ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH
NURSING 8TH EDITION CONCEPTS OF CARE IN
EVIDENCE-BASED PRACTICE 8TH EDITION
MORGAN TOWNSEND TEST BANK GOOD LUCK
IN YOUR EXAM
Chapter 1. Mental Health and MentalIllness
1. A nurse is assessing a client who is experiencing occasional feelings of sadness
because of therecent death of a beloved pet. The clients appetite, sleep patterns,and daily
routine have not changed. How should the nurse interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of mentalillness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no mentalillness.
ANS: 4
Rationale: The nurse should assess that the clients daily functioning is not impaired. The
clientwho experiences feelings of sadness after the loss of a pet is responding within normal
expectations. Without significant impairment, the clientsdistress does not indicate a mental
illness.
Cognitive Level: Analysis
Integrated Process:
Assessment
2. At what point should the nurse determine that a client is at risk for developing amentalillness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
2. When maladaptive responses to stress are coupled with interference in dailyfunctioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
ANS: 2
Rationale: The nurse should determine that the client is at risk for mental illness when
responsesto stress are maladaptive and interfere with daily functioning. TheDSM-5 indicates
that in orderto be diagnosed with a mental illness, daily
functioning must be significantly impaired. The clients ability to communicatedistress would be
considered a positive attribute.
Cognitive Level:
,Application Integrated
Process: Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently to
stress.One twin becomes anxious and irritable, and the other withdraws and cries. How should
the nurse explain these different stress responsesto the parents?
1. Reactions to stress are relative rather than absolute; individual responses to stressvary.
2. It is abnormal for identical twins to react differently to similar stressors.
3. Identical twins should share the same temperament and respond similarly tostress.
4. Environmental influences to stress weigh more heavily than genetic influences.
ANS: 1
Rationale: The nurse should explain to the parents that, although the twins have identical
DNA,there are several other factors that affect reactions to stress. Mentalhealth is a state of
being thatis relative to the individual client. Environmental influences and temperament can
affect stress reactions.
Cognitive Level: Application
Integrated Process:
Implementation
4. Which client should the nurse anticipate to be most receptive to psychiatrictreatment?
1. A Jewish, female social worker.
2. A Baptist, homeless male.
3. A Catholic, black male.
4. A Protestant, Swedish business executive.
ANS: 1
Rationale: The nurse should anticipate that the client of Jewish culture would place a high
importance on preventative health care and would consider mental health as equally important
asphysical health. Women are also more likely to seek treatment for mental health problems than
men.
Cognitive Level:
ApplicationIntegrated
Process: Planning
5. A psychiatric nurse intern states, This clients use of defense mechanisms shouldbe
eliminated.Which is a correct evaluation of this nurses statement?
1. Defense mechanisms can be appropriate responses to stress and need not beeliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manageanxiety and
shouldalways be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should bediscouraged
andnot eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered andencouraged.
ANS: 1
Rationale: The nurse should determine that defense mechanisms can be appropriate during
timesof stress. The client with no defense mechanisms may have a lower tolerance for stress,
thus leading to anxiety disorders. Defense mechanisms should be confronted when they impede
,the client from developing
healthy coping skills.
Cognitive Level:
Application Integrated
Process: Evaluation
6. During an intake assessment, a nurse asks both physiological and psychosocialquestions.
Theclient angrily responds, Im here for my heart, not my head problems. Which is the nurses
best response?
1. Its just a routine part of our assessment. All clients are asked these samequestions.
2. Why are you concerned about these types of questions?
3. Psychological factors, like excessive stress, have been found to affect medicalconditions.
4. We can skip these questions, if you like. It isnt imperative that we complete thissection.
ANS: 3
Rationale: The nurse should attempt to educate the client on the negative effects of
excessivestress on medical conditions. It is not appropriate to skip physiological and
psychosocial questions, as this would lead to an inaccurate assessment.
Cognitive Level: Application
Integrated Process:
Implementation
7. An employee uses the defense mechanism of displacement when the boss openly
disagreeswith suggestions. What behavior would be expected from thisemployee?
1. The employee assertively confronts the boss.
2. The employee leaves the staff meeting to work out in the gym.
3. The employee criticizes a coworker.
4. The employee takes the boss out to lunch.
ANS: 3
Rationale: The nurse should expect that the client using the defense mechanism
displacementwould criticize a coworker after being confronted by the boss.
Displacement refers to transferring feelings from one target to a neutral or less-threatening
target.
Cognitive Level: Analysis
Integrated Process:
Assessment
8. A fourth-grade boy teases and makes jokes about a cute girl in his class. Thisbehavior
shouldbe identified by a nurse as indicative of which defense mechanism?
