DAVIS ADVANTAGE FOR TOWNSEND'S ESSENTIALS
OF PSYCHIATRIC MENTAL-HEALTH NURSING
CONCEPTS OF CARE IN EVIDENCE- PRACTICE 9TH
EDITION MORGAN TOWNSEND TEST BANK
Chapter,1.,Mental,Health,and,Mental,Illness,
Multiple,Choice,
1.,A,nurse,is,assessing,a,client,who,is,experiencing,occasional,feelings,of,sadness,because,of,the,rec
ent,death,of,a,beloved,pet.,The,clients,appetite,,sleep,patterns,,and,daily,routine,have,not,changed.,H
ow,should,the,nurse,interpret,the,clients,behaviors?
1. The,clients,behaviors,demonstrate,mental,illness,in,the,form,of,depression.
2. The,clients,behaviors,are,extensive,,which,indicates,the,presence,of,mental,illness.
3. The,clients,behaviors,are,not,congruent,with,cultural,norms.
4. The,clients,behaviors,demonstrate,no,functional,impairment,,indicating,no,mental,illness.
ANS:,4,
Rationale:,The,nurse,should,assess,that,the,clients,daily,functioning,is,not,impaired.,The,client,who,
experiences,feelings,of,sadness,after,the,loss,of,a,pet,is,responding,within,normal,expectations.,Wit
hout,significant,impairment,,the,clients,distress,does,not,indicate,a,mental,illness.,
Cognitive,Level:,Analysis,
Integrated,Process:,Assessment,
2.,At,what,point,should,the,nurse,determine,that,a,client,is,at,risk,for,developing,a,mental
illness?
1. When,thoughts,,feelings,,and,behaviors,are,not,reflective,of,the,DSM-5,criteria.
2. When,maladaptive,responses,to,stress,are,coupled,with,interference,in,daily,functioning.
3. When,a,client,communicates,significant,distress.
4. When,a,client,uses,defense,mechanisms,as,ego,protection.
ANS:,2,
Rationale:,The,nurse,should,determine,that,the,client,is,at,risk,for,mental,illness,when,responses,to,s
tress,are,maladaptive,and,interfere,with,daily,functioning.,The,DSM-
5,indicates,that,in,order,to,be,diagnosed,with,a,mental,illness,,daily,functioning,must,be,significantl
y,impaired.,The,clients,ability,to,communicate,distress,would,be,considered,a,positive,attribute.,
Cognitive,Level:,Application,
Integrated,Process:,Assessment,
,3.,A,nurse,is,assessing,a,set,of,15-year-
old,identical,twins,who,respond,very,differently,to,stress.,One,twin,becomes,anxious,and,irritable,,a
nd,the,other,withdraws,and,cries.,How,should,the,nurse,explain,these,different,stress,responses,to,th
e,parents?
