Chapter 01: Mental Health and Mental Illness
Halter: Varcarolis’ Foundations of Psychiatric-Mental Health Nursing: A Clinical
Approach, 9th Edition
MULTIPLE CHOICE
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
a. Conducting a mental health assessment.
b. Prescribing psychotropic medication.
c. Establishing a therapeutic relationship.
d. Individualizing a nursing care plan.
ANS: B
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
prepared at the basic level is permitted to perform mental health assessments, establish
relationships, and provide individualized care planning.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing
skills.” Select the best response by the mental health nurse.
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
client ratios must be better because of the nature of the clients’ problems.”
b. “Psychiatric nurses use complex communication skills as well as critical thinking
to solve multidimensional problems. I am challenged by those situations.”
c. “That’s a misconception. Psychiatric nurses frequently use high technology
monitoring equipment and manage complex intravenous therapies.”
d. “Psychiatric nurses do not have to deal with as much pain and suffering as
medical–surgical nurses do. That appeals to me.”
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical–surgical
nursing, though there is substantial overlap. Psychiatric nurses must be able to help clients
with medical as well as mental health problems, reflecting the holistic perspective these nurses
must have. Nurse–client ratios and workloads in psychiatric settings have increased, just like
other specialties. Psychiatric nursing involves clinical practice, not just documentation.
Psychosocial pain and suffering are as real as physical pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with
mental illness, a group of nurses write letters to their elected representatives in opposition to
the legislation. Which role have the nurses fulfilled?
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice
, ANS: C
An advocate defends or asserts another’s cause, particularly when the other person lacks the
ability to do that for self. Examples of individual advocacy include helping clients understand
their rights or make decisions. On a community scale, advocacy includes political activity,
public speaking, and publication in the interest of improving the human condition. Since
funding is necessary to deliver quality programming for persons with mental illness, the letter-
writing campaign advocates for that cause on behalf of clients who are unable to articulate
their own needs.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
4. A family has a long history of conflicted relationships among the members. Which family
member’s comment best reflects a mentally healthy perspective?
a. “I’ve made mistakes but everyone else in this family has also.”
b. “I remember joy and mutual respect from our early years together.”
c. “I will make some changes in my behavior for the good of the family.”
d. “It’s best for me to move away from my family. Things will never change.”
ANS: C
The correct response demonstrates the best evidence of a healthy recognition of the
importance of relationships. Mental health includes rational thinking, communication skills,
learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may
be healthy, but the correct response shows a higher level of mental health. The other incorrect
responses show blaming and avoidance.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
illness?
a. reporting occasional sleeplessness and anxiety.
b. reporting a consistently sad, discouraged, and hopeless mood.
c. being able to describe the difference between “as if” and “for real.”
d. experiencing difficulty making a decision about whether to change jobs.
ANS: B
The correct response describes a mood alteration, which reflects mental illness. The distracters
describe behaviors that are mentally healthy or within the usual scope of human experience.
PTS: 1 DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
achieved for an adult client?
a. being willing to work towards achieving ideals and meeting demands.
b. behaving without considering the consequences of personal actions.
c. aggressively meeting personal needs without considering the rights of others.
d. seeking help from others to avoid assuming responsibility for major areas of own
life.
, ANS: A d f
Mental health is a state of well- df df df df df df
being in which individuals reach their own potential, cope with the normal stresses of life, wor
df df df df df df df df df df df df df df df
k productively, and contribute to the community. Mental health provides people with the capac
df df df df df df df df df df df df df
ity for rational thinking, communication skills, learning, emotional growth, resilience, and self-
df df df df df df df df df df df
esteem. The correct response describes an adaptive, healthy behavior. The distracters describe
df df df df df df df df df df df df
maladaptive behaviors. df
PTS: 1 DIF: Cognitive Level: Apply (Application)
d f d f df df df
TOP: Nursing Process: Evaluation
d MSC: Client Needs: Psychosocial Integrity
f df df d f df df df
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. Which
df df df df df df df df df df df df df
resource should the nurse consult to determine criteria used to establish this diagnosis?
