,
,
,
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 5
REF: 3 TOP: Nursing Process: Assessment
MSC: Client Needs: Safe, Effective Care Environment
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have
the most complete information?
a. Nursing Outcomes Classification (NOC)
b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
c. The ANAs Psychiatric-Mental Health Nursing Scope and Standards of Practice
d. International Statistical Classification of Diseases and Related Health Problems (ICD-10)
ANS: B
The DSM-5 details the diagnostic criteria for psychiatric clinical conditions. The other references are good
resources but do not define the diagnostic criteria.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 10 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
9. Which individual is demonstrating the highest level of resilience? One who:
a. is able to repress stressors.
b. becomes depressed after the death of a spouse.
c. lives in a shelter for two years after the home is destroyed by fire.
d. takes a temporary job to maintain financial stability after loss of a permanent job.
ANS: D
Resilience is closely associated with the process of adapting and helps people facing tragedies, loss, trauma,
and severe stress. It is the ability and capacity for people to secure the resources they need to support their
well-being. Repression and depression are unhealthy. Living in a shelter for two years shows a failure to move
forward after a tragedy. See related audience response question.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 3 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
10. Complete this analogy. NANDA: clinical judgment: NIC: _________________
a. patient outcomes c. diagnosis
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 6
b. nursing actions d. symptoms
ANS: B
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis Association, identifies
diagnostic statements regarding human responses to actual or potential health problems. These statements
represent clinical judgments. NIC (Nursing Interventions Classification) identifies actions provided by nurses
that enhance patient outcomes. Nursing care activities may be direct or indirect.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: 13 TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
11. A college student said, Most of the time Im happy and feel good about myself. I have learned that what I
get out of something is proportional to the effort I put into it. Which number on this mental health continuum
should the nurse select?
Mental Illness Mental
Health
1 2 3 4 5
a. 1
b. 2
c. 3
d. 4
e. 5
ANS: E
The student is happy and has an adequate self-concept. The student is reality-oriented, works effectively, and
has control over own behavior. Mental health does not mean that a person is always happy.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 2 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
12. Which disorder is a culture-bound syndrome?
a. Epilepsy c. Running amok
b. Schizophrenia d. Major depression
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 7
ANS: C
Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized by people in those
cultures. A syndrome recognized in parts of Southeast Asia is running amok, in which a person (usually a
male) runs around engaging in furious, almost indiscriminate violent behavior.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 5 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
13. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies:
a. deviant behaviors. c. people with mental disorders.
b. present disability or distress. d. mental disorders people have.
ANS: D
The DSM-5 classifies disorders people have rather than people themselves. The terminology of the tool reflects
this distinction by referring to individuals with a disorder rather than as a schizophrenic or alcoholic, for
example. Deviant behavior is not generally considered a mental disorder. Present disability or distress is only
one aspect of the diagnosis.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 10 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
14. A citizen at a community health fair asks the nurse, What is the most prevalent mental disorder in the
United States? Select the nurses best response.
a. Schizophrenia c. Dissociative fugue
b. Bipolar disorder d. Alzheimers disease
ANS: D
The 12-month prevalence for Alzheimers disease is 10% for persons older than 65 and 50% for persons older
than 85. The prevalence of schizophrenia is 1.1% per year. The prevalence of bipolar disorder is 2.6%.
Dissociative fugue is a rare disorder. See related audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 9 TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
15. In the majority culture of the United States, which individual has the greatest risk to be labeled mentally
ill? One who:
a. describes hearing Gods voice speaking.
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 8
b. is usually pessimistic but strives to meet personal goals.
c. is wealthy and gives away $20 bills to needy individuals.
d. always has an optimistic viewpoint about life and having own needs met.
