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FORTINASH PSYCHIATRIC MENTAL HEALTHNURSING
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Fortinash:vPsychiatric vMentalvHealthv Nursing,v5thvEdition
Chapterv01:vPsychiatricvNursing:vTheory,vPrinciples,vandvTrends
1. Whichvunderstandingvisvthevbasisvforvthevnursingvactionsvfocusedvonvminimizingv
mentalvhealthvpromotion vofvfamilies vwithvchronicallyvmentallyvillvmembers?
a. Familyvmembersvarevatv anvincreasedvriskvforvmentalvillness.
b. Thevmentalvhealthvcarevsystemvisvnotvpreparedvtovdealvwithvfamilyvcrises.
c. Familyvmembersvarevseldomvpreparedvtovcopevwithvavchronicallyvillvindividual.
d. Thevchronically vmentallyvillvreceivevcarevbestvwhenvdeliveredvinvavformalvsetting.
ANS:vv A
Whenvfamiliesvlivevwithvavdominantvmembervwhovhasvavpersistentvandvseverevmentalvdiso
rdervthevoutcomesvarevoftenvexpressedvasvfamilyvmembersvwhovarevatvincreasedvriskvforvphys
icalvandvmentalvillnesses.vThevremainingvoptionsvarevnotvnecessarily vtrue.
DIF: CognitivevLevel:vApplication REF: Pagev 3
2. Whichv nursingv activityv showsv thev nursev activelyv engagedv inv thev primaryv preventionv ofvm
entalvdisorders?
a. Providingvavpatient,v whosev depressionvisv wellv managed,v withvmedicationvonv time
b. Makingvregularv follow-upvvisitsvtovav newvmotherv atvriskvforv post-
partumvdepression
c. Providingvthevfamilyvofvavpatient,vdiagnosedvwithvdepression,vinformationvonvsuici
devprevention
d. Assistingv av patientv whov hasv obsessivev compulsivev tendencies v preparev andvpractic
evforvavjobvinterview
ANS:v B
Primaryvpreventionv helpsvtovreducevthev occurrencevofvmentalvdisorders vbyvstayingvinvolvedv
withvavpatient.vProvidingvmedicationvandvinformationvonvexistingv illnessesv arevexamples vofv
secondaryvpreventionvwhichvhelpsvtovreducevthev prevalencev ofv mentalvdisorders.vAssistingv
avmentallyvillvpatientvwithvpreparationvforvavjobvinterviewvisvtertiaryvpreventionvsincevitvinvol
vesvrehabilitation.
DIF: CognitivevLevel:vApplication REF: Pagev 4
3. Whichvintervention vreflectsvattentionvbeingvfocusedvonvthevpatient’s vintentionsvr
egardingvhisvdiagnosisvofvseverevdepression?
a. Beingvplacedvonvsuicidevprecautions
b. Encouraging vvisitsvbyvhisvfamilyvmembers
c. Receivingv av combinationv ofv medicationsv tov addressv hisv emotionalv needs
d. Beingv askedv tov decidev wherev hev willv attendv hisv prescribedv therapyv sessions
ANS:vvD
Avprimaryvfactorvinvpatientvtreatmentvincludesvconsiderationvofvthevpatient’svintentionsvreg
ardingvhisvorvhervownvcare.vPatientsvarevcentralvtovthevprocessvthatvdeterminesvtheirvcarevas
vtheir v abilities v allow.v Underv thev guidancev ofv PMH v nurses v andv other v mentalv health v personnel,
v patients v are v encouragedv tov make v decisions v and v tov actively v engage v inv their v own v treatment v
plansv tov meetv theirv needs.v Thev remainingvoptionsv arev focusedv onvspecificsvofvthevdetermine
dvplanvofvcare.
