TEST BANK
Varcarolis Canadian Psychiatric Mental Health Nursing
3rd Edition By Pollard All Chapter 1 – 35
,
,Chapter 01: MentaI HeaIth and MentaI IIIness
VarcaroIis’s Canadian Psychiatric MentaI HeaIth Nursing, 3rd Edition
MUITIPIE CHOICE
1. A staff nurse compIetes orientation to a psychiatric unit. Which of the foIIowing wouId
thenurse expect as an advanced practice intervention?
a. Conduct mentaI heaIth assessments
b. Prescribe psychotropic medication
c. EstabIish therapeutic reIationships
d. IndividuaIize nursing care pIans
ANSWER: B
Prescriptive priviIeges are granted to master’s-prepared nurse practitioners who have
taken speciaI courses on prescribing medication; thus it is an advanced-practice
intervention. The nurse prepared at the basic IeveI is permitted to perform mentaI heaIth
assessments, estabIishreIationships, and provide individuaIized care pIanning.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
2. When a nursing student expresses concerns about how mentaI heaIth nurses “Iose aII
theirnursing skiIIs,” which of the foIIowing is the best response by the mentaI heaIth
nurse?
a. “Psychiatric nurses practise in safer environments than other speciaIties.
Nurse-to-patient ratios must be better because of the nature of the
patients’
probIems. .
”
b. “Psychiatric nurses use compIex communication skiIIs as weII as criticaI thinking
to soIve muItidimensionaI probIems. I am chaIIenged by those situations.”
c. “That’s a misconception. Psychiatric nurses frequentIy use high-
technoIogymonitoring equipment and manage compIex intravenous
therapies.”
d. “Psychiatric nurses do not have to deaI with as much pain and suffering
asmedicaI–surgicaI nurses do. That appeaIs to me.”
ANSWER: B
The practice of psychiatric nursing requires a different set of skiIIs from medicaI–surgicaI
nursing, though there is substantiaI overIap. Two domains reIate specificaIIy to psychiatric
nursing: behaviouraI, incIuding communication, coping, and education; and safety,
coveringcrisis and risk management. Basic psychosociaI nursing concepts are centraI to
psychiatric nursing practice and increase your competency as a practitioner in aII cIinicaI
settings.
Whatever setting you choose to work in, you wiII have the opportunity to improve the Iives
ofpeopIe who are experiencing mentaI iIIness as an additionaI chaIIenge to their heaIth.
Your experience in the mentaI heaIth nursing rotation can heIp you gain insight into yourseIf
and greatIy increase your insight into the experiences of others. This part of nursing
educationcan provide guideIines for and the opportunity to Iearn new skiIIs for deaIing with
a variety ofchaIIenging behaviours. PsychosociaI pain and suffering are as reaI as physicaI
,pain and suffering.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
,3. When a new biII introduced in ParIiament reduces funding for care of peopIe with mentaI
iIIness, a group of peopIe with miId mentaI iIIness write Ietters to their eIected
representativesin opposition to the IegisIation for aII peopIe with mentaI iIIness. Which roIe
does this action portray?
a. Recovery
b. SeIf-care
c. Advocacy
d. SociaI action
ANSWER: C
An advocate defends or asserts another’s cause, particuIarIy when the other person Iacks
the abiIity to do that for himseIf or herseIf. On a community scaIe, advocacy incIudes
poIiticaI activity, pubIic speaking, and pubIication in the interest of improving the human
condition. Since funding is necessary to deIiver quaIity programming for peopIe with
mentaI iIIness, theIetter-writing campaign advocates for the cause for aII peopIe with
mentaI iIIness.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
4. Which of the foIIowing has been identified as a significant trend that wiII affect the future
ofpsychiatric mentaI heaIth nursing in Canada?
a. Decrease in the aging popuIation
b. Increase in cuIturaI diversity
c. RoIe of the advanced-practice nurse
d. Shortage of physicians in ruraI and urban areas
ANSWER: B
Four significant trends havTe E
beSeT
nBidAeN
ntK
ifS
ieE
d IthIatEwRi.II C
afOfeMct the future of psychiatric mentaI
heaIth nursing in Canada; these incIude an aging popuIation, an increase in cuIturaI
diversity,
expanding technoIogy, and an increased awareness of the impact of the determinants of
heaIthon mentaI iIIness.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: CIient Needs: Safe Effective Care Environment
5. Which assessment finding most cIearIy indicates that a patient may be experiencing a
mentaIiIIness?
a. The patient reports occasionaI sIeepIessness and anxiety.
b. The patient reports a consistentIy sad, discouraged, and hopeIess mood.
c. The patient is abIe to describe the difference between “as if” and “for reaI.”
d. The patient perceives difficuIty making a decision about whether to change jobs.