ANS: A
The question asks about risk. Hearing voices is generally associated with mental illness, but in charismatic
religious groups, hearing the voice of God or a prophet is a desirable event. Cultural norms vary, which makes
it more difficult to make an accurate diagnosis. The individuals described in the other options are less likely to
be labeled mentally ill.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: 4 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
16. A patients relationships are intense and unstable. The patient initially idealizes the significant other and
then devalues him or her, resulting in frequent feelings of emptiness. This patient will benefit from
interventions to develop which aspect of mental health?
a. Effectiveness in work c. Productive activities
b. Communication skills d. Fulfilling relationships
ANS: D
The information given centers on relationships with others that are described as intense and unstable. The
relationships of mentally healthy individuals are stable, satisfying, and socially integrated. Data are not present
to describe work effectiveness, communication skills, or activities.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 2 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
17. Which belief will best support a nurses efforts to provide patient advocacy during a multidisciplinary
patient care planning session?
a. All mental illnesses are culturally determined.
b. Schizophrenia and bipolar disorder are cross-cultural disorders.
c. Symptoms of mental disorders are unchanged from culture to culture.
d. Assessment findings in mental disorders reflect a persons cultural patterns.
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 9
ANS: D
A nurse who understands that a patients symptoms are influenced by culture will be able to advocate for the
patient to a greater degree than a nurse who believes that culture is of little relevance. The distracters are untrue
statements.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 4 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
18. A nurse is part of a multidisciplinary team working with groups of depressed patients. Half the patients
receive supportive interventions and antidepressant medication. The other half receives only medication. The
team measures outcomes for each group. Which type of study is evident?
a. Incidence c. Co-morbidity
b. Prevalence d. Clinical epidemiology
ANS: D
Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if there is
no treatment and the problem is left to run its course) of an illness, studies of diagnostic screening tests, and
observational and experimental studies of interventions used to treat people with the illness or symptoms.
Prevalence refers to numbers of new cases. Co-morbidity refers to having more than one mental disorder at a
time.Incidence refers to the number of new cases of mental disorders in a healthy population within a given
period. See related audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 9 TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
19. The spouse of a patient diagnosed with schizophrenia says, I dont understand how events from childhood
have anything to do with this disabling illness. Which response by the nurse will best help the spouse
understand the cause of this disorder?
a. Psychological stress is the basis of most mental disorders.
b. This illness results from developmental factors rather than stress.
c. Research shows that this condition more likely has a biological basis.
d. It must be frustrating for you that your spouse is sick so much of the time.
ANS: C
Many of the most prevalent and disabling mental disorders have strong biological influences. Genetics are only
one part of biological factors. Empathy does not address increasing the spouses level of knowledge about the
cause of the disorder. The other distracters are not established facts.
PTS: 1 DIF: Cognitive Level: Apply (Application)
, Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 10
REF: 6 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
20. A category 5 tornado occurred in a community of 400 people resulting in destruction of many homes and
businesses. In the 2 years after this disaster, 140 individuals were diagnosed with posttraumatic stress disorder
(PTSD). Which term best applies to these newly diagnosed cases?
a. Prevalence c. Incidence
b. Co-morbidity d. Parity
ANS: C
Incidence refers to the number of new cases of mental disorders in a healthy population within a given period
of time. Prevalence describes the total number of cases, new and existing, in a given population during a
specific period of time, regardless of when they became ill. Parity refers to equivalence, and legislation
required insurers that provide mental health coverage to offer annual and lifetime benefits at the same level
provided for medical/surgical coverage. Co-morbidity refers to having more than one mental disorder at a time.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 9 TOP: Nursing Process: Planning/Outcomes Identification
MSC: Client Needs: Safe, Effective Care Environment
21. Which component of treatment of mental illness is specifically recognized by Quality and Safety Education
for Nurses (QSEN)?
a. All genomes are unique.
b. Care is centered on the patient.
c. Healthy development is vital to mental health.
d. Recovery occurs on a continuum from illness to health.