df df df df df df df df df df df df df
a. International Statistical Classification of Diseases and Related Health Problems (I df df df df df df df df df
CD-10)
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
df df df df df df df df df
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) df df df df df df df
d. A behavioral health reference manual
df df df df
ANS: C d f
The DSM- df
V gives the criteria used to diagnose each mental disorder. It is the official guideline for diagnosi
df df df df df df df df df df df df df df df df
ng psychiatric disorders. The distracters may not contain diagnostic criteria for a psychiatric ill
df df df df df df df df df df df df df
ness.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
d f d f df df df
TOP: Nursing Process: Assessment
d MSC: Client Needs: Safe, Effective Care Environment
f df df d f df df df df df
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource w
df df df df df df df df df df df df df df df
ould have the most complete information?
df df df df df
a. Nursing Outcomes Classification (NOC) df df df
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
df df df df df df df df df
d. ICD-10
ANS: B d f
The DSM- df
V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline for
df df df df df df df df df df df df df df df
diagnosing psychiatric disorders. The other references are good resources but do not define the d
df df df df df df df df df df df df df df
iagnostic criteria. df
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
d f d f df df df
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
d f df df d f df df df df df
9. Which individual behavior demonstrates resilience?
df df df df
a. Repress stressors associated with a divorce. df df df df df
b. Continuing to grieve the death of a spouse for 5 years. df df df df df df df df df df
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire. df df df df df df df df df df df df df df df
d. Taking a temporary job to maintain financial stability after loss of a permanent jo
df df df df df df df df df df df df df
b.
ANS: D d f
, Resilience is closely associated with the process of adapting and helps people facing tragedies, l
df df df df df df df df df df df df df df
oss, trauma, and severe stress. It is the ability and capacity for people to secure the resources the
df df df df df df df df df df df df df df df df df
y need to support their well-
df df df df df
being. Repression and protracted grief are unhealthy. Living in a shelter for 2 years shows a fail
df df df df df df df df df df df df df df df df
ure to move forward after a tragedy. See related audience response question.
df df df df df df df df df df df
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
d f d f df df df
TOP: Nursing Process: Assessment
d MSC: Client Needs: Psychosocial Integrity
f df df d f df df df
10. The relationship of the North American Nursing Diagnosis Association (NANDA) is to cl
df df df df df df df df df df df df
inical judgment as Nursing Interventions Classification (NIC) is to what?
df df df df df df df df df
a. client outcomes. df
b. nursing actions. df
c. diagnosis.
d. symptoms.
ANS: B d f
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis Assoc
df df df df df df df df df df
iation, identifies diagnostic statements regarding human responses to actual or potential health p
df df df df df df df df df df df df
roblems. These statements represent clinical judgments. NIC (Nursing Interventions Classificat
df df df df df df df df df
ion) identifies actions provided by nurses that enhance client outcomes. Nursing care activities
df df df df df df df df df df df df df
may be direct or indirect.
df df df df
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
d f d f df df df
TOP: Nursing Process: Evaluation
d MSC: Client Needs: Safe, Effective Care Environment
f df df d f df df df df df
11. An adult says, “Most of the time I’m happy and feel good about myself. I have learned that w
df df df df df df df df df df df df df df df df df df
hat I get out of something is proportional to the effort I put into it.” Which number on this me
df df df df df df df df df df df df df df df df df df df
ntal health continuum should the nurse select?
df df df df df df
Mental Illness Mental Health 1 df df df df
2345
df df df df
a. 1
b. 2 d f d f
c. 3
d. 4 d f d f
e. 5
ANS: E d f
The adult is generally happy and has an adequate self-
df df df df df df df df df
concept. The statement indicates the adult is reality- df df df df df df df
oriented, works effectively, and has control over own behavior. Mental health does not mean that
df df df df df df df df df df df df df df d
a person is always happy.
f df df df df
PTS: 1 DIF: Cognitive Level: Apply (Application)
d f d f df df df
TOP: Nursing Process: Assessment
d MSC: Client Needs: Psychosocial Integrity
f df df d f df df df
12. Which disorder is an example of a culture-bound syndrome?
df df df df df df df df
a. Epilepsy
b. Schizophrenia
c. Running amok df
d. Major depressive disorder df df
Halter: Varcarolis’ Foundations of Psychiatric-Mental Health Nursing: A Clinical
Approach, 9th Edition
MULTIPLE CHOICE
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
a. Conducting a mental health assessment.
b. Prescribing psychotropic medication.
c. Establishing a therapeutic relationship.
d. Individualizing a nursing care plan.