1. Reactions,to,stress,are,relative,rather,than,absolute;,individual,responses,to,stress,vary.
2. It,is,abnormal,for,identical,twins,to,react,differently,to,similar,stressors.
3. Identical,twins,should,share,the,same,temperament,and,respond,similarly,to,stress.
4. Environmental,influences,to,stress,weigh,more,heavily,than,genetic,influences.
ANS:,1,
Rationale:,The,nurse,should,explain,to,the,parents,that,,although,the,twins,have,identical,DNA,,ther
e,are,several,other,factors,that,affect,reactions,to,stress.,Mental,health,is,a,state,of,being,that,is,relati
ve,to,the,individual,client.,Environmental,influences,and,temperament,can,affect,stress,reactions.,
Cognitive,Level:,Application,
Integrated,Process:,Implementation,
4.,Which,client,should,the,nurse,anticipate,to,be,most,receptive,to,psychiatric,treatment?,
1. A,Jewish,,female,social,worker.,
2. A,Baptist,,homeless,male.,
3. A,Catholic,,black,male.,
4. A,Protestant,,Swedish,business,executive.,
ANS:,1,
Rationale:,The,nurse,should,anticipate,that,the,client,of,Jewish,culture,would,place,a,high,importan
ce,on,preventative,health,care,and,would,consider,mental,health,as,equally,important,as,physical,he
alth.,Women,are,also,more,likely,to,seek,treatment,for,mental,health,problems,than,men.,
Cognitive,Level:,Application,Integrated,
Process:,Planning,
5. A,psychiatric,nurse,intern,states,,This,clients,use,of,defense,mechanisms,should,be,eliminated.,
Which,is,a,correct,evaluation,of,this,nurses,statement?,
1. Defense,mechanisms,can,be,appropriate,responses,to,stress,and,need,not,be,eliminated.,
2. Defense,mechanisms,are,a,maladaptive,attempt,of,the,ego,to,manage,anxiety,and,should,always,
be,eliminated.,
3. Defense,mechanisms,,used,by,individuals,with,weak,ego,integrity,,should,be,discouraged,and,no
t,eliminated.,
4. Defense,mechanisms,cause,disintegration,of,the,ego,and,should,be,fostered,and,encouraged.,
ANS:,1,
Rationale:,The,nurse,should,determine,that,defense,mechanisms,can,be,appropriate,during,times,of,
stress.,The,client,with,no,defense,mechanisms,may,have,a,lower,tolerance,for,stress,,thus,leading,to,
anxiety,disorders.,Defense,mechanisms,should,be,confronted,when,they,impede,the,client,from,dev
eloping,healthy,coping,skills.,
Cognitive,Level:,Application,
Integrated,Process:,Evaluation,
,6.,During,an,intake,assessment,,a,nurse,asks,both,physiological,and,psychosocial,questions.,The,cli
ent,angrily,responds,,Im,here,for,my,heart,,not,my,head,problems.,Which,is,the,nurses,best,response
?,
1. Its,just,a,routine,part,of,our,assessment.,All,clients,are,asked,these,same,questions.,
2. Why,are,you,concerned,about,these,types,of,questions?,
3. Psychological,factors,,like,excessive,stress,,have,been,found,to,affect,medical,conditions.,
4. We,can,skip,these,questions,,if,you,like.,It,isnt,imperative,that,we,complete,this,section.,
ANS:,3,
Rationale:,The,nurse,should,attempt,to,educate,the,client,on,the,negative,effects,of,excessive,stress,
on,medical,conditions.,It,is,not,appropriate,to,skip,physiological,and,psychosocial,questions,,as,this,
would,lead,to,an,inaccurate,assessment.,
Cognitive,Level:,Application,
Integrated,Process:,Implementation,
7.,An,employee,uses,the,defense,mechanism,of,displacement,when,the,boss,openly,disagrees,with,s
uggestions.,What,behavior,would,be,expected,from,this,employee?,
1. The,employee,assertively,confronts,the,boss.,
2. The,employee,leaves,the,staff,meeting,to,work,out,in,the,gym.,
3. The,employee,criticizes,a,coworker.,
4. The,employee,takes,the,boss,out,to,lunch.,
ANS:,3,
Rationale:,The,nurse,should,expect,that,the,client,using,the,defense,mechanism,displacement,would
,criticize,a,coworker,after,being,confronted,by,the,boss.,Displacement,refers,to,transferring,feelings
,from,one,target,to,a,neutral,or,less-threatening,target.,
Cognitive,Level:,Analysis,
Integrated,Process:,Assessment,
8.,A,fourth-
grade,boy,teases,and,makes,jokes,about,a,cute,girl,in,his,class.,This,behavior,should,be,identified,by
,a,nurse,as,indicative,of,which,defense,mechanism?,
1. Displacement,
2. Projection,
3. Reaction,formation,
4. Sublimation,
ANS:,3,
Rationale:,The,nurse,should,identify,that,the,boy,is,using,reaction,formation,as,a,defense,mechanis
m.,Reaction,formation,is,the,attempt,to,prevent,undesirable,thoughts,from,being,expressed,by,expre
ssing,opposite,thoughts,or,behaviors.,Displacement,refers,to,transferring,feelings,from,one,target,to
,another.,Rationalization,refers,to,making,excuses,to,justify,behavior.,Projection,refers,to,the,attribu
tion,of,unacceptable,feelings,or,behaviors,to,another,person.,Sublimation,refers,to,channeling,unac
ceptable,drives,or,impulses,into,more,constructive,,acceptable,activities.,