1. Displacement
2. Projection
3. Reaction formation
4. Sublimation
ANS: 3
Rationale: The nurse should identify that the boy is using reaction formation as adefense
, mechanism. Reaction formation is the attempt to prevent undesirable thoughts from being
expressed by expressing opposite thoughts or behaviors.
Displacement refers to transferring feelings from one target to another. Rationalization refers
to making excuses to justify behavior.Projection refers tothe attribution of unacceptable
feelings or behaviors to another person.
Sublimation refers to channeling unacceptable drives or impulses into more
constructive,acceptable activities.
Cognitive Level:
Application Integrated
Process: Assessment
9. Which nursing statement about the concept of neurosis is most accurate?
1. An individual experiencing neurosis is unaware that he or she is experiencingdistress.
2. An individual experiencing neurosis feels helpless to change his or her situation.
3. An individual experiencing neurosis is aware of psychological causes of his or herbehavior.
4. An individual experiencing neurosis has a loss of contact with reality.
ANS: 2
Rationale: The nurse should define the concept of neurosis with the followingcharacteristics:
The sclient sfeels shelpless sto schange shis sor sher ssituation, sthe sclient sis saware sthat she sorsshe sis
sexperiencing sdistress, sthe sclient sis saware sthe sbehaviors sare smaladaptive, sthe sclient sis
sunaware sof sthe spsychological scauses sof sthe sdistress, sand sthe sclient sexperiences sno sloss sof
scontact swith sreality.
Cognitive sLevel:
Application
sIntegratedsProcess:
sAssessment
10. sWhich snursing sstatement sregarding sthe sconcept sof spsychosis sis smost saccurate?
1. Individuals sexperiencing spsychoses sare saware sthat stheir sbehaviors
saresmaladaptive.
2. Individuals sexperiencing spsychoses sexperience slittle sdistress.
3. Individuals sexperiencing spsychoses sare saware sof sexperiencing spsychologicalsproblems.
4. Individuals sexperiencing spsychoses sare sbased sin sreality.
ANS: s2
Rationale: sThe snurse sshould sunderstand sthat sthe sclient swith spsychosis sexperiences slittle
sdistress sowing sto shis sor sher slack sof sawareness sof sreality. sThe sclient swith spsychosis s is
s unaware s that s his s or sher s behavior s is s maladaptive s or s that s he s or s she s has sa spsychological
sproblem.
Cognitive sLevel:
Application
sIntegratedsProcess:
sAssessment
NURSING 8TH EDITION CONCEPTS OF CARE IN
EVIDENCE-BASED PRACTICE 8TH EDITION
MORGAN TOWNSEND TEST BANK GOOD LUCK
IN YOUR EXAM
Chapter 1. Mental Health and MentalIllness
1. A nurse is assessing a client who is experiencing occasional feelings of sadness
because of therecent death of a beloved pet. The clients appetite, sleep patterns,and daily
routine have not changed. How should the nurse interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of mentalillness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no mentalillness.
ANS: 4
Rationale: The nurse should assess that the clients daily functioning is not impaired. The
clientwho experiences feelings of sadness after the loss of a pet is responding within normal
expectations. Without significant impairment, the clientsdistress does not indicate a mental
illness.
Cognitive Level: Analysis
Integrated Process:
Assessment
2. At what point should the nurse determine that a client is at risk for developing amentalillness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
2. When maladaptive responses to stress are coupled with interference in dailyfunctioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
ANS: 2
Rationale: The nurse should determine that the client is at risk for mental illness when
responsesto stress are maladaptive and interfere with daily functioning. TheDSM-5 indicates
that in orderto be diagnosed with a mental illness, daily
functioning must be significantly impaired. The clients ability to communicatedistress would be
considered a positive attribute.
Cognitive Level:
,Application Integrated
Process: Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently to
stress.One twin becomes anxious and irritable, and the other withdraws and cries. How should
the nurse explain these different stress responsesto the parents?
1. Reactions to stress are relative rather than absolute; individual responses to stressvary.
2. It is abnormal for identical twins to react differently to similar stressors.
3. Identical twins should share the same temperament and respond similarly tostress.
4. Environmental influences to stress weigh more heavily than genetic influences.
ANS: 1
Rationale: The nurse should explain to the parents that, although the twins have identical
DNA,there are several other factors that affect reactions to stress. Mentalhealth is a state of
being thatis relative to the individual client. Environmental influences and temperament can
affect stress reactions.
Cognitive Level: Application
Integrated Process:
Implementation
4. Which client should the nurse anticipate to be most receptive to psychiatrictreatment?
1. A Jewish, female social worker.
2. A Baptist, homeless male.
3. A Catholic, black male.
4. A Protestant, Swedish business executive.
ANS: 1
Rationale: The nurse should anticipate that the client of Jewish culture would place a high
importance on preventative health care and would consider mental health as equally important
asphysical health. Women are also more likely to seek treatment for mental health problems than
men.