ANS: B
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
prepared at the basic level is permitted to perform mental health assessments, establish
relationships, and provide individualized care planning.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing
skills.” Select the best response by the mental health nurse.
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
client ratios must be better because of the nature of the clients’ problems.”
b. “Psychiatric nurses use complex communication skills as well as critical thinking
to solve multidimensional problems. I am challenged by those situations.”
c. “That’s a misconception. Psychiatric nurses frequently use high technology
monitoring equipment and manage complex intravenous therapies.”
d. “Psychiatric nurses do not have to deal with as much pain and suffering as
medical–surgical nurses do. That appeals to me.”
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical–surgical
nursing, though there is substantial overlap. Psychiatric nurses must be able to help clients
with medical as well as mental health problems, reflecting the holistic perspective these nurses
must have. Nurse–client ratios and workloads in psychiatric settings have increased, just like
other specialties. Psychiatric nursing involves clinical practice, not just documentation.
Psychosocial pain and suffering are as real as physical pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with
mental illness, a group of nurses write letters to their elected representatives in opposition to
the legislation. Which role have the nurses fulfilled?
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice
, ANS: C
An advocate defends or asserts another’s cause, particularly when the other person lacks the
ability to do that for self. Examples of individual advocacy include helping clients understand
their rights or make decisions. On a community scale, advocacy includes political activity,
public speaking, and publication in the interest of improving the human condition. Since
funding is necessary to deliver quality programming for persons with mental illness, the letter-
writing campaign advocates for that cause on behalf of clients who are unable to articulate
their own needs.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
4. A family has a long history of conflicted relationships among the members. Which family
member’s comment best reflects a mentally healthy perspective?
a. “I’ve made mistakes but everyone else in this family has also.”
b. “I remember joy and mutual respect from our early years together.”
c. “I will make some changes in my behavior for the good of the family.”
d. “It’s best for me to move away from my family. Things will never change.”
ANS: C
The correct response demonstrates the best evidence of a healthy recognition of the
importance of relationships. Mental health includes rational thinking, communication skills,
learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may
be healthy, but the correct response shows a higher level of mental health. The other incorrect
responses show blaming and avoidance.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
illness?
a. reporting occasional sleeplessness and anxiety.
b. reporting a consistently sad, discouraged, and hopeless mood.
c. being able to describe the difference between “as if” and “for real.”
d. experiencing difficulty making a decision about whether to change jobs.
ANS: B
The correct response describes a mood alteration, which reflects mental illness. The distracters
describe behaviors that are mentally healthy or within the usual scope of human experience.
PTS: 1 DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
achieved for an adult client?
a. being willing to work towards achieving ideals and meeting demands.
b. behaving without considering the consequences of personal actions.
c. aggressively meeting personal needs without considering the rights of others.
d. seeking help from others to avoid assuming responsibility for major areas of own
life.
, ANS: A d f
Mental health is a state of well- df df df df df df
being in which individuals reach their own potential, cope with the normal stresses of life, wor
df df df df df df df df df df df df df df df
k productively, and contribute to the community. Mental health provides people with the capac
df df df df df df df df df df df df df
ity for rational thinking, communication skills, learning, emotional growth, resilience, and self-
df df df df df df df df df df df
esteem. The correct response describes an adaptive, healthy behavior. The distracters describe
df df df df df df df df df df df df
maladaptive behaviors. df
PTS: 1 DIF: Cognitive Level: Apply (Application)
d f d f df df df
TOP: Nursing Process: Evaluation
d MSC: Client Needs: Psychosocial Integrity
f df df d f df df df
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. Which
df df df df df df df df df df df df df
resource should the nurse consult to determine criteria used to establish this diagnosis?