Cognitive,Level:,Application,
, Integrated,Process:,Assessment,
9.,Which,nursing,statement,about,the,concept,of,neurosis,is,most,accurate?,
1. An,individual,experiencing,neurosis,is,unaware,that,he,or,she,is,experiencing,distress.,
2. An,individual,experiencing,neurosis,feels,helpless,to,change,his,or,her,situation.,
3. An,individual,experiencing,neurosis,is,aware,of,psychological,causes,of,his,or,her,behavior.,
4. An,individual,experiencing,neurosis,has,a,loss,of,contact,with,reality.,
ANS:,2,
Rationale:,The,nurse,should,define,the,concept,of,neurosis,with,the,following,characteristics:,
The,client,feels,helpless,to,change,his,or,her,situation,,the,client,is,aware,that,he,or,she,is,experienci
ng,distress,,the,client,is,aware,the,behaviors,are,maladaptive,,the,client,is,unaware,of,the,psychologi
cal,causes,of,the,distress,,and,the,client,experiences,no,loss,of,contact,with,reality.,
Cognitive,Level:,Application,
Integrated,Process:,Assessment,
10.,Which,nursing,statement,regarding,the,concept,of,psychosis,is,most,accurate?,
1. Individuals,experiencing,psychoses,are,aware,that,their,behaviors,are,maladaptive.,
2. Individuals,experiencing,psychoses,experience,little,distress.,
3. Individuals,experiencing,psychoses,are,aware,of,experiencing,psychological,problems.,
4. Individuals,experiencing,psychoses,are,based,in,reality.,
ANS:,2,
Rationale:,The,nurse,should,understand,that,the,client,with,psychosis,experiences,little,distress,owi
ng,to,his,or,her,lack,of,awareness,of,reality.,The,client,with,psychosis,is,unaware,that,his,or,her,beha
vior,is,maladaptive,or,that,he,or,she,has,a,psychological,problem.,
Cognitive,Level:,Application,
Integrated,Process:,Assessment,
11.,When,under,stress,,a,client,routinely,uses,alcohol,to,excess.,Finding,her,drunk,,her,husband,yell
s,at,the,client,about,her,chronic,alcohol,abuse.,Which,action,alerts,the,nurse,to,the,clients,use,of,the,
defense,mechanism,of,denial?,
1. The,client,hides,liquor,bottles,in,a,closet.,
2. The,client,yells,at,her,son,for,slouching,in,his,chair.,
3. The,client,burns,dinner,on,purpose.,
4. The,client,says,to,the,spouse,,I,dont,drink,too,much!,
ANS:,4,
Rationale:,The,clients,statement,I,dont,drink,too,much!,alerts,the,nurse,to,the,use,of,the,defense,mec
hanism,of,denial.,The,client,is,refusing,to,acknowledge,the,existence,of,a,real,situation,and,the,feeli
ngs,associated,with,it.,
Cognitive,Level:,Application,
Integrated,Process:,Assessment,
OF PSYCHIATRIC MENTAL-HEALTH NURSING
CONCEPTS OF CARE IN EVIDENCE- PRACTICE 9TH
EDITION MORGAN TOWNSEND TEST BANK
Chapter,1.,Mental,Health,and,Mental,Illness,
Multiple,Choice,
1.,A,nurse,is,assessing,a,client,who,is,experiencing,occasional,feelings,of,sadness,because,of,the,rec
ent,death,of,a,beloved,pet.,The,clients,appetite,,sleep,patterns,,and,daily,routine,have,not,changed.,H
ow,should,the,nurse,interpret,the,clients,behaviors?
1. The,clients,behaviors,demonstrate,mental,illness,in,the,form,of,depression.
2. The,clients,behaviors,are,extensive,,which,indicates,the,presence,of,mental,illness.
3. The,clients,behaviors,are,not,congruent,with,cultural,norms.
4. The,clients,behaviors,demonstrate,no,functional,impairment,,indicating,no,mental,illness.
ANS:,4,
Rationale:,The,nurse,should,assess,that,the,clients,daily,functioning,is,not,impaired.,The,client,who,
experiences,feelings,of,sadness,after,the,loss,of,a,pet,is,responding,within,normal,expectations.,Wit
hout,significant,impairment,,the,clients,distress,does,not,indicate,a,mental,illness.,
Cognitive,Level:,Analysis,
Integrated,Process:,Assessment,
2.,At,what,point,should,the,nurse,determine,that,a,client,is,at,risk,for,developing,a,mental
illness?
1. When,thoughts,,feelings,,and,behaviors,are,not,reflective,of,the,DSM-5,criteria.
2. When,maladaptive,responses,to,stress,are,coupled,with,interference,in,daily,functioning.
3. When,a,client,communicates,significant,distress.
4. When,a,client,uses,defense,mechanisms,as,ego,protection.
ANS:,2,
Rationale:,The,nurse,should,determine,that,the,client,is,at,risk,for,mental,illness,when,responses,to,s
tress,are,maladaptive,and,interfere,with,daily,functioning.,The,DSM-
5,indicates,that,in,order,to,be,diagnosed,with,a,mental,illness,,daily,functioning,must,be,significantl
y,impaired.,The,clients,ability,to,communicate,distress,would,be,considered,a,positive,attribute.,
Cognitive,Level:,Application,
Integrated,Process:,Assessment,
,3.,A,nurse,is,assessing,a,set,of,15-year-
old,identical,twins,who,respond,very,differently,to,stress.,One,twin,becomes,anxious,and,irritable,,a
nd,the,other,withdraws,and,cries.,How,should,the,nurse,explain,these,different,stress,responses,to,th
e,parents?