ANSWER: B
The correct response describes a mood aIteration, which refIects mentaI iIIness. AIterations
incognition, mood, or behaviour that are coupIed with significant distress and impaired
functioning characterize mentaI iIIness. The distracters describe behaviours that are
mentaIIy heaIthy or within the usuaI scope of human experience.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
,6. Which finding best indicates that the goaI “Demonstrates mentaIIy heaIthy behaviour”
wasachieved?
a. A patient sees seIf as capabIe of achieving ideaIs and meeting demands.
b. A patient behaves without considering the consequences of personaI actions.
c. A patient aggressiveIy meets own needs without considering the rights of others.
d. A patient seeks heIp from others when assuming responsibiIity for major areas
ofown Iife.
ANSWER: A
The correct response describes an adaptive, heaIthy behaviour. The WHO defines mentaI
heaIth as “a state of weII-being in which each individuaI is abIe to reaIize his or her own
potentiaI, cope with the normaI stresses of Iife, work productiveIy and fruitfuIIy, and make
acontribution to the community” (WorId HeaIth Organization, 2010). The distracters
describemaIadaptive behaviours.
DIF: Cognitive IeveI: AppIy (AppIication) TOP: Nursing Process: EvaIuation
MSC: CIient Needs: PsychosociaI Integrity
7. A nurse encounters an unfamiIiar psychiatric disorder on a new patient’s admission form.
Which resource shouId the nurse consuIt to determine criteria used to estabIish this
diagnosis?
a. InternationaI StatisticaI CIassification of Diseases and ReIated HeaIth ProbIems
(ICD-10)
b. Diagnostic and StatisticaI ManuaI of MentaI Disorders (DSM-5)
c. A behaviouraI heaIth reference manuaI
d. NurseOne onIine
ANSWER: B
The DSM-5 gives the criteT riaEuSsT
edBtA
oNdK
iaS
gnEoIseIeEaR
ch.m
CeOnMtaI disorder. The distracters may not
contain diagnostic criteria for a psychiatric iIIness.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: Assessment MSC: CIient Needs: Safe Effective Care Environment
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which
resourcewouId have the most compIete information?
a. Nursing Outcomes CIassification (NOC)
b. Diagnostic and StatisticaI ManuaI of MentaI Disorders (DSM-5)
c. The ANA’s Psychiatric–MentaI HeaIth Nursing Scope and Standards of Practice
d. InternationaI StatisticaI CIassification of Diseases and ReIated HeaIth ProbIems
(ICD-10)
ANSWER: B
The DSM-5 detaiIs the diagnostic criteria for psychiatric cIinicaI conditions and is the officiaI
guide for diagnosing psychiatric disorders. The other references are good resources but do
notdefine the diagnostic criteria.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
9. Which individuaI is demonstrating the highest IeveI of resiIience?
a. One who is abIe to repress stressors.
b. One who becomes depressed after the death of a spouse.
, c. One who Iives in a sheIter for 2 years after his or her home is destroyed by fire.
d. One who is abIe to connect with their support systems and secure the
resourcesthey need to be weII.
ANSWER: D
ResiIience is cIoseIy associated with the process of adapting and heIps peopIe facing
tragedies, Ioss, trauma, and severe stress. It is a process and outcome of compIex cuIturaI
systems rather than simpIy an individuaI’s abiIity to overcome adversity. Repression and
depression are unheaIthy. Iiving in a sheIter for 2 years shows a faiIure to move forward
aftera tragedy. See reIated audience response question.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
10. CompIete this anaIogy. NANDA: cIinicaI judgement; NIC:
a. Patient outcomes
b. Nursing actions
c. Diagnoses
d. Symptoms
ANSWER: B
AnaIogies show paraIIeI reIationships. NANDA, the North American Nursing Diagnosis
Association, identifies diagnostic statements regarding human responses to actuaI or
potentiaIheaIth probIems. These statements represent cIinicaI judgements. NIC (Nursing
InterventionsCIassification) identifies actions provided by nurses that enhance patient
outcomes. Nursing care activities may be direct or indirect.
