,Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by
Varcarolis) 2
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing MULTIPLE
CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient
living in the community and diagnosed with serious and persistent mental illness? Within 3
months, the patient will: a. deny suicidal ideation.
b. report a sense of well-being.
c. take medications as prescribed.
d. attend clinic appointments on time.
ANS: B
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
C
role performance.
on
The goal of recovery is to empower the individual with mental illness to achieve a sense of
meaning and satisfaction in life and to function at the highest possible level of wellness. The
fid
incorrect options focus on the classic medical model rather than recovery.
DIF: Cognitive Level: Application (Applying) REF: 2
en
TOP: Nursing Process: Outcomes Identification
tia
MSC: NCLEX: Health Promotion and Maintenance
l
2. In the shift-change report, an off-going nurse criticizes a patient who wears heavy
makeup. Which comment by the nurse who receives the report best demonstrates
advocacy?
a. This is a psychiatric hospital. Craziness is what we are all about.
b. Lets all show acceptance of this patient by wearing lots of makeup too.
c. Your comments are inconsiderate and inappropriate. Keep the report objective.
d. Our patients need our help to learn behaviors that will help them get along in society.
ANS: D
,Accepting patients needs for self-expression and seeking to teach skills that will contribute
to their well-being demonstrate respect and are important parts of advocacy. The on-
coming nurse needs to take action to ensure that others are not prejudiced against the
patient. Humor can be appropriate within the privacy of a shift report but not at the
expense of respect for patients. Judging the off-going nurse in a critical way will create
conflict.
Nurses must show compassion for each other.
DIF: Cognitive Level: Application (Applying) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
3. A nurse assesses a newly admitted patient diagnosed with major depressive disorder.
Whichstatement is an example of attending?
a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.
b. Tell me why you felt you had to be hospitalized to receive treatment for your depression.
C
c. You will feel better after we get some antidepressant medication started for you.
on
d. Id like to sit with you a while so you may feel more comfortable talking with me.
fid
ANS: D
en
Attending is a technique that demonstrates the nurses commitment to the relationship and
reduces feelings of isolation. This technique shows respect for the patient and
tia
demonstrates caring. Generalizations, probing, and false reassurances are non-therapeutic.
l
DIF: Cognitive Level: Application (Applying) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a
divorce. Selectthe nurses most caring comment.
a. Lets discuss some means of coping other than suicide when you have these feelings.
b. I understand why youre so depressed. When I got divorced, I was devastated too.
c. You should forget about your marriage and move on with your life.
d. How did you get so depressed that hospitalization was necessary?
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by Varcarolis) 3
ANS: A
,The nurses communication should evidence caring and a commitment to work with the
patient. This commitment lets the patient know the nurse will help. Probing and advice are
not helpful or therapeutic interventions.
DIF: Cognitive Level: Application (Applying) REF: 6
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
5. A patient shows the nurse an article from the Internet about a health problem. Which
characteristic of the web sites address most alerts the nurse that the site may have biased
and prejudicedinformation?
a. Address ends in .org.
b. Address ends in .com.
c. Address ends in .gov.
d. Address ends in .net.
ANS: B
C
on
Financial influences on a site are a clue that the information may be biased. .com at the end
of the address indicates that the site is a commercial one. .gov indicates that the site is
fid
maintained by a government entity.
.org indicates that the site is nonproprietary; the site may or may not have reliable
en
information, but it does not profit from its activities. .net can have multiple meanings.
tia
DIF: Cognitive Level: Comprehension (Understanding) REF: 5
l
TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance
6. A nurse says, When I was in school, I learned to call upset patients by name to get their
attention; however, I read a descriptive research study that says that this approach does not
work. I plan to stop calling patients by name. Which statement is the best appraisal of this
nurses comment?
a. One descriptive research study rarely provides enough evidence to change practice.
b. Staff nurses apply new research findings only with the help from clinical nurse
specialists.
c. New research findings should be incorporated into clinical algorithms before using them
in practice.
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not
change.
ANS: A
, Descriptive research findings provide evidence for practice but must be viewed in
relation to other studies before practice changes. One study is not enough. Descriptive
studies arelow on the hierarchy of evidence.
