NUR 405 EXAM 1 QUESTIONS AND ANSWERS
1. A nurse is assessing a client who is experiencing occasional feelings of sadness
because of the recent death of a beloved pet. The client's appetite, sleep patterns, and
daily routine have not changed. How should the nurse interpret the client's behaviors?
A. The client's behaviors demonstrate mental illness in the form of depression.
B. The client's behaviors are extensive, which indicates the presence of mental illness.
C. The client's behaviors are not congruent with cultural norms.
D. The client's behaviors demonstrate no functional impairment, indicating no mental
illness. - Answers - ANS: D
The nurse should assess that the client's daily functioning is not impaired. The client
who experiences feelings of sadness after the loss of a pet is responding within normal
expectations. Without significant impairment, the client's distress does not indicate a
mental illness.
2. A nurse is assessing 15-year-old identical twins who respond very differently to
st2ess. One twin becomes anxious and irritable, while the other withdraws and cries.
How should the nurse explain these different responses to stress to the parents?
A. Reactions to stress are relative rather than absolute; individual responses to stress
vary.
B. It is abnormal for identical twins to react differently to similar stressors.
C. Identical twins should share the same temperament and respond similarly to stress.
D. Environmental influences weigh more heavily than genetic influences on reactions to
stress. - Answers - ANS: A
Responses to stress are variable among individuals and may be influenced by
perception, past experience, and environmental factors in addition to genetic factors.
3. A client has a history of excessive drinking, which has led to multiple arrests for
driving under the influence (DUI). The client states, "I work hard to provide for my family.
I don't see why I can't drink to relax." The nurse recognizes the use of which defense
mechanism?
A. Projection
B. Rationalization
C. Regression
D. Sublimation - Answers - ANS: B
The nurse should recognize that the client is using rationalization, a common defense
mechanism. The client is attempting to make excuses and create logical reasons to
justify unacceptable feelings or behaviors.
4. At what point should the nurse determine that a client is at risk for developing a
mental disorder?
A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
B. When maladaptive responses to stress are coupled with interference in daily
functioning
C. When the client communicates significant distress
,D. When the client uses defense mechanisms as ego protection - Answers - ANS: B
The nurse should determine that the client is at risk for mental disorder when responses
to stress are maladaptive and interfere with daily functioning. The DSM-5 indicates that
in order to be diagnosed with a mental disorder, there must be significant disturbance in
cognition, emotion, regulation, or behavior that reflects a dysfunction in the
psychological, biological or developmental processes underlying mental functioning.
These disorders are usually associated with significant distress or disability in social,
occupational, or other important activities. The client's ability to communicate distress
would be considered a positive attribute
5. Which client should the nurse anticipate to be most receptive to psychiatric
treatment?
A. A Jewish, female journalist
B. A Baptist, homeless male
C. A Catholic, black male
D. A Protestant, Swedish business executive - Answers - ANS: A
The nurse should anticipate that the client of Jewish culture would place a high
importance on preventative health care and would consider mental health as equally
important as physical health. Women are also more likely than men to seek treatment
for mental health problems.
6. A new psychiatric nurse states, "This client's use of defense mechanisms should be
eliminated." Which is a correct evaluation of this nurse's statement?
A. Defense mechanisms can be self-protective responses to stress and need not be
eliminated.
B. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and
should always be eliminated.
C. Defense mechanisms, used by individuals with weak ego integrity, should be
discouraged and not eliminated.
D. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged. - Answers - ANS: A
The nurse should know that defense mechanisms serve the purpose of reducing anxiety
during times of stress. A client with no defense mechanisms may have a lower tolerance
for stress, predisposing him or her to anxiety disorders. Defense mechanisms should be
confronted when they impede the client from developing healthy coping skills.
7. During an intake assessment, a nurse asks both physiological and psychosocial
questions. The client angrily responds, "I'm here for my heart, not my head problems."
Which is the nurse's best response?
A. "It's just a routine part of our assessment. All clients are asked these same
questions."
B. "Why are you concerned about these types of questions?"
C. "Psychological factors, like excessive stress, have been found to affect medical
conditions."
D. "We can skip these questions, if you like. It isn't imperative that we complete this
section." - Answers - ANS: C
, The nurse should attempt to educate the client on the negative effects of excessive
stress on medical conditions. It is not appropriate to skip either physiological or
psychosocial questions, as this would lead to an inaccurate assessment.
