Mental Health Exam 1 - ch 1-9 Questions
and Answers
1. A 55-year-old lives 100 miles from her parents and mother-in-law. In the past year, her
father had back surgery, her mother broke her hip, and her mother-in-law had a cardiac
event. Which nursing diagnosis is most applicable to the 55-year-old?
a. Risk for dysfunctional grief related to impending deaths of parents
b. Risk for injury related to frequent long drives to care for aging parents
c. Risk for situational low self-esteem related to overwhelming responsibilities
d. Risk for caregiver stress related to responsibilities for care of aging parents -
ANS-Answer: d.
2. The focus of the question is the caregiver. The demands associated with the care of
three elderly persons who live at a distance have the potential of overwhelming the
caregiver. Because there is no evidence of role strain, a risk diagnosis is formulated.
A colleague tells the nurse, "I have not been able to sleep for the past 3 days. I feel like
a robot." What is the nurse's best action?
a. Direct the colleague to leave the facility immediately.
b. Observe the colleague closely for evidence of impaired practice.
c. Offer to administer medications to patients assigned to the colleague.
d. Confer with the supervisor about the nurse's ability to safely deliver care. -
ANS-Answer: d.
3. Sleep deprivation causes impaired practice, which jeopardizes patient safety. The
colleague's comments indicate that impairment is likely. The nurse should confer with the
supervisor to determine the appropriate action.
A day-shift nurse contacts a nurse scheduled for the night shift at home and says, "Our
unit is full, and there are eight patients in the emergency department waiting for a bed."
The night-shift nurse replies, "Thanks for telling me. I am calling in sick." Which type of
problem is evident by the night-shift nurse's reply?
a. Ethical problem of fidelity
b. Legal problem of negligence
c. Legal problem of an intentional tort
d. Violation of the patients' right to treatment - ANS-Answer: a.
4. Fidelity is the ethical principle of maintaining loyalty and commitment to the patient. The
nurse in this situation is not maintaining commitment to patients by refusing to work the
shift. It is not, however, illegal for a nurse to call off for personal reasons, making this an
ethical decision.
A distraught 8-year-old girl tells the nurse, "I had a horrible nightmare and was so
scared. I tried to get in bed with my parents, but they said, 'No.' I think I could have gone
back to sleep if I had been with them." Which family dynamic is likely the basis of this
child's comment?
a. Boundaries in the family are rigid.
, b. The family has poor differentiation of roles.
c. The girl is enmeshed in part of a family triangle.
d. Generational boundaries in the family are diffuse. - ANS-Answer: a.
5. Rigid or disengaged boundaries are those in which the rules and roles are followed
despite the consequences.
A few nurses are privately discussing patients under their care. Which nurse's comment
indicates the need for clinical supervision regarding countertransference?
a. "My patient is always asking my permission to do something, just like a child."
b. "When our unit is understaffed, it seems like we have more incidents of disruptive
behavior."
c. "My patient tries to tell me what to do all the time. I got a divorce because my spouse
used to do that."
d. "Our patients have had so many traumatic life experiences. I find myself feeling
sympathetic sometimes." - ANS-Answer: c.
6. Countertransference refers to the tendency of the nurse to displace onto the patient
feelings related to people in his or her past. Frequently, the patient's transference to the
nurse evokes countertransference feelings in the nurse.
A mentally ill gunman opens fire in a crowded movie theater, killing six people and
injuring others. Which comment about this event by a member of the community most
clearly shows the stigma of mental illness?
a. "Gun control laws are inadequate in our country."
b. "It's frightening to feel that it is not safe to go to a movie theater."
c. "All these people with mental illness are violent and should be locked up."
d. "These events happen because American families no longer go to church together." -
ANS-Answer: c.
7. Stigma refers to the array of negative attitudes and beliefs regarding mental illness. Bias,
prejudice, fear, and misinformation contribute to stigma.
A neighbor telephones the nurse daily, giving lengthy details about multiple somatic
complaints and relationship problems. Which limit-setting strategy should the nurse
employ?
a. Suggest the neighbor call other people in the community.
b. Say to the neighbor, "I can talk to you for 15 minutes twice a week."
c. Use the telephone's caller identification to screen calls from the neighbor.
d. Tell the neighbor, "You should discuss these concerns with your personal physician
rather than me." - ANS-Answer: b.
8. The nurse has a responsibility for self-care and must set limits on the neighbor's
intrusive calls. Specifying the frequency and time allotment for calls shows compassion
for the neighbor while preventing infringement on the nurse's personal life.