Clinical algorithms use flow charts to manage problems and do not specify one response to
a clinical problem.
Classic tenets of practice should change as research findings provide evidence for change.DIF:
Cognitive Level: Analysis (Analyzing) REF: 3
TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance
7. Twonursing students discuss career plans after graduation. One student wants to enter
psychiatric nursing.
The other student asks, Why would you want to be a psychiatric nurse? All they do is talk.
You will lose your skills. Select the best response by the student interested in psychiatric
nursing.
C
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient
on
ratios must be better because of the nature of patients problems.
b. Psychiatric nurses use complex communication skills, as well as critical thinking, to solve
fid
multidimensional problems. Im challenged by those situations.
en
c. I think I will be good in the mental health field. I do not like clinical rotations in school, so
I do not want to continue them after I graduate.
tia
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical
l
surgical nurses. That appeals to me.
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical surgical
nursing, although substantial overlap does exist. Psychiatric nurses must be able to help
patients with medical and mental health problems, reflecting the holistic perspective these
nurses must have. Nurse-patient ratios and workloads in psychiatric settings have
increased, similar to other specialties. Psychiatric nursing involves clinical practice,
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by Varcarolis) 4
not simply documentation. Psychosocial pain is real and can cause as much suffering as
physical pain.
DIF: Cognitive Level: Application (Applying) REF: 3
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
,8. Which research evidence would most influence a group of nurses to change their
practice?
a. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway
ANS: B
Research findings are graded using a hierarchy of evidence. A systematic review of
randomized controlled trials is Level A and provides the strongest evidence for changing
practice. Expert committee recommendations and descriptive studies lend less powerful
and influential evidence. A critical pathway is not evidence; it incorporates research
findings after they have been analyzed.
DIF: Cognitive Level: Comprehension (Understanding) REF: 3
C
TOP: Nursing Process: Planning MSC: NCLEX: Safe, Effective Care Environment
on
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with
fid
mental illnesses.
en
A group of nurses write letters to their elected representatives in opposition to the
legislation. Which role have the nurses fulfilled?
tia
a. Advocacy
l
b. Attending
c. Recovery
d. Evidence-based practice
ANS: A
An advocate defends or asserts anothers cause, particularly when the other person lacks
the ability to do that for himself or herself. Examples of individual advocacy include helping
patients understand their rights or make decisions. On a community scale, advocacy
includes political activity, public speaking, and publication in the interest of improving the
individuals with mental illness; the letter-writing campaign advocates for that cause on
behalf of patients who are unable to articulate their own needs.
DIF: Cognitive Level: Comprehension (Understanding) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
, 10. An informal group of patients discuss their perceptions of nursing care. Which
comment best indicates a patients perception that his or her nurse is caring?
a. My nurse always asks me which type of juice I want to help me swallow my medication.
b. My nurse explained my treatment plan to me and asked for my ideas about how to make
it better.
c. My nurse told me that if I take all the medicines the doctor prescribes I will get
discharged soon.
d. My nurse spends time listening to me talk about my problems. That helps me feel like Im
not alone.
ANS: D
Caring evidences empathic understanding, as well as competency. It helps change pain and
suffering into a shared experience, creating a human connection that alleviates feelings of
C
isolation. The incorrect options give examples of statements that demonstrate advocacy or
giving advice.
on
DIF: Cognitive Level: Application (Applying) REF: 3
fid
TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity 11. A patient who
en
immigrated to the United States from Honduras was diagnosed with schizophrenia. The
patient took an antipsychotic medication for 3 weeks but showed no improvement. Which
resource should the treatment team consult for information on more effective medications
tia
for this patient?
l
a. Clinical algorithm
b. Clinical pathway
c. Clinical practice guideline
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by Varcarolis) 5
d. International Statistical Classification of Diseases and Related Health Problems (ICD)
ANS: A
A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches
drawn from large databases of information. These guidelines help the treatment team make
decisions cognizant of an individual patients needs, such as ethnic origin, age, or gender. A
clinical pathway is a map of interventions and treatments related to a specific disorder.
Clinical practice guidelines summarize best practices about specific health problems. The
ICD classifies diseases.