df df df df df df df df df df df df df
a. International Statistical Classification of Diseases and Related Health Problems (I df df df df df df df df df
CD-10)
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
df df df df df df df df df
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) df df df df df df df
d. A behavioral health reference manual
df df df df
ANS: C d f
The DSM- df
V gives the criteria used to diagnose each mental disorder. It is the official guideline for diagnosi
df df df df df df df df df df df df df df df df
ng psychiatric disorders. The distracters may not contain diagnostic criteria for a psychiatric ill
df df df df df df df df df df df df df
ness.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
d f d f df df df
TOP: Nursing Process: Assessment
d MSC: Client Needs: Safe, Effective Care Environment
f df df d f df df df df df
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource w
df df df df df df df df df df df df df df df
ould have the most complete information?
df df df df df
a. Nursing Outcomes Classification (NOC) df df df
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
df df df df df df df df df
d. ICD-10
ANS: B d f
The DSM- df
V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline for
df df df df df df df df df df df df df df df
diagnosing psychiatric disorders. The other references are good resources but do not define the d
df df df df df df df df df df df df df df
iagnostic criteria. df
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
d f d f df df df
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
d f df df d f df df df df df
9. Which individual behavior demonstrates resilience?
df df df df
a. Repress stressors associated with a divorce. df df df df df
b. Continuing to grieve the death of a spouse for 5 years. df df df df df df df df df df
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire. df df df df df df df df df df df df df df df
d. Taking a temporary job to maintain financial stability after loss of a permanent jo
df df df df df df df df df df df df df
b.
ANS: D d f
, Resilience is closely associated with the process of adapting and helps people facing tragedies, l
df df df df df df df df df df df df df df
oss, trauma, and severe stress. It is the ability and capacity for people to secure the resources the
df df df df df df df df df df df df df df df df df
y need to support their well-
df df df df df
being. Repression and protracted grief are unhealthy. Living in a shelter for 2 years shows a fail
df df df df df df df df df df df df df df df df
ure to move forward after a tragedy. See related audience response question.
df df df df df df df df df df df
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
d f d f df df df
TOP: Nursing Process: Assessment
d MSC: Client Needs: Psychosocial Integrity
f df df d f df df df
10. The relationship of the North American Nursing Diagnosis Association (NANDA) is to cl
df df df df df df df df df df df df
inical judgment as Nursing Interventions Classification (NIC) is to what?
df df df df df df df df df
a. client outcomes. df
b. nursing actions. df
c. diagnosis.
d. symptoms.
ANS: B d f
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis Assoc
df df df df df df df df df df
iation, identifies diagnostic statements regarding human responses to actual or potential health p
df df df df df df df df df df df df
roblems. These statements represent clinical judgments. NIC (Nursing Interventions Classificat
df df df df df df df df df
ion) identifies actions provided by nurses that enhance client outcomes. Nursing care activities
df df df df df df df df df df df df df
may be direct or indirect.
df df df df
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
d f d f df df df
TOP: Nursing Process: Evaluation
d MSC: Client Needs: Safe, Effective Care Environment
f df df d f df df df df df
11. An adult says, “Most of the time I’m happy and feel good about myself. I have learned that w
df df df df df df df df df df df df df df df df df df
hat I get out of something is proportional to the effort I put into it.” Which number on this me
df df df df df df df df df df df df df df df df df df df
ntal health continuum should the nurse select?
df df df df df df
Mental Illness Mental Health 1 df df df df
2345
df df df df
a. 1
b. 2 d f d f
c. 3
d. 4 d f d f
e. 5
ANS: E d f
The adult is generally happy and has an adequate self-
df df df df df df df df df
concept. The statement indicates the adult is reality- df df df df df df df
oriented, works effectively, and has control over own behavior. Mental health does not mean that
df df df df df df df df df df df df df df d
a person is always happy.
f df df df df
PTS: 1 DIF: Cognitive Level: Apply (Application)
d f d f df df df
TOP: Nursing Process: Assessment
d MSC: Client Needs: Psychosocial Integrity
f df df d f df df df
12. Which disorder is an example of a culture-bound syndrome?
df df df df df df df df
a. Epilepsy
b. Schizophrenia
c. Running amok df
d. Major depressive disorder df df