8. Which statement reflects a student nurse's accurate understanding of the concepts of
mental health and mental illness?
A. "The concepts are rigid and religiously based."
B. "The concepts are multidimensional and culturally defined."
C. "The concepts are universal and unchanging."
D. "The concepts are unidimensional and fixed." - Answers - ANS: B
The student nurse should understand that mental health and mental illness are
multidimensional and culturally defined. It is important for nurses to be aware of cultural
norms when evaluating a client's mental state.
9. A mental health technician asks the nurse, "How do psychiatrists determine which
diagnosis to give a patient?" Which of these responses by the nurse would be most
accurate?
A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical
Manual of Mental Disorders (DSM-5).
B. Hospital policy dictates how psychiatrists diagnose mental disorders.
C. Psychiatrists assess the patient and identify diagnoses based on the patient's
unhealthy responses and contributing factors.
D. The American Medical Association identifies 10 diagnostic labels that psychiatrists
can choose from. - Answers - ANS: A
The DSM-5 is an organized manual describing mental disorders and the criteria that
determine whether a given diagnosis is appropriate. It is published by the American
Psychiatric Association (APA). It intends to facilitate accurate and reliable medical
diagnosis and treatment. Item C describes nursing rather than medical diagnosis.
10. The nurse is preparing to provide medication instruction for a patient. Which of the
following understandings about anxiety will be essential to effective instruction?
A. Learning is best when anxiety is moderate to severe.
B. Learning is enhanced when anxiety is mild.
C. Panic level anxiety helps the nurse teach better.
D. Severe anxiety is characterized by intense concentration and enhances the attention
span. - Answers - ANS: B
Mild anxiety sharpens the senses, increases the perceptual field, and results in
heightened awareness of the environment. Learning is enhanced. As anxiety increases,
attention span decreases and learning becomes more difficult.
11. Which of the following are identified as psychoneurotic responses to severe anxiety
as they appear in the DSM-5?
A. Somatic symptom disorders
B. Grief responses
C. Psychosis
D. Bipolar disorder - Answers - ANS: A
1. A nurse is assessing a client who is experiencing occasional feelings of sadness
because of the recent death of a beloved pet. The client's appetite, sleep patterns, and
daily routine have not changed. How should the nurse interpret the client's behaviors?
A. The client's behaviors demonstrate mental illness in the form of depression.
B. The client's behaviors are extensive, which indicates the presence of mental illness.
C. The client's behaviors are not congruent with cultural norms.
D. The client's behaviors demonstrate no functional impairment, indicating no mental
illness. - Answers - ANS: D
The nurse should assess that the client's daily functioning is not impaired. The client
who experiences feelings of sadness after the loss of a pet is responding within normal
expectations. Without significant impairment, the client's distress does not indicate a
mental illness.
2. A nurse is assessing 15-year-old identical twins who respond very differently to
st2ess. One twin becomes anxious and irritable, while the other withdraws and cries.
How should the nurse explain these different responses to stress to the parents?
A. Reactions to stress are relative rather than absolute; individual responses to stress
vary.
B. It is abnormal for identical twins to react differently to similar stressors.
C. Identical twins should share the same temperament and respond similarly to stress.
D. Environmental influences weigh more heavily than genetic influences on reactions to
stress. - Answers - ANS: A
Responses to stress are variable among individuals and may be influenced by
perception, past experience, and environmental factors in addition to genetic factors.
3. A client has a history of excessive drinking, which has led to multiple arrests for
driving under the influence (DUI). The client states, "I work hard to provide for my family.
I don't see why I can't drink to relax." The nurse recognizes the use of which defense
mechanism?
A. Projection
B. Rationalization
C. Regression
D. Sublimation - Answers - ANS: B
The nurse should recognize that the client is using rationalization, a common defense
mechanism. The client is attempting to make excuses and create logical reasons to
justify unacceptable feelings or behaviors.
4. At what point should the nurse determine that a client is at risk for developing a
mental disorder?