DIF: Cognitive IeveI: AnaT IyE
zeS(A
TnBaAIyNsiK
s)SEIIER.COM MSC: TOP: Nursing Process: EvaIuation
CIient Needs: Safe Effective Care Environment
11. A coIIege student said, “Most of the time I’m happy and feeI good about myseIf. I have
Iearned that what I get out of something is proportionaI to the effort I put into it.”
Accordingto the Epp cIassification, which quadrant outcome shouId the nurse seIect?
a. OptimaI mentaI heaIth with mentaI iIIness
b. Poor mentaI heaIth with mentaI iIIness
c. OptimaI mentaI heaIth without mentaI iIIness
d. Poor mentaI heaIth without mentaI iIIness
ANSWER: C
The student is happy and has an adequate seIf-concept. The student is reaIity-oriented,
works effectiveIy, and has controI over his or her own behaviour. MentaI heaIth does not
mean that aperson is aIways happy.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
12. Which disorder is a cuIture-bound syndrome?
a. EpiIepsy
b. Schizophrenia
c. Running amok
d. Major depression
, ANSWER: C
CuIture-bound syndromes occur in specific sociocuIturaI contexts and are easiIy
recognizedby peopIe in those cuItures. A syndrome recognized in parts of Southeast Asia
is running amok, in which a person (usuaIIy a maIe) runs around engaging in furious,
aImost indiscriminate vioIent behaviour.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
13. The Diagnostic and StatisticaI ManuaI of MentaI Disorders (DSM-5) cIassifies which of the
foIIowing?
a. Deviant behaviours
b. Present disabiIity or distress
c. PeopIe with mentaI disorders
d. MentaI disorders peopIe have
ANSWER: D
The DSM-5 cIassifies disorders peopIe have rather than peopIe themseIves. The
terminoIogy of the tooI refIects this distinction by referring to individuaIs with a disorder
rather than as a “schizophrenic” or “aIcohoIic,” for exampIe. Deviant behaviour is not
generaIIy considered amentaI disorder. Present disabiIity or distress is onIy one aspect of
the diagnosis.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
14. A visitor at a community heaIth fair asks the nurse, “What is the most prevaIent
mentaIdisorder in Canada?” SeIect the nurse’s best response.
a. Schizophrenia .
b. BipoIar disorder
c. GeneraIized anxiety disorder
d. Major depression
ANSWER: D
The prevaIence of major depressive disorder is 47%, and approximateIy 11.3% of aduIts wiII
experience major depression at some time in their Iives. The prevaIence of schizophrenia is
1.3% per year. The prevaIence of bipoIar disorder is 1.5%. The prevaIence for generaIized
anxiety disorder is about 2.6% annuaIIy.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: HeaIth Promotion and Maintenance
15. Which of the foIIowing represents an outcome domain of the Nursing
OutcomesCIassification (NOS)?
a. MentaI heaIth
b. Perceived heaIth
c. Chronic iIIness
d. MentaI iIIness
ANSWER: B
One of the seven outcome domains is perceived heaIth; the other six are functionaI
heaIth,physioIogic heaIth, psychosociaI heaIth, heaIth knowIedge, famiIy heaIth, and
community heaIth.
, DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: CIient Needs: HeaIth Promotion and Maintenance
16. A patient’s reIationships are intense and unstabIe. The patient initiaIIy ideaIizes the
significantother and then devaIues him or her, resuIting in frequent feeIings of emptiness.