DIF: CognitivevLevel:vApplication REF: Pagev 5
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4. Whenvavpatient’s vfamilyvasksvwhyvtheirvchronicallyvmentally villvadultvchildvisvbeingvdi
schargedvtovavcommunity-basedvlivingvfacility,vthevnursevresponds:
a. “Itvisvavwayvtovmeetvthevneedvforvsocialvsupport.”
b. “Itvisvtoovexpensivevtovkeepvstabilizedvpatientsvinvacutevcarevsettings.”
c. “Thisvtypevofvfacilityvwillvprovidevthevspecializedvcarevthatvisvneeded.”
d. “Beingvoutvinvthevcommunityvwillvhelpvprovidevhopevandvpurposevforvliving.”
ANS:vvD
Hospitalizationvmayvbevnecessary vforvacutevcare,vbut,vwhenvpatients varevstabilized,vtheyvm
ovevintov community-based,v patient-
centeredv settings v orv arev dischargedvhomev withvcontinuedvoutpatient vtreatmentvinvthevco
mmunity.vConcentratedveffortsvarevmadevtovreducevthevpatient’svsickvrolevbyvprovidingvop
portunitiesvforvthevdevelopmentvofvavpurposeful vlifevandvinstillingvhopevforveachvpatient’svf
uture.vAlthoughvsocialvsupportvisvimportant,vsuchv avlivingv arrangement visvnotvthevonlyv wayv
tovachievevit.vAlthoughv acutevcarevisvexpensive,vitvisvnotvthevmajorvconcernvwhenvdetermin
ingvlong-termvcarevoptions.vCommunity-
basedvfacilities varevnotvthevonlyvoptionvforvspecializedvcare.
DIF: CognitivevLevel:vApplication REF: Pagev 5
5. Whatvisvthevbestvexplanationvtovoffervwhenvthevmothervofvavchronicallyvillvteenagevp
atientv asks,v “Underv whatv circumstancesv wouldv hev bev consideredv incompetent?”
a. “Whenvyouv canv providev thev courtv withv enoughv evidencev tov showv thatv hev isv notvabl
evtovcarevforvhimselfvsafely.”
b. “Itvisvnotvlikelyvthatvsomeonevhisvagev wouldvbevdeterminedvtovbevincompetentvreg
ardlessvofvhisvmentalvcondition.”
c. “Hevwouldvhavevtovengagevinvbehaviorvthatvwouldvresultvinv harmvtovhimselfvorvtovso
meonevelse;vlikevyouvorvhisvsiblings.”
d. “Ifvthevillnessv becomesvsovseverevthatv hisv judgmentv isvimpairedvtovthevpointv whevthre
evdecisions vhevmakesvarevharmfulvtovhimselfvorvtovothers.”
ANS:vvD
Whenv av personv isv unablev tov cognitivelyv processv informationv orv tov makev decisionsv aboutvhis
v orv her v ownv welfare, vthev personv may v bev determined vtov bev mentally vincompetent.
Providingvself-
carevisvnotvthevonlyvcriteriavconsidered.vAgevisvnotvavfactorvconsidered.vThevdecisionvisvoften
vbasedvonvthevpotential vforvsuchv behavior.
DIF: CognitivevLevel:vApplication REF: Pagev 6
6. Whichvpsychiatricvnursingvinterventionvshowsvanvunderstandingvofvintegratedvcare?
a. Av chronically v abusedv womanv isv assessedv forv anxiety.
b. Avmanicv patientvisvtakenvtovthev gymv tovusevthev exercisev equipment.
c. Thev oldervadultv diagnosedvwithvdepressionvisv monitoredv forvsuicidalvideations.
d. Avteenagerv whovrefusesv tov obeyv thev unit’svrulesv isvnotv allowvtov playvvideov game s.
ANS:vv A
Thevmajorityvofvhealthvdisciplinesvnowvrecognizevthatvmentalvdisorders vandvphysicalvillness
esvarevcloselyvlinked.vThevpresencevofvavmentalvdisordervincreasesvthevriskvforvthevdevelop
mentv ofv physical v illnessesv andv vicev versa.v Assessingv av chronicallyv abusedvindividualvforvanxi
etyvcallvshouldvattentionvtovthevpsychiatricvdisordervthatvcouldv developvfromvthevabuse.vThe
v remaining v options vshow v interventions v thatv arev appropriate v for v the v mental vdisorder.