A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
B. When maladaptive responses to stress are coupled with interference in daily
functioning
C. When the client communicates significant distress
,D. When the client uses defense mechanisms as ego protection - Answers - ANS: B
The nurse should determine that the client is at risk for mental disorder when responses
to stress are maladaptive and interfere with daily functioning. The DSM-5 indicates that
in order to be diagnosed with a mental disorder, there must be significant disturbance in
cognition, emotion, regulation, or behavior that reflects a dysfunction in the
psychological, biological or developmental processes underlying mental functioning.
These disorders are usually associated with significant distress or disability in social,
occupational, or other important activities. The client's ability to communicate distress
would be considered a positive attribute
5. Which client should the nurse anticipate to be most receptive to psychiatric
treatment?
A. A Jewish, female journalist
B. A Baptist, homeless male
C. A Catholic, black male
D. A Protestant, Swedish business executive - Answers - ANS: A
The nurse should anticipate that the client of Jewish culture would place a high
importance on preventative health care and would consider mental health as equally
important as physical health. Women are also more likely than men to seek treatment
for mental health problems.
6. A new psychiatric nurse states, "This client's use of defense mechanisms should be
eliminated." Which is a correct evaluation of this nurse's statement?
A. Defense mechanisms can be self-protective responses to stress and need not be
eliminated.
B. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and
should always be eliminated.
C. Defense mechanisms, used by individuals with weak ego integrity, should be
discouraged and not eliminated.
D. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged. - Answers - ANS: A
The nurse should know that defense mechanisms serve the purpose of reducing anxiety
during times of stress. A client with no defense mechanisms may have a lower tolerance
for stress, predisposing him or her to anxiety disorders. Defense mechanisms should be
confronted when they impede the client from developing healthy coping skills.
7. During an intake assessment, a nurse asks both physiological and psychosocial
questions. The client angrily responds, "I'm here for my heart, not my head problems."
Which is the nurse's best response?
A. "It's just a routine part of our assessment. All clients are asked these same
questions."
B. "Why are you concerned about these types of questions?"
C. "Psychological factors, like excessive stress, have been found to affect medical
conditions."
D. "We can skip these questions, if you like. It isn't imperative that we complete this
section." - Answers - ANS: C
, The nurse should attempt to educate the client on the negative effects of excessive
stress on medical conditions. It is not appropriate to skip either physiological or
psychosocial questions, as this would lead to an inaccurate assessment.
8. Which statement reflects a student nurse's accurate understanding of the concepts of
mental health and mental illness?
A. "The concepts are rigid and religiously based."
B. "The concepts are multidimensional and culturally defined."
C. "The concepts are universal and unchanging."
D. "The concepts are unidimensional and fixed." - Answers - ANS: B
The student nurse should understand that mental health and mental illness are
multidimensional and culturally defined. It is important for nurses to be aware of cultural
norms when evaluating a client's mental state.
9. A mental health technician asks the nurse, "How do psychiatrists determine which
diagnosis to give a patient?" Which of these responses by the nurse would be most
accurate?
A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical
Manual of Mental Disorders (DSM-5).
B. Hospital policy dictates how psychiatrists diagnose mental disorders.
C. Psychiatrists assess the patient and identify diagnoses based on the patient's
unhealthy responses and contributing factors.
D. The American Medical Association identifies 10 diagnostic labels that psychiatrists
can choose from. - Answers - ANS: A
The DSM-5 is an organized manual describing mental disorders and the criteria that
determine whether a given diagnosis is appropriate. It is published by the American
Psychiatric Association (APA). It intends to facilitate accurate and reliable medical
diagnosis and treatment. Item C describes nursing rather than medical diagnosis.
10. The nurse is preparing to provide medication instruction for a patient. Which of the
following understandings about anxiety will be essential to effective instruction?
A. Learning is best when anxiety is moderate to severe.
B. Learning is enhanced when anxiety is mild.
C. Panic level anxiety helps the nurse teach better.
D. Severe anxiety is characterized by intense concentration and enhances the attention
span. - Answers - ANS: B
Mild anxiety sharpens the senses, increases the perceptual field, and results in
heightened awareness of the environment. Learning is enhanced. As anxiety increases,
attention span decreases and learning becomes more difficult.
11. Which of the following are identified as psychoneurotic responses to severe anxiety
as they appear in the DSM-5?
A. Somatic symptom disorders
B. Grief responses
C. Psychosis
D. Bipolar disorder - Answers - ANS: A