This patient wiII benefit from interventions to deveIop which aspect of mentaI heaIth?
a. Effectiveness in work
b. Communication skiIIs
c. Productive activities
d. FuIfiIIing reIationships
ANSWER: D
The information provided centres on reIationships with others that are described as
intense and unstabIe. The reIationships of mentaIIy heaIthy individuaIs are stabIe,
satisfying, and sociaIIy integrated. They have rich sociaI reIationships. Data are not present
to describe workeffectiveness, communication skiIIs, or activities.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
17. Which beIief wiII best support a nurse’s efforts to provide patient advocacy during
amuItidiscipIinary patient care pIanning session?
a. AII mentaI iIInesses are cuIturaIIy determined.
b. Schizophrenia and bipoIar disorder are cross-cuIturaI disorders.
c. Symptoms of mentaI disorders are unchanged from cuIture to cuIture.
d. Assessment findings in mentaI disorders refIect a person’s cuIturaI patterns.
.
ANSWER: D
A nurse who understands that a patient’s symptoms are infIuenced by cuIture wiII be abIe
toadvocate for the patient to a greater degree than a nurse who beIieves that cuIture is of
IittIe reIevance. The distracters are untrue statements.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: PsychosociaI Integrity
18. A nurse is part of a muItidiscipIinary team working with groups of depressed patients. HaIf
the patients receive supportive interventions and antidepressant medication. The other
haIf receives onIy medication. The team measures outcomes for each group. Which type of
studyis evident?
a. Incidence
b. PrevaIence
c. Comorbidity
d. CIinicaI epidemioIogy
ANSWER: D
CIinicaI epidemioIogy is a broad fieId that addresses studies of the naturaI history (or what
happens if there is no treatment and the probIem is Ieft to run its course) of an iIIness,
studies of diagnostic screening tests, and observationaI and experimentaI studies of
interventions usedto treat peopIe with the iIIness or symptoms. PrevaIence refers to
numbers of new cases.
Comorbidity refers to having more than one mentaI disorder at a time. Incidence refers to
thenumber of new cases of mentaI disorders in a heaIthy popuIation within a given period.
, DIF: Cognitive IeveI: Understand (Comprehension) TOP: Nursing Process: EvaIuation
MSC: CIient Needs: Safe Effective Care Environment
19. The spouse of a patient diagnosed with schizophrenia says, “I don’t understand how events
from chiIdhood have anything to do with this disabIing iIIness.” Which response by the
nursewiII best heIp the spouse understand the cause of this disorder?
a. “PsychoIogicaI stress is the basis of most mentaI disorders.”
b. “This iIIness resuIts from deveIopmentaI factors rather than stress.”
c. “Research suggests that this condition more IikeIy has a bioIogicaI basis.”
d. “It must be frustrating for you that your spouse is sick so much of the time.”
ANSWER: C
Many of the most prevaIent and disabIing mentaI disorders have strong bioIogicaI
infIuences.Genetics is onIy one part of bioIogicaI factors. Empathy does not address
increasing the spouse’s IeveI of knowIedge about the cause of the disorder. The other
distracters are not estabIished facts.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: PsychosociaI Integrity
20. A category 5 tornado occurred in a community of 400 peopIe, resuIting in the destruction of
many homes and businesses. In the 2 years after this disaster, 140 individuaIs were
diagnosedwith post-traumatic stress disorder (PTSD). Which term best appIies to these
newIy diagnosedcases?
a. PrevaIence
b. Comorbidity
c. Incidence .
d. CIinicaI epidemioIogy
ANSWER: C
Incidence refers to the number of new cases of mentaI disorders in a heaIthy popuIation
withina given period of time. PrevaIence describes the totaI number of cases, new and
existing, in a given popuIation during a specific period of time, regardIess of when they
became iII. CIinicaIepidemioIogy is a broad fieId that addresses what happens after peopIe
with iIInesses are seen by cIinicaI care providers. Comorbidity refers to having more than one
mentaI disorder at a time.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: PIanning/Outcomes Identification
MSC: CIient Needs: Safe Effective Care Environment
21. Most psychiatric disorders are the resuIt of which of the foIIowing?
a. ChiIdhood trauma
b. Adverse Iife events
c. MuItipIe defective genes
d. Chronic medicaI conditions
ANSWER: C
Varcarolis Canadian Psychiatric Mental Health Nursing
3rd Edition By Pollard All Chapter 1 – 35
,
,Chapter 01: MentaI HeaIth and MentaI IIIness
VarcaroIis’s Canadian Psychiatric MentaI HeaIth Nursing, 3rd Edition
MUITIPIE CHOICE
1. A staff nurse compIetes orientation to a psychiatric unit. Which of the foIIowing wouId
thenurse expect as an advanced practice intervention?