DIF: CognitivevLevel:vApplication REF: Pagev 6
7. Whatv reasonv doesv thev nursev givev thev patientv forv thev emphasisv andv attentionv being
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paidvtovthevrecovery vphasevofvtheirvtreatment vplan?
a. Recoveryv care,v evenv whenv intensive,v isv lessv expensivev thanv acutev psychiatricvcar
e.
b. Effectivevrecoveryvcarevisvlikelyvtovresultvinvfewervrelapsesvandvsubsequentvhospit
alizations.
c. Planningv forv recoveryv carev isv timev consumingv andv involvesv dealingv withv manyvco
mplicatedvdetails.
d. Recoveryvcarevisvusuallyvdonevonvanvoutpatientvbasisvandvsovisvgenerallyvbettervac
ceptedvbyvpatients.
ANS:v B
Muchvattentionvisvpaidvtovrecovery vcarevsinceveffectivevrecovery vcarevhelpsvimprovevpatie
ntv outcomesv andv thusv minimizev subsequentv hospitalizations.v Recoveryv carev isv notvnecess
arilyv lessv expensivev thanv acutev care.v Althoughv effectivev recovery v carev planningvmayvbevti
mevconsumingvandvdetailvoriented,vthatvisvnotvthevreasonv forvimplementingvit.vRecovery vca
revisvnotvnecessarily vwellvacceptedvbyvpatients.
DIF: CognitivevLevel:vApplication REF: Pagev 7
8. Thevnursevisvattendingvavneighborhood vmeetingvwherevavhalf-
wayvhousevisvbeingvproposedv forv thev neighborhoodv whenv av memberv ofvthev community
v states,v “Wev don’tvwantv thev facility; v wev especially vdon’tv wantv violentv peoplevlivingv nea
rvus.”vThevresponsevbyvthevnursevthatvbestvaddressesvthevpublic’svconcernvis:
a. “Invtruth,v mostvindividualsv withvpsychiatricv disorderv arev passivev andv withdrawnvan
dvposevlittlevthreatvtovthosevaroundvthem.”
b. “Thev mentally villv seldomv behavevinvthev mannerv theyv arev portrayedv byv movies;vthe
yvarevpeoplevjustvlikevthevrestvofvus.”
c. “Patientsvwithvpsychiatricvdisordervarevsovwellvmedicatedvthatvtheyvdovnotvdisplavvi y
olentvbehaviors.”
d. “Thevmentally villvdeservevavsafe,vcomfortablevplacevtovlivev amongvpeoplevwhovtrul
yvcarevforvthem.”
ANS:vv A
Avmajorvreasonv forvthev existencev ofvthev stigmav placedv onv personsv withv mentalvillnessvisvlackv
ofvknowledge.vThevmainvfearvisvofvviolence,valthoughvonlyvavsmallvpercentagevofvpatients vwi
thvmentalvillnessvdisplayvthisvbehavior.vProvidingvthevpublicvwithvaccuratevinformationvcanv h
elpvreducev stigma.v Thev remainingvoptions v dov notv directlyv addressvthevconcernsvstated.
DIF: CognitivevLevel:vApplication REF: Pagesv 13-14
9. Whichv activity v showsv thatv av therapeuticv alliancev hasv beenv establishedv betweenvthevn
ursevandvpatient?
a. Thev nursev respectsv thev patient’sv rightv tov privacyv whenv visitorsv arev spendingv timvwiev
thvthevpatient.
b. Thev patientv isv eagerlyv attendingv allv groupv sessionsv andv workingv independentlyv ovidn
entifyingvtheirvpersonalvstressors.
c. Thevpatientvisvfreelyvdescribingvtheirvfeelingsvrelatedvtovthevphysicalvandvemotion
alvtraumavtheyvexperiencedvasvavchildvwithvthevnurse.
d. Thev nursevdutifully vadministers vthev patient’s vmedications vonv timevandvwithvappro
priatevknowledgevofvthevpotentialvsideveffects.