A new patient whose chief concern is, "I'm tired of crying every day." Which comment
from the patient would prompt the nurse to suspect that a medical reason is causing the
problem rather than depression?
a. "I usually drink two or three cups of coffee in the morning."
b. "I often have headaches, especially when the pollen count is high."
c. "Years ago I had thyroid problems, but they cleared up and I stopped the medicine."
and Answers
1. A 55-year-old lives 100 miles from her parents and mother-in-law. In the past year, her
father had back surgery, her mother broke her hip, and her mother-in-law had a cardiac
event. Which nursing diagnosis is most applicable to the 55-year-old?
a. Risk for dysfunctional grief related to impending deaths of parents
b. Risk for injury related to frequent long drives to care for aging parents
c. Risk for situational low self-esteem related to overwhelming responsibilities
d. Risk for caregiver stress related to responsibilities for care of aging parents -
ANS-Answer: d.
2. The focus of the question is the caregiver. The demands associated with the care of
three elderly persons who live at a distance have the potential of overwhelming the
caregiver. Because there is no evidence of role strain, a risk diagnosis is formulated.
A colleague tells the nurse, "I have not been able to sleep for the past 3 days. I feel like
a robot." What is the nurse's best action?
a. Direct the colleague to leave the facility immediately.
b. Observe the colleague closely for evidence of impaired practice.
c. Offer to administer medications to patients assigned to the colleague.
d. Confer with the supervisor about the nurse's ability to safely deliver care. -
ANS-Answer: d.
3. Sleep deprivation causes impaired practice, which jeopardizes patient safety. The
colleague's comments indicate that impairment is likely. The nurse should confer with the
supervisor to determine the appropriate action.
A day-shift nurse contacts a nurse scheduled for the night shift at home and says, "Our
unit is full, and there are eight patients in the emergency department waiting for a bed."
The night-shift nurse replies, "Thanks for telling me. I am calling in sick." Which type of
problem is evident by the night-shift nurse's reply?
a. Ethical problem of fidelity
b. Legal problem of negligence
c. Legal problem of an intentional tort
d. Violation of the patients' right to treatment - ANS-Answer: a.
4. Fidelity is the ethical principle of maintaining loyalty and commitment to the patient. The
nurse in this situation is not maintaining commitment to patients by refusing to work the
shift. It is not, however, illegal for a nurse to call off for personal reasons, making this an
ethical decision.
A distraught 8-year-old girl tells the nurse, "I had a horrible nightmare and was so
scared. I tried to get in bed with my parents, but they said, 'No.' I think I could have gone
back to sleep if I had been with them." Which family dynamic is likely the basis of this
child's comment?
a. Boundaries in the family are rigid.
, b. The family has poor differentiation of roles.
c. The girl is enmeshed in part of a family triangle.
d. Generational boundaries in the family are diffuse. - ANS-Answer: a.
5. Rigid or disengaged boundaries are those in which the rules and roles are followed
despite the consequences.
A few nurses are privately discussing patients under their care. Which nurse's comment
indicates the need for clinical supervision regarding countertransference?
a. "My patient is always asking my permission to do something, just like a child."
b. "When our unit is understaffed, it seems like we have more incidents of disruptive
behavior."
c. "My patient tries to tell me what to do all the time. I got a divorce because my spouse
used to do that."
d. "Our patients have had so many traumatic life experiences. I find myself feeling
sympathetic sometimes." - ANS-Answer: c.
6. Countertransference refers to the tendency of the nurse to displace onto the patient
feelings related to people in his or her past. Frequently, the patient's transference to the
nurse evokes countertransference feelings in the nurse.
A mentally ill gunman opens fire in a crowded movie theater, killing six people and
injuring others. Which comment about this event by a member of the community most
clearly shows the stigma of mental illness?
a. "Gun control laws are inadequate in our country."
b. "It's frightening to feel that it is not safe to go to a movie theater."
c. "All these people with mental illness are violent and should be locked up."
d. "These events happen because American families no longer go to church together." -
ANS-Answer: c.
7. Stigma refers to the array of negative attitudes and beliefs regarding mental illness. Bias,
prejudice, fear, and misinformation contribute to stigma.
A neighbor telephones the nurse daily, giving lengthy details about multiple somatic
complaints and relationship problems. Which limit-setting strategy should the nurse
employ?
a. Suggest the neighbor call other people in the community.
b. Say to the neighbor, "I can talk to you for 15 minutes twice a week."
c. Use the telephone's caller identification to screen calls from the neighbor.
d. Tell the neighbor, "You should discuss these concerns with your personal physician
rather than me." - ANS-Answer: b.
8. The nurse has a responsibility for self-care and must set limits on the neighbor's
intrusive calls. Specifying the frequency and time allotment for calls shows compassion
for the neighbor while preventing infringement on the nurse's personal life.
A new patient whose chief concern is, "I'm tired of crying every day." Which comment
from the patient would prompt the nurse to suspect that a medical reason is causing the
problem rather than depression?
a. "I usually drink two or three cups of coffee in the morning."
b. "I often have headaches, especially when the pollen count is high."
c. "Years ago I had thyroid problems, but they cleared up and I stopped the medicine."