DIF: Cognitive Level: Application (Applying) REF: 5
Varcarolis) 2
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing MULTIPLE
CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient
living in the community and diagnosed with serious and persistent mental illness? Within 3
months, the patient will: a. deny suicidal ideation.
b. report a sense of well-being.
c. take medications as prescribed.
d. attend clinic appointments on time.
ANS: B
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
C
role performance.
on
The goal of recovery is to empower the individual with mental illness to achieve a sense of
meaning and satisfaction in life and to function at the highest possible level of wellness. The
fid
incorrect options focus on the classic medical model rather than recovery.
DIF: Cognitive Level: Application (Applying) REF: 2
en
TOP: Nursing Process: Outcomes Identification
tia
MSC: NCLEX: Health Promotion and Maintenance
l
2. In the shift-change report, an off-going nurse criticizes a patient who wears heavy
makeup. Which comment by the nurse who receives the report best demonstrates
advocacy?
a. This is a psychiatric hospital. Craziness is what we are all about.
b. Lets all show acceptance of this patient by wearing lots of makeup too.
c. Your comments are inconsiderate and inappropriate. Keep the report objective.
d. Our patients need our help to learn behaviors that will help them get along in society.
ANS: D
,Accepting patients needs for self-expression and seeking to teach skills that will contribute
to their well-being demonstrate respect and are important parts of advocacy. The on-
coming nurse needs to take action to ensure that others are not prejudiced against the
patient. Humor can be appropriate within the privacy of a shift report but not at the
expense of respect for patients. Judging the off-going nurse in a critical way will create
conflict.
Nurses must show compassion for each other.
DIF: Cognitive Level: Application (Applying) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
3. A nurse assesses a newly admitted patient diagnosed with major depressive disorder.
Whichstatement is an example of attending?
a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.
b. Tell me why you felt you had to be hospitalized to receive treatment for your depression.
C
c. You will feel better after we get some antidepressant medication started for you.
on
d. Id like to sit with you a while so you may feel more comfortable talking with me.
fid
ANS: D
en
Attending is a technique that demonstrates the nurses commitment to the relationship and
reduces feelings of isolation. This technique shows respect for the patient and
tia
demonstrates caring. Generalizations, probing, and false reassurances are non-therapeutic.
l
DIF: Cognitive Level: Application (Applying) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a
divorce. Selectthe nurses most caring comment.
a. Lets discuss some means of coping other than suicide when you have these feelings.
b. I understand why youre so depressed. When I got divorced, I was devastated too.
c. You should forget about your marriage and move on with your life.
d. How did you get so depressed that hospitalization was necessary?
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by Varcarolis) 3
ANS: A
,The nurses communication should evidence caring and a commitment to work with the
patient. This commitment lets the patient know the nurse will help. Probing and advice are
not helpful or therapeutic interventions.
DIF: Cognitive Level: Application (Applying) REF: 6
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
5. A patient shows the nurse an article from the Internet about a health problem. Which
characteristic of the web sites address most alerts the nurse that the site may have biased
and prejudicedinformation?
a. Address ends in .org.
b. Address ends in .com.
c. Address ends in .gov.
d. Address ends in .net.
ANS: B
C
on
Financial influences on a site are a clue that the information may be biased. .com at the end
of the address indicates that the site is a commercial one. .gov indicates that the site is
fid
maintained by a government entity.
.org indicates that the site is nonproprietary; the site may or may not have reliable
en
information, but it does not profit from its activities. .net can have multiple meanings.
tia
DIF: Cognitive Level: Comprehension (Understanding) REF: 5
l
TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance
6. A nurse says, When I was in school, I learned to call upset patients by name to get their
attention; however, I read a descriptive research study that says that this approach does not
work. I plan to stop calling patients by name. Which statement is the best appraisal of this
nurses comment?
a. One descriptive research study rarely provides enough evidence to change practice.
b. Staff nurses apply new research findings only with the help from clinical nurse
specialists.
c. New research findings should be incorporated into clinical algorithms before using them
in practice.
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not
change.
ANS: A
, Descriptive research findings provide evidence for practice but must be viewed in
relation to other studies before practice changes. One study is not enough. Descriptive
studies arelow on the hierarchy of evidence.