ANS:vv C
Avprimaryvaspectvofvworkingvwithvpatientsvinvanyvsettingvandvparticularly vinvthe
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v v
FORTINASH PSYCHIATRIC MENTAL HEALTHNURSING
v v v v
5TH EDITION
v v
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Fortinash:vPsychiatric vMentalvHealthv Nursing,v5thvEdition
Chapterv01:vPsychiatricvNursing:vTheory,vPrinciples,vandvTrends
1. Whichvunderstandingvisvthevbasisvforvthevnursingvactionsvfocusedvonvminimizingv
mentalvhealthvpromotion vofvfamilies vwithvchronicallyvmentallyvillvmembers?
a. Familyvmembersvarevatv anvincreasedvriskvforvmentalvillness.
b. Thevmentalvhealthvcarevsystemvisvnotvpreparedvtovdealvwithvfamilyvcrises.
c. Familyvmembersvarevseldomvpreparedvtovcopevwithvavchronicallyvillvindividual.
d. Thevchronically vmentallyvillvreceivevcarevbestvwhenvdeliveredvinvavformalvsetting.
ANS:vv A
Whenvfamiliesvlivevwithvavdominantvmembervwhovhasvavpersistentvandvseverevmentalvdiso
rdervthevoutcomesvarevoftenvexpressedvasvfamilyvmembersvwhovarevatvincreasedvriskvforvphys
icalvandvmentalvillnesses.vThevremainingvoptionsvarevnotvnecessarily vtrue.
DIF: CognitivevLevel:vApplication REF: Pagev 3
2. Whichv nursingv activityv showsv thev nursev activelyv engagedv inv thev primaryv preventionv ofvm
entalvdisorders?
a. Providingvavpatient,v whosev depressionvisv wellv managed,v withvmedicationvonv time
b. Makingvregularv follow-upvvisitsvtovav newvmotherv atvriskvforv post-
partumvdepression
c. Providingvthevfamilyvofvavpatient,vdiagnosedvwithvdepression,vinformationvonvsuici
devprevention
d. Assistingv av patientv whov hasv obsessivev compulsivev tendencies v preparev andvpractic
evforvavjobvinterview
ANS:v B
Primaryvpreventionv helpsvtovreducevthev occurrencevofvmentalvdisorders vbyvstayingvinvolvedv
withvavpatient.vProvidingvmedicationvandvinformationvonvexistingv illnessesv arevexamples vofv
secondaryvpreventionvwhichvhelpsvtovreducevthev prevalencev ofv mentalvdisorders.vAssistingv
avmentallyvillvpatientvwithvpreparationvforvavjobvinterviewvisvtertiaryvpreventionvsincevitvinvol
vesvrehabilitation.
DIF: CognitivevLevel:vApplication REF: Pagev 4
3. Whichvintervention vreflectsvattentionvbeingvfocusedvonvthevpatient’s vintentionsvr
egardingvhisvdiagnosisvofvseverevdepression?
a. Beingvplacedvonvsuicidevprecautions
b. Encouraging vvisitsvbyvhisvfamilyvmembers
c. Receivingv av combinationv ofv medicationsv tov addressv hisv emotionalv needs
d. Beingv askedv tov decidev wherev hev willv attendv hisv prescribedv therapyv sessions
ANS:vvD
Avprimaryvfactorvinvpatientvtreatmentvincludesvconsiderationvofvthevpatient’svintentionsvreg
ardingvhisvorvhervownvcare.vPatientsvarevcentralvtovthevprocessvthatvdeterminesvtheirvcarevas
vtheir v abilities v allow.v Underv thev guidancev ofv PMH v nurses v andv other v mentalv health v personnel,
v patients v are v encouragedv tov make v decisions v and v tov actively v engage v inv their v own v treatment v
plansv tov meetv theirv needs.v Thev remainingvoptionsv arev focusedv onvspecificsvofvthevdetermine
dvplanvofvcare.