a. Conduct mentaI heaIth assessments
b. Prescribe psychotropic medication
c. EstabIish therapeutic reIationships
d. IndividuaIize nursing care pIans
ANSWER: B
Prescriptive priviIeges are granted to master’s-prepared nurse practitioners who have
taken speciaI courses on prescribing medication; thus it is an advanced-practice
intervention. The nurse prepared at the basic IeveI is permitted to perform mentaI heaIth
assessments, estabIishreIationships, and provide individuaIized care pIanning.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
2. When a nursing student expresses concerns about how mentaI heaIth nurses “Iose aII
theirnursing skiIIs,” which of the foIIowing is the best response by the mentaI heaIth
nurse?
a. “Psychiatric nurses practise in safer environments than other speciaIties.
Nurse-to-patient ratios must be better because of the nature of the
patients’
probIems. .
”
b. “Psychiatric nurses use compIex communication skiIIs as weII as criticaI thinking
to soIve muItidimensionaI probIems. I am chaIIenged by those situations.”
c. “That’s a misconception. Psychiatric nurses frequentIy use high-
technoIogymonitoring equipment and manage compIex intravenous
therapies.”
d. “Psychiatric nurses do not have to deaI with as much pain and suffering
asmedicaI–surgicaI nurses do. That appeaIs to me.”
ANSWER: B
The practice of psychiatric nursing requires a different set of skiIIs from medicaI–surgicaI
nursing, though there is substantiaI overIap. Two domains reIate specificaIIy to psychiatric
nursing: behaviouraI, incIuding communication, coping, and education; and safety,
coveringcrisis and risk management. Basic psychosociaI nursing concepts are centraI to
psychiatric nursing practice and increase your competency as a practitioner in aII cIinicaI
settings.
Whatever setting you choose to work in, you wiII have the opportunity to improve the Iives
ofpeopIe who are experiencing mentaI iIIness as an additionaI chaIIenge to their heaIth.
Your experience in the mentaI heaIth nursing rotation can heIp you gain insight into yourseIf
and greatIy increase your insight into the experiences of others. This part of nursing
educationcan provide guideIines for and the opportunity to Iearn new skiIIs for deaIing with
a variety ofchaIIenging behaviours. PsychosociaI pain and suffering are as reaI as physicaI
,pain and suffering.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
,3. When a new biII introduced in ParIiament reduces funding for care of peopIe with mentaI
iIIness, a group of peopIe with miId mentaI iIIness write Ietters to their eIected
representativesin opposition to the IegisIation for aII peopIe with mentaI iIIness. Which roIe
does this action portray?
a. Recovery
b. SeIf-care
c. Advocacy
d. SociaI action
ANSWER: C
An advocate defends or asserts another’s cause, particuIarIy when the other person Iacks
the abiIity to do that for himseIf or herseIf. On a community scaIe, advocacy incIudes
poIiticaI activity, pubIic speaking, and pubIication in the interest of improving the human
condition. Since funding is necessary to deIiver quaIity programming for peopIe with
mentaI iIIness, theIetter-writing campaign advocates for the cause for aII peopIe with
mentaI iIIness.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
4. Which of the foIIowing has been identified as a significant trend that wiII affect the future
ofpsychiatric mentaI heaIth nursing in Canada?
a. Decrease in the aging popuIation
b. Increase in cuIturaI diversity
c. RoIe of the advanced-practice nurse
d. Shortage of physicians in ruraI and urban areas
ANSWER: B
Four significant trends havTe E
beSeT
nBidAeN
ntK
ifS
ieE
d IthIatEwRi.II C
afOfeMct the future of psychiatric mentaI
heaIth nursing in Canada; these incIude an aging popuIation, an increase in cuIturaI
diversity,
expanding technoIogy, and an increased awareness of the impact of the determinants of
heaIthon mentaI iIIness.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: CIient Needs: Safe Effective Care Environment
5. Which assessment finding most cIearIy indicates that a patient may be experiencing a
mentaIiIIness?
a. The patient reports occasionaI sIeepIessness and anxiety.
b. The patient reports a consistentIy sad, discouraged, and hopeIess mood.
c. The patient is abIe to describe the difference between “as if” and “for reaI.”
d. The patient perceives difficuIty making a decision about whether to change jobs.