1. Reactions,to,stress,are,relative,rather,than,absolute;,individual,responses,to,stress,vary.
2. It,is,abnormal,for,identical,twins,to,react,differently,to,similar,stressors.
3. Identical,twins,should,share,the,same,temperament,and,respond,similarly,to,stress.
4. Environmental,influences,to,stress,weigh,more,heavily,than,genetic,influences.
ANS:,1,
Rationale:,The,nurse,should,explain,to,the,parents,that,,although,the,twins,have,identical,DNA,,ther
e,are,several,other,factors,that,affect,reactions,to,stress.,Mental,health,is,a,state,of,being,that,is,relati
ve,to,the,individual,client.,Environmental,influences,and,temperament,can,affect,stress,reactions.,
Cognitive,Level:,Application,
Integrated,Process:,Implementation,
4.,Which,client,should,the,nurse,anticipate,to,be,most,receptive,to,psychiatric,treatment?,
1. A,Jewish,,female,social,worker.,
2. A,Baptist,,homeless,male.,
3. A,Catholic,,black,male.,
4. A,Protestant,,Swedish,business,executive.,
ANS:,1,
Rationale:,The,nurse,should,anticipate,that,the,client,of,Jewish,culture,would,place,a,high,importan
ce,on,preventative,health,care,and,would,consider,mental,health,as,equally,important,as,physical,he
alth.,Women,are,also,more,likely,to,seek,treatment,for,mental,health,problems,than,men.,
Cognitive,Level:,Application,Integrated,
Process:,Planning,
5. A,psychiatric,nurse,intern,states,,This,clients,use,of,defense,mechanisms,should,be,eliminated.,
Which,is,a,correct,evaluation,of,this,nurses,statement?,
1. Defense,mechanisms,can,be,appropriate,responses,to,stress,and,need,not,be,eliminated.,
2. Defense,mechanisms,are,a,maladaptive,attempt,of,the,ego,to,manage,anxiety,and,should,always,
be,eliminated.,
3. Defense,mechanisms,,used,by,individuals,with,weak,ego,integrity,,should,be,discouraged,and,no
t,eliminated.,
4. Defense,mechanisms,cause,disintegration,of,the,ego,and,should,be,fostered,and,encouraged.,
ANS:,1,
Rationale:,The,nurse,should,determine,that,defense,mechanisms,can,be,appropriate,during,times,of,
stress.,The,client,with,no,defense,mechanisms,may,have,a,lower,tolerance,for,stress,,thus,leading,to,
anxiety,disorders.,Defense,mechanisms,should,be,confronted,when,they,impede,the,client,from,dev
eloping,healthy,coping,skills.,
Cognitive,Level:,Application,
Integrated,Process:,Evaluation,
,6.,During,an,intake,assessment,,a,nurse,asks,both,physiological,and,psychosocial,questions.,The,cli
ent,angrily,responds,,Im,here,for,my,heart,,not,my,head,problems.,Which,is,the,nurses,best,response
?,
1. Its,just,a,routine,part,of,our,assessment.,All,clients,are,asked,these,same,questions.,
2. Why,are,you,concerned,about,these,types,of,questions?,
3. Psychological,factors,,like,excessive,stress,,have,been,found,to,affect,medical,conditions.,
4. We,can,skip,these,questions,,if,you,like.,It,isnt,imperative,that,we,complete,this,section.,
ANS:,3,
Rationale:,The,nurse,should,attempt,to,educate,the,client,on,the,negative,effects,of,excessive,stress,
on,medical,conditions.,It,is,not,appropriate,to,skip,physiological,and,psychosocial,questions,,as,this,
would,lead,to,an,inaccurate,assessment.,
Cognitive,Level:,Application,
Integrated,Process:,Implementation,
7.,An,employee,uses,the,defense,mechanism,of,displacement,when,the,boss,openly,disagrees,with,s
uggestions.,What,behavior,would,be,expected,from,this,employee?,
1. The,employee,assertively,confronts,the,boss.,
2. The,employee,leaves,the,staff,meeting,to,work,out,in,the,gym.,
3. The,employee,criticizes,a,coworker.,
4. The,employee,takes,the,boss,out,to,lunch.,
ANS:,3,
