identical DNA,
several other factors influence how they react to stress. Mental health is personal and varies from one
individual to another. Things like their environment and temperament can play a big role in how they
handle stress.


**Cognitive Level:** Application
**Integrated Process:** Implementation


4. Which client is the nurse likely to be most open to psychiatric treatment?
i. A Jewish female social worker.

,ii. A Baptist homeless male.
iii. A Catholic Black male.
iv. A Protestant Swedish business executive.


**ANS: 1**
**Rationale:** The nurse might expect that a client from a Jewish background would value preventive
healthcare highly and see mental health as just as important as physical health. Additionally, women
generally tend to seek help for mental health issues more than men do.


**Cognitive Level:** Application
**Integrated Process:** Planning


A psychiatric nurse intern says, "This client's use of defense mechanisms should be eliminated." How
should we evaluate this nurse's statement?
1. Defense mechanisms can be appropriate responses to stress and don’t necessarily need to be
eliminated.
2. Defense mechanisms are a maladaptive way for the ego to manage anxiety and should always be
removed.
3. Defense mechanisms in individuals with weak ego integrity should be discouraged, but not
eliminated.
4. Defense mechanisms disrupt the ego and should be encouraged.


**ANS: 1**
**Rationale:** The nurse should recognize that defense mechanisms can actually be helpful during
stressful times. A client without any defense mechanisms might struggle more with stress, leading to
anxiety disorders. It's important to address these mechanisms when they prevent the client from
developing healthier coping strategies.


**Cognitive Level:** Application
**Integrated Process:** Evaluation

, 6. During an intake assessment, a nurse asks both physical and psychological questions. The client
angrily responds, "I’m here for my heart, not my head problems." What’s the best response for the
nurse?
i. "It’s just a routine part of our assessment. We ask these questions of all clients."
ii. "What concerns you about these kinds of questions?"
iii. "Psychological factors, like too much stress, can really affect medical conditions."
iv. "We can skip these questions if you prefer. It's not essential that we complete this part."


Sure! Here’s a more humanized version of your text:


---


**Answer: 3**
**Rationale:** The nurse should help the client understand how excessive stress can negatively impact
their health. It's important not to skip over physiological and psychosocial questions, as doing so would
result in an incomplete assessment.


**Cognitive Level:** Application
**Integrated Process:** Implementation


7. When an employee feels upset because the boss openly disagrees with their suggestions, they use a
defense mechanism called displacement. What behavior might this employee exhibit?
i. The employee assertively confronts the boss.
ii. The employee leaves the staff meeting to work out in the gym.
iii. The employee criticizes a coworker.
iv. The employee takes the boss out to lunch.


**Answer: 3**
**Rationale:** The nurse should anticipate that the employee using displacement might end up
criticizing a coworker after feeling confronted by the boss. Displacement involves shifting feelings from
one target to another that feels safer or less threatening.