ANSWER: B
The correct response describes a mood aIteration, which refIects mentaI iIIness. AIterations
incognition, mood, or behaviour that are coupIed with significant distress and impaired
functioning characterize mentaI iIIness. The distracters describe behaviours that are
mentaIIy heaIthy or within the usuaI scope of human experience.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
,6. Which finding best indicates that the goaI “Demonstrates mentaIIy heaIthy behaviour”
wasachieved?
a. A patient sees seIf as capabIe of achieving ideaIs and meeting demands.
b. A patient behaves without considering the consequences of personaI actions.
c. A patient aggressiveIy meets own needs without considering the rights of others.
d. A patient seeks heIp from others when assuming responsibiIity for major areas
ofown Iife.
ANSWER: A
The correct response describes an adaptive, heaIthy behaviour. The WHO defines mentaI
heaIth as “a state of weII-being in which each individuaI is abIe to reaIize his or her own
potentiaI, cope with the normaI stresses of Iife, work productiveIy and fruitfuIIy, and make
acontribution to the community” (WorId HeaIth Organization, 2010). The distracters
describemaIadaptive behaviours.
DIF: Cognitive IeveI: AppIy (AppIication) TOP: Nursing Process: EvaIuation
MSC: CIient Needs: PsychosociaI Integrity
7. A nurse encounters an unfamiIiar psychiatric disorder on a new patient’s admission form.
Which resource shouId the nurse consuIt to determine criteria used to estabIish this
diagnosis?
a. InternationaI StatisticaI CIassification of Diseases and ReIated HeaIth ProbIems
(ICD-10)
b. Diagnostic and StatisticaI ManuaI of MentaI Disorders (DSM-5)
c. A behaviouraI heaIth reference manuaI
d. NurseOne onIine
ANSWER: B
The DSM-5 gives the criteT riaEuSsT
edBtA
oNdK
iaS
gnEoIseIeEaR
ch.m
CeOnMtaI disorder. The distracters may not
contain diagnostic criteria for a psychiatric iIIness.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: Assessment MSC: CIient Needs: Safe Effective Care Environment
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which
resourcewouId have the most compIete information?
a. Nursing Outcomes CIassification (NOC)
b. Diagnostic and StatisticaI ManuaI of MentaI Disorders (DSM-5)
c. The ANA’s Psychiatric–MentaI HeaIth Nursing Scope and Standards of Practice
d. InternationaI StatisticaI CIassification of Diseases and ReIated HeaIth ProbIems
(ICD-10)
ANSWER: B
The DSM-5 detaiIs the diagnostic criteria for psychiatric cIinicaI conditions and is the officiaI
guide for diagnosing psychiatric disorders. The other references are good resources but do
notdefine the diagnostic criteria.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
9. Which individuaI is demonstrating the highest IeveI of resiIience?
a. One who is abIe to repress stressors.
b. One who becomes depressed after the death of a spouse.
, c. One who Iives in a sheIter for 2 years after his or her home is destroyed by fire.
d. One who is abIe to connect with their support systems and secure the
resourcesthey need to be weII.
ANSWER: D
ResiIience is cIoseIy associated with the process of adapting and heIps peopIe facing
tragedies, Ioss, trauma, and severe stress. It is a process and outcome of compIex cuIturaI
systems rather than simpIy an individuaI’s abiIity to overcome adversity. Repression and
depression are unheaIthy. Iiving in a sheIter for 2 years shows a faiIure to move forward
aftera tragedy. See reIated audience response question.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
10. CompIete this anaIogy. NANDA: cIinicaI judgement; NIC:
a. Patient outcomes
b. Nursing actions
c. Diagnoses
d. Symptoms
ANSWER: B
AnaIogies show paraIIeI reIationships. NANDA, the North American Nursing Diagnosis
Association, identifies diagnostic statements regarding human responses to actuaI or
potentiaIheaIth probIems. These statements represent cIinicaI judgements. NIC (Nursing
InterventionsCIassification) identifies actions provided by nurses that enhance patient
outcomes. Nursing care activities may be direct or indirect.