Rationale:,The,nurse,should,expect,that,the,client,using,the,defense,mechanism,displacement,would
,criticize,a,coworker,after,being,confronted,by,the,boss.,Displacement,refers,to,transferring,feelings
,from,one,target,to,a,neutral,or,less-threatening,target.,
Cognitive,Level:,Analysis,
Integrated,Process:,Assessment,
8.,A,fourth-
grade,boy,teases,and,makes,jokes,about,a,cute,girl,in,his,class.,This,behavior,should,be,identified,by
,a,nurse,as,indicative,of,which,defense,mechanism?,
1. Displacement,
2. Projection,
3. Reaction,formation,
4. Sublimation,
ANS:,3,
Rationale:,The,nurse,should,identify,that,the,boy,is,using,reaction,formation,as,a,defense,mechanis
m.,Reaction,formation,is,the,attempt,to,prevent,undesirable,thoughts,from,being,expressed,by,expre
ssing,opposite,thoughts,or,behaviors.,Displacement,refers,to,transferring,feelings,from,one,target,to
,another.,Rationalization,refers,to,making,excuses,to,justify,behavior.,Projection,refers,to,the,attribu
tion,of,unacceptable,feelings,or,behaviors,to,another,person.,Sublimation,refers,to,channeling,unac
ceptable,drives,or,impulses,into,more,constructive,,acceptable,activities.,
Cognitive,Level:,Application,
, Integrated,Process:,Assessment,
9.,Which,nursing,statement,about,the,concept,of,neurosis,is,most,accurate?,
1. An,individual,experiencing,neurosis,is,unaware,that,he,or,she,is,experiencing,distress.,
2. An,individual,experiencing,neurosis,feels,helpless,to,change,his,or,her,situation.,
3. An,individual,experiencing,neurosis,is,aware,of,psychological,causes,of,his,or,her,behavior.,
4. An,individual,experiencing,neurosis,has,a,loss,of,contact,with,reality.,
ANS:,2,
Rationale:,The,nurse,should,define,the,concept,of,neurosis,with,the,following,characteristics:,
The,client,feels,helpless,to,change,his,or,her,situation,,the,client,is,aware,that,he,or,she,is,experienci
ng,distress,,the,client,is,aware,the,behaviors,are,maladaptive,,the,client,is,unaware,of,the,psychologi
cal,causes,of,the,distress,,and,the,client,experiences,no,loss,of,contact,with,reality.,
Cognitive,Level:,Application,
Integrated,Process:,Assessment,
10.,Which,nursing,statement,regarding,the,concept,of,psychosis,is,most,accurate?,
1. Individuals,experiencing,psychoses,are,aware,that,their,behaviors,are,maladaptive.,
2. Individuals,experiencing,psychoses,experience,little,distress.,
3. Individuals,experiencing,psychoses,are,aware,of,experiencing,psychological,problems.,
4. Individuals,experiencing,psychoses,are,based,in,reality.,
ANS:,2,
Rationale:,The,nurse,should,understand,that,the,client,with,psychosis,experiences,little,distress,owi
ng,to,his,or,her,lack,of,awareness,of,reality.,The,client,with,psychosis,is,unaware,that,his,or,her,beha
vior,is,maladaptive,or,that,he,or,she,has,a,psychological,problem.,
Cognitive,Level:,Application,
Integrated,Process:,Assessment,
11.,When,under,stress,,a,client,routinely,uses,alcohol,to,excess.,Finding,her,drunk,,her,husband,yell
s,at,the,client,about,her,chronic,alcohol,abuse.,Which,action,alerts,the,nurse,to,the,clients,use,of,the,
defense,mechanism,of,denial?,
1. The,client,hides,liquor,bottles,in,a,closet.,
2. The,client,yells,at,her,son,for,slouching,in,his,chair.,
3. The,client,burns,dinner,on,purpose.,
4. The,client,says,to,the,spouse,,I,dont,drink,too,much!,
ANS:,4,
Rationale:,The,clients,statement,I,dont,drink,too,much!,alerts,the,nurse,to,the,use,of,the,defense,mec
hanism,of,denial.,The,client,is,refusing,to,acknowledge,the,existence,of,a,real,situation,and,the,feeli
ngs,associated,with,it.,
Cognitive,Level:,Application,
Integrated,Process:,Assessment,