Clinical algorithms use flow charts to manage problems and do not specify one response to
a clinical problem.
Classic tenets of practice should change as research findings provide evidence for change.DIF:
Cognitive Level: Analysis (Analyzing) REF: 3
TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance
7. Twonursing students discuss career plans after graduation. One student wants to enter
psychiatric nursing.
The other student asks, Why would you want to be a psychiatric nurse? All they do is talk.
You will lose your skills. Select the best response by the student interested in psychiatric
nursing.
C
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient
on
ratios must be better because of the nature of patients problems.
b. Psychiatric nurses use complex communication skills, as well as critical thinking, to solve
fid
multidimensional problems. Im challenged by those situations.
en
c. I think I will be good in the mental health field. I do not like clinical rotations in school, so
I do not want to continue them after I graduate.
tia
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical
l
surgical nurses. That appeals to me.
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical surgical
nursing, although substantial overlap does exist. Psychiatric nurses must be able to help
patients with medical and mental health problems, reflecting the holistic perspective these
nurses must have. Nurse-patient ratios and workloads in psychiatric settings have
increased, similar to other specialties. Psychiatric nursing involves clinical practice,
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by Varcarolis) 4
not simply documentation. Psychosocial pain is real and can cause as much suffering as
physical pain.
DIF: Cognitive Level: Application (Applying) REF: 3
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
,8. Which research evidence would most influence a group of nurses to change their
practice?
a. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway
ANS: B
Research findings are graded using a hierarchy of evidence. A systematic review of
randomized controlled trials is Level A and provides the strongest evidence for changing
practice. Expert committee recommendations and descriptive studies lend less powerful
and influential evidence. A critical pathway is not evidence; it incorporates research
findings after they have been analyzed.
DIF: Cognitive Level: Comprehension (Understanding) REF: 3
C
TOP: Nursing Process: Planning MSC: NCLEX: Safe, Effective Care Environment
on
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with
fid
mental illnesses.
en
A group of nurses write letters to their elected representatives in opposition to the
legislation. Which role have the nurses fulfilled?
tia
a. Advocacy
l
b. Attending
c. Recovery
d. Evidence-based practice
ANS: A
An advocate defends or asserts anothers cause, particularly when the other person lacks
the ability to do that for himself or herself. Examples of individual advocacy include helping
patients understand their rights or make decisions. On a community scale, advocacy
includes political activity, public speaking, and publication in the interest of improving the
individuals with mental illness; the letter-writing campaign advocates for that cause on
behalf of patients who are unable to articulate their own needs.
DIF: Cognitive Level: Comprehension (Understanding) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
, 10. An informal group of patients discuss their perceptions of nursing care. Which
comment best indicates a patients perception that his or her nurse is caring?
a. My nurse always asks me which type of juice I want to help me swallow my medication.
b. My nurse explained my treatment plan to me and asked for my ideas about how to make
it better.
c. My nurse told me that if I take all the medicines the doctor prescribes I will get
discharged soon.
d. My nurse spends time listening to me talk about my problems. That helps me feel like Im
not alone.
ANS: D
Caring evidences empathic understanding, as well as competency. It helps change pain and
suffering into a shared experience, creating a human connection that alleviates feelings of
C
isolation. The incorrect options give examples of statements that demonstrate advocacy or
giving advice.
on
DIF: Cognitive Level: Application (Applying) REF: 3
fid
TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity 11. A patient who
en
immigrated to the United States from Honduras was diagnosed with schizophrenia. The
patient took an antipsychotic medication for 3 weeks but showed no improvement. Which
resource should the treatment team consult for information on more effective medications
tia
for this patient?
l
a. Clinical algorithm
b. Clinical pathway
c. Clinical practice guideline
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by Varcarolis) 5
d. International Statistical Classification of Diseases and Related Health Problems (ICD)
ANS: A
A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches
drawn from large databases of information. These guidelines help the treatment team make
decisions cognizant of an individual patients needs, such as ethnic origin, age, or gender. A
clinical pathway is a map of interventions and treatments related to a specific disorder.
Clinical practice guidelines summarize best practices about specific health problems. The
ICD classifies diseases.
DIF: Cognitive Level: Application (Applying) REF: 5