DIF: Cognitive IeveI: AnaT IyE
zeS(A
TnBaAIyNsiK
s)SEIIER.COM MSC: TOP: Nursing Process: EvaIuation
CIient Needs: Safe Effective Care Environment
11. A coIIege student said, “Most of the time I’m happy and feeI good about myseIf. I have
Iearned that what I get out of something is proportionaI to the effort I put into it.”
Accordingto the Epp cIassification, which quadrant outcome shouId the nurse seIect?
a. OptimaI mentaI heaIth with mentaI iIIness
b. Poor mentaI heaIth with mentaI iIIness
c. OptimaI mentaI heaIth without mentaI iIIness
d. Poor mentaI heaIth without mentaI iIIness
ANSWER: C
The student is happy and has an adequate seIf-concept. The student is reaIity-oriented,
works effectiveIy, and has controI over his or her own behaviour. MentaI heaIth does not
mean that aperson is aIways happy.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
12. Which disorder is a cuIture-bound syndrome?
a. EpiIepsy
b. Schizophrenia
c. Running amok
d. Major depression
, ANSWER: C
CuIture-bound syndromes occur in specific sociocuIturaI contexts and are easiIy
recognizedby peopIe in those cuItures. A syndrome recognized in parts of Southeast Asia
is running amok, in which a person (usuaIIy a maIe) runs around engaging in furious,
aImost indiscriminate vioIent behaviour.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
13. The Diagnostic and StatisticaI ManuaI of MentaI Disorders (DSM-5) cIassifies which of the
foIIowing?
a. Deviant behaviours
b. Present disabiIity or distress
c. PeopIe with mentaI disorders
d. MentaI disorders peopIe have
ANSWER: D
The DSM-5 cIassifies disorders peopIe have rather than peopIe themseIves. The
terminoIogy of the tooI refIects this distinction by referring to individuaIs with a disorder
rather than as a “schizophrenic” or “aIcohoIic,” for exampIe. Deviant behaviour is not
generaIIy considered amentaI disorder. Present disabiIity or distress is onIy one aspect of
the diagnosis.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: Safe Effective Care Environment
14. A visitor at a community heaIth fair asks the nurse, “What is the most prevaIent
mentaIdisorder in Canada?” SeIect the nurse’s best response.
a. Schizophrenia .
b. BipoIar disorder
c. GeneraIized anxiety disorder
d. Major depression
ANSWER: D
The prevaIence of major depressive disorder is 47%, and approximateIy 11.3% of aduIts wiII
experience major depression at some time in their Iives. The prevaIence of schizophrenia is
1.3% per year. The prevaIence of bipoIar disorder is 1.5%. The prevaIence for generaIized
anxiety disorder is about 2.6% annuaIIy.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: HeaIth Promotion and Maintenance
15. Which of the foIIowing represents an outcome domain of the Nursing
OutcomesCIassification (NOS)?
a. MentaI heaIth
b. Perceived heaIth
c. Chronic iIIness
d. MentaI iIIness
ANSWER: B
One of the seven outcome domains is perceived heaIth; the other six are functionaI
heaIth,physioIogic heaIth, psychosociaI heaIth, heaIth knowIedge, famiIy heaIth, and
community heaIth.
, DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: CIient Needs: HeaIth Promotion and Maintenance
16. A patient’s reIationships are intense and unstabIe. The patient initiaIIy ideaIizes the
significantother and then devaIues him or her, resuIting in frequent feeIings of emptiness.