DIF: CognitivevLevel:vApplication REF: Pagev 5
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4. Whenvavpatient’s vfamilyvasksvwhyvtheirvchronicallyvmentally villvadultvchildvisvbeingvdi
schargedvtovavcommunity-basedvlivingvfacility,vthevnursevresponds:
a. “Itvisvavwayvtovmeetvthevneedvforvsocialvsupport.”
b. “Itvisvtoovexpensivevtovkeepvstabilizedvpatientsvinvacutevcarevsettings.”
c. “Thisvtypevofvfacilityvwillvprovidevthevspecializedvcarevthatvisvneeded.”
d. “Beingvoutvinvthevcommunityvwillvhelpvprovidevhopevandvpurposevforvliving.”
ANS:vvD
Hospitalizationvmayvbevnecessary vforvacutevcare,vbut,vwhenvpatients varevstabilized,vtheyvm
ovevintov community-based,v patient-
centeredv settings v orv arev dischargedvhomev withvcontinuedvoutpatient vtreatmentvinvthevco
mmunity.vConcentratedveffortsvarevmadevtovreducevthevpatient’svsickvrolevbyvprovidingvop
portunitiesvforvthevdevelopmentvofvavpurposeful vlifevandvinstillingvhopevforveachvpatient’svf
uture.vAlthoughvsocialvsupportvisvimportant,vsuchv avlivingv arrangement visvnotvthevonlyv wayv
tovachievevit.vAlthoughv acutevcarevisvexpensive,vitvisvnotvthevmajorvconcernvwhenvdetermin
ingvlong-termvcarevoptions.vCommunity-
basedvfacilities varevnotvthevonlyvoptionvforvspecializedvcare.
DIF: CognitivevLevel:vApplication REF: Pagev 5
5. Whatvisvthevbestvexplanationvtovoffervwhenvthevmothervofvavchronicallyvillvteenagevp
atientv asks,v “Underv whatv circumstancesv wouldv hev bev consideredv incompetent?”
a. “Whenvyouv canv providev thev courtv withv enoughv evidencev tov showv thatv hev isv notvabl
evtovcarevforvhimselfvsafely.”
b. “Itvisvnotvlikelyvthatvsomeonevhisvagev wouldvbevdeterminedvtovbevincompetentvreg
ardlessvofvhisvmentalvcondition.”
c. “Hevwouldvhavevtovengagevinvbehaviorvthatvwouldvresultvinv harmvtovhimselfvorvtovso
meonevelse;vlikevyouvorvhisvsiblings.”
d. “Ifvthevillnessv becomesvsovseverevthatv hisv judgmentv isvimpairedvtovthevpointv whevthre
evdecisions vhevmakesvarevharmfulvtovhimselfvorvtovothers.”
ANS:vvD
Whenv av personv isv unablev tov cognitivelyv processv informationv orv tov makev decisionsv aboutvhis
v orv her v ownv welfare, vthev personv may v bev determined vtov bev mentally vincompetent.
Providingvself-
carevisvnotvthevonlyvcriteriavconsidered.vAgevisvnotvavfactorvconsidered.vThevdecisionvisvoften
vbasedvonvthevpotential vforvsuchv behavior.
DIF: CognitivevLevel:vApplication REF: Pagev 6
6. Whichvpsychiatricvnursingvinterventionvshowsvanvunderstandingvofvintegratedvcare?
a. Av chronically v abusedv womanv isv assessedv forv anxiety.
b. Avmanicv patientvisvtakenvtovthev gymv tovusevthev exercisev equipment.
c. Thev oldervadultv diagnosedvwithvdepressionvisv monitoredv forvsuicidalvideations.
d. Avteenagerv whovrefusesv tov obeyv thev unit’svrulesv isvnotv allowvtov playvvideov game s.
ANS:vv A
Thevmajorityvofvhealthvdisciplinesvnowvrecognizevthatvmentalvdisorders vandvphysicalvillness
esvarevcloselyvlinked.vThevpresencevofvavmentalvdisordervincreasesvthevriskvforvthevdevelop
mentv ofv physical v illnessesv andv vicev versa.v Assessingv av chronicallyv abusedvindividualvforvanxi
etyvcallvshouldvattentionvtovthevpsychiatricvdisordervthatvcouldv developvfromvthevabuse.vThe
v remaining v options vshow v interventions v thatv arev appropriate v for v the v mental vdisorder.