Cognitive Level:
ApplicationIntegrated
Process: Planning
5. A psychiatric nurse intern states, This clients use of defense mechanisms shouldbe
eliminated.Which is a correct evaluation of this nurses statement?
1. Defense mechanisms can be appropriate responses to stress and need not beeliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manageanxiety and
shouldalways be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should bediscouraged
andnot eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered andencouraged.
ANS: 1
Rationale: The nurse should determine that defense mechanisms can be appropriate during
timesof stress. The client with no defense mechanisms may have a lower tolerance for stress,
thus leading to anxiety disorders. Defense mechanisms should be confronted when they impede
,the client from developing
healthy coping skills.
Cognitive Level:
Application Integrated
Process: Evaluation
6. During an intake assessment, a nurse asks both physiological and psychosocialquestions.
Theclient angrily responds, Im here for my heart, not my head problems. Which is the nurses
best response?
1. Its just a routine part of our assessment. All clients are asked these samequestions.
2. Why are you concerned about these types of questions?
3. Psychological factors, like excessive stress, have been found to affect medicalconditions.
4. We can skip these questions, if you like. It isnt imperative that we complete thissection.
ANS: 3
Rationale: The nurse should attempt to educate the client on the negative effects of
excessivestress on medical conditions. It is not appropriate to skip physiological and
psychosocial questions, as this would lead to an inaccurate assessment.
Cognitive Level: Application
Integrated Process:
Implementation
7. An employee uses the defense mechanism of displacement when the boss openly
disagreeswith suggestions. What behavior would be expected from thisemployee?
1. The employee assertively confronts the boss.
2. The employee leaves the staff meeting to work out in the gym.
3. The employee criticizes a coworker.
4. The employee takes the boss out to lunch.
ANS: 3
Rationale: The nurse should expect that the client using the defense mechanism
displacementwould criticize a coworker after being confronted by the boss.
Displacement refers to transferring feelings from one target to a neutral or less-threatening
target.
Cognitive Level: Analysis
Integrated Process:
Assessment
8. A fourth-grade boy teases and makes jokes about a cute girl in his class. Thisbehavior
shouldbe identified by a nurse as indicative of which defense mechanism?
1. Displacement
2. Projection
3. Reaction formation
4. Sublimation
ANS: 3
Rationale: The nurse should identify that the boy is using reaction formation as adefense
, mechanism. Reaction formation is the attempt to prevent undesirable thoughts from being
expressed by expressing opposite thoughts or behaviors.
Displacement refers to transferring feelings from one target to another. Rationalization refers
to making excuses to justify behavior.Projection refers tothe attribution of unacceptable
feelings or behaviors to another person.
Sublimation refers to channeling unacceptable drives or impulses into more
constructive,acceptable activities.
Cognitive Level:
Application Integrated
Process: Assessment
9. Which nursing statement about the concept of neurosis is most accurate?
1. An individual experiencing neurosis is unaware that he or she is experiencingdistress.
2. An individual experiencing neurosis feels helpless to change his or her situation.
3. An individual experiencing neurosis is aware of psychological causes of his or herbehavior.
4. An individual experiencing neurosis has a loss of contact with reality.
ANS: 2
Rationale: The nurse should define the concept of neurosis with the followingcharacteristics:
The sclient sfeels shelpless sto schange shis sor sher ssituation, sthe sclient sis saware sthat she sorsshe sis
sexperiencing sdistress, sthe sclient sis saware sthe sbehaviors sare smaladaptive, sthe sclient sis
sunaware sof sthe spsychological scauses sof sthe sdistress, sand sthe sclient sexperiences sno sloss sof
scontact swith sreality.
Cognitive sLevel:
Application
sIntegratedsProcess:
sAssessment
10. sWhich snursing sstatement sregarding sthe sconcept sof spsychosis sis smost saccurate?
1. Individuals sexperiencing spsychoses sare saware sthat stheir sbehaviors
saresmaladaptive.
2. Individuals sexperiencing spsychoses sexperience slittle sdistress.
3. Individuals sexperiencing spsychoses sare saware sof sexperiencing spsychologicalsproblems.
4. Individuals sexperiencing spsychoses sare sbased sin sreality.
ANS: s2
Rationale: sThe snurse sshould sunderstand sthat sthe sclient swith spsychosis sexperiences slittle
sdistress sowing sto shis sor sher slack sof sawareness sof sreality. sThe sclient swith spsychosis s is
s unaware s that s his s or sher s behavior s is s maladaptive s or s that s he s or s she s has sa spsychological
sproblem.
Cognitive sLevel:
Application
sIntegratedsProcess:
sAssessment