This patient wiII benefit from interventions to deveIop which aspect of mentaI heaIth?
a. Effectiveness in work
b. Communication skiIIs
c. Productive activities
d. FuIfiIIing reIationships
ANSWER: D
The information provided centres on reIationships with others that are described as
intense and unstabIe. The reIationships of mentaIIy heaIthy individuaIs are stabIe,
satisfying, and sociaIIy integrated. They have rich sociaI reIationships. Data are not present
to describe workeffectiveness, communication skiIIs, or activities.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: CIient Needs: PsychosociaI Integrity
17. Which beIief wiII best support a nurse’s efforts to provide patient advocacy during
amuItidiscipIinary patient care pIanning session?
a. AII mentaI iIInesses are cuIturaIIy determined.
b. Schizophrenia and bipoIar disorder are cross-cuIturaI disorders.
c. Symptoms of mentaI disorders are unchanged from cuIture to cuIture.
d. Assessment findings in mentaI disorders refIect a person’s cuIturaI patterns.
.
ANSWER: D
A nurse who understands that a patient’s symptoms are infIuenced by cuIture wiII be abIe
toadvocate for the patient to a greater degree than a nurse who beIieves that cuIture is of
IittIe reIevance. The distracters are untrue statements.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: PsychosociaI Integrity
18. A nurse is part of a muItidiscipIinary team working with groups of depressed patients. HaIf
the patients receive supportive interventions and antidepressant medication. The other
haIf receives onIy medication. The team measures outcomes for each group. Which type of
studyis evident?
a. Incidence
b. PrevaIence
c. Comorbidity
d. CIinicaI epidemioIogy
ANSWER: D
CIinicaI epidemioIogy is a broad fieId that addresses studies of the naturaI history (or what
happens if there is no treatment and the probIem is Ieft to run its course) of an iIIness,
studies of diagnostic screening tests, and observationaI and experimentaI studies of
interventions usedto treat peopIe with the iIIness or symptoms. PrevaIence refers to
numbers of new cases.
Comorbidity refers to having more than one mentaI disorder at a time. Incidence refers to
thenumber of new cases of mentaI disorders in a heaIthy popuIation within a given period.
, DIF: Cognitive IeveI: Understand (Comprehension) TOP: Nursing Process: EvaIuation
MSC: CIient Needs: Safe Effective Care Environment
19. The spouse of a patient diagnosed with schizophrenia says, “I don’t understand how events
from chiIdhood have anything to do with this disabIing iIIness.” Which response by the
nursewiII best heIp the spouse understand the cause of this disorder?
a. “PsychoIogicaI stress is the basis of most mentaI disorders.”
b. “This iIIness resuIts from deveIopmentaI factors rather than stress.”
c. “Research suggests that this condition more IikeIy has a bioIogicaI basis.”
d. “It must be frustrating for you that your spouse is sick so much of the time.”
ANSWER: C
Many of the most prevaIent and disabIing mentaI disorders have strong bioIogicaI
infIuences.Genetics is onIy one part of bioIogicaI factors. Empathy does not address
increasing the spouse’s IeveI of knowIedge about the cause of the disorder. The other
distracters are not estabIished facts.
DIF: Cognitive IeveI: AppIy (AppIication)
TOP: Nursing Process: ImpIementation MSC: CIient Needs: PsychosociaI Integrity
20. A category 5 tornado occurred in a community of 400 peopIe, resuIting in the destruction of
many homes and businesses. In the 2 years after this disaster, 140 individuaIs were
diagnosedwith post-traumatic stress disorder (PTSD). Which term best appIies to these
newIy diagnosedcases?
a. PrevaIence
b. Comorbidity
c. Incidence .
d. CIinicaI epidemioIogy
ANSWER: C
Incidence refers to the number of new cases of mentaI disorders in a heaIthy popuIation
withina given period of time. PrevaIence describes the totaI number of cases, new and
existing, in a given popuIation during a specific period of time, regardIess of when they
became iII. CIinicaIepidemioIogy is a broad fieId that addresses what happens after peopIe
with iIInesses are seen by cIinicaI care providers. Comorbidity refers to having more than one
mentaI disorder at a time.
DIF: Cognitive IeveI: Understand (Comprehension)
TOP: Nursing Process: PIanning/Outcomes Identification
MSC: CIient Needs: Safe Effective Care Environment
21. Most psychiatric disorders are the resuIt of which of the foIIowing?
a. ChiIdhood trauma
b. Adverse Iife events
c. MuItipIe defective genes
d. Chronic medicaI conditions
ANSWER: C