DIF: CognitivevLevel:vApplication REF: Pagev 6
7. Whatv reasonv doesv thev nursev givev thev patientv forv thev emphasisv andv attentionv being
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paidvtovthevrecovery vphasevofvtheirvtreatment vplan?
a. Recoveryv care,v evenv whenv intensive,v isv lessv expensivev thanv acutev psychiatricvcar
e.
b. Effectivevrecoveryvcarevisvlikelyvtovresultvinvfewervrelapsesvandvsubsequentvhospit
alizations.
c. Planningv forv recoveryv carev isv timev consumingv andv involvesv dealingv withv manyvco
mplicatedvdetails.
d. Recoveryvcarevisvusuallyvdonevonvanvoutpatientvbasisvandvsovisvgenerallyvbettervac
ceptedvbyvpatients.
ANS:v B
Muchvattentionvisvpaidvtovrecovery vcarevsinceveffectivevrecovery vcarevhelpsvimprovevpatie
ntv outcomesv andv thusv minimizev subsequentv hospitalizations.v Recoveryv carev isv notvnecess
arilyv lessv expensivev thanv acutev care.v Althoughv effectivev recovery v carev planningvmayvbevti
mevconsumingvandvdetailvoriented,vthatvisvnotvthevreasonv forvimplementingvit.vRecovery vca
revisvnotvnecessarily vwellvacceptedvbyvpatients.
DIF: CognitivevLevel:vApplication REF: Pagev 7
8. Thevnursevisvattendingvavneighborhood vmeetingvwherevavhalf-
wayvhousevisvbeingvproposedv forv thev neighborhoodv whenv av memberv ofvthev community
v states,v “Wev don’tvwantv thev facility; v wev especially vdon’tv wantv violentv peoplevlivingv nea
rvus.”vThevresponsevbyvthevnursevthatvbestvaddressesvthevpublic’svconcernvis:
a. “Invtruth,v mostvindividualsv withvpsychiatricv disorderv arev passivev andv withdrawnvan
dvposevlittlevthreatvtovthosevaroundvthem.”
b. “Thev mentally villv seldomv behavevinvthev mannerv theyv arev portrayedv byv movies;vthe
yvarevpeoplevjustvlikevthevrestvofvus.”
c. “Patientsvwithvpsychiatricvdisordervarevsovwellvmedicatedvthatvtheyvdovnotvdisplavvi y
olentvbehaviors.”
d. “Thevmentally villvdeservevavsafe,vcomfortablevplacevtovlivev amongvpeoplevwhovtrul
yvcarevforvthem.”
ANS:vv A
Avmajorvreasonv forvthev existencev ofvthev stigmav placedv onv personsv withv mentalvillnessvisvlackv
ofvknowledge.vThevmainvfearvisvofvviolence,valthoughvonlyvavsmallvpercentagevofvpatients vwi
thvmentalvillnessvdisplayvthisvbehavior.vProvidingvthevpublicvwithvaccuratevinformationvcanv h
elpvreducev stigma.v Thev remainingvoptions v dov notv directlyv addressvthevconcernsvstated.
DIF: CognitivevLevel:vApplication REF: Pagesv 13-14
9. Whichv activity v showsv thatv av therapeuticv alliancev hasv beenv establishedv betweenvthevn
ursevandvpatient?
a. Thev nursev respectsv thev patient’sv rightv tov privacyv whenv visitorsv arev spendingv timvwiev
thvthevpatient.
b. Thev patientv isv eagerlyv attendingv allv groupv sessionsv andv workingv independentlyv ovidn
entifyingvtheirvpersonalvstressors.
c. Thevpatientvisvfreelyvdescribingvtheirvfeelingsvrelatedvtovthevphysicalvandvemotion
alvtraumavtheyvexperiencedvasvavchildvwithvthevnurse.
d. Thev nursevdutifully vadministers vthev patient’s vmedications vonv timevandvwithvappro
priatevknowledgevofvthevpotentialvsideveffects.
ANS:vv C
Avprimaryvaspectvofvworkingvwithvpatientsvinvanyvsettingvandvparticularly vinvthe
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