ANS: B
The key areas of care promoted by QSEN are patient-centered care, teamwork and collaboration, evidence-
based practice, quality improvement, safety, and informatics.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 8 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
22. Select the best response for the nurse who receives a question from another health professional seeking to
understand the difference between a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis
and a nursing diagnosis.
a. There is no functional difference between the two. Both identify human disorders.
,
,
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 5
REF: 3 TOP: Nursing Process: Assessment
MSC: Client Needs: Safe, Effective Care Environment
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have
the most complete information?
a. Nursing Outcomes Classification (NOC)
b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
c. The ANAs Psychiatric-Mental Health Nursing Scope and Standards of Practice
d. International Statistical Classification of Diseases and Related Health Problems (ICD-10)
ANS: B
The DSM-5 details the diagnostic criteria for psychiatric clinical conditions. The other references are good
resources but do not define the diagnostic criteria.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 10 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
9. Which individual is demonstrating the highest level of resilience? One who:
a. is able to repress stressors.
b. becomes depressed after the death of a spouse.
c. lives in a shelter for two years after the home is destroyed by fire.
d. takes a temporary job to maintain financial stability after loss of a permanent job.
ANS: D
Resilience is closely associated with the process of adapting and helps people facing tragedies, loss, trauma,
and severe stress. It is the ability and capacity for people to secure the resources they need to support their
well-being. Repression and depression are unhealthy. Living in a shelter for two years shows a failure to move
forward after a tragedy. See related audience response question.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 3 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
10. Complete this analogy. NANDA: clinical judgment: NIC: _________________
a. patient outcomes c. diagnosis
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 6
b. nursing actions d. symptoms
ANS: B
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis Association, identifies
diagnostic statements regarding human responses to actual or potential health problems. These statements
represent clinical judgments. NIC (Nursing Interventions Classification) identifies actions provided by nurses
that enhance patient outcomes. Nursing care activities may be direct or indirect.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: 13 TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
11. A college student said, Most of the time Im happy and feel good about myself. I have learned that what I
get out of something is proportional to the effort I put into it. Which number on this mental health continuum
should the nurse select?
Mental Illness Mental
Health
1 2 3 4 5
a. 1
b. 2
c. 3
d. 4
e. 5
ANS: E
The student is happy and has an adequate self-concept. The student is reality-oriented, works effectively, and
has control over own behavior. Mental health does not mean that a person is always happy.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 2 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
12. Which disorder is a culture-bound syndrome?
a. Epilepsy c. Running amok
b. Schizophrenia d. Major depression
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 7
ANS: C
Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized by people in those
cultures. A syndrome recognized in parts of Southeast Asia is running amok, in which a person (usually a
male) runs around engaging in furious, almost indiscriminate violent behavior.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 5 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
13. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies:
a. deviant behaviors. c. people with mental disorders.
b. present disability or distress. d. mental disorders people have.
ANS: D
The DSM-5 classifies disorders people have rather than people themselves. The terminology of the tool reflects
this distinction by referring to individuals with a disorder rather than as a schizophrenic or alcoholic, for
example. Deviant behavior is not generally considered a mental disorder. Present disability or distress is only
one aspect of the diagnosis.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 10 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
14. A citizen at a community health fair asks the nurse, What is the most prevalent mental disorder in the
United States? Select the nurses best response.
a. Schizophrenia c. Dissociative fugue
b. Bipolar disorder d. Alzheimers disease
ANS: D
The 12-month prevalence for Alzheimers disease is 10% for persons older than 65 and 50% for persons older
than 85. The prevalence of schizophrenia is 1.1% per year. The prevalence of bipolar disorder is 2.6%.
Dissociative fugue is a rare disorder. See related audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 9 TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
15. In the majority culture of the United States, which individual has the greatest risk to be labeled mentally
ill? One who:
a. describes hearing Gods voice speaking.
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 8
b. is usually pessimistic but strives to meet personal goals.
c. is wealthy and gives away $20 bills to needy individuals.
d. always has an optimistic viewpoint about life and having own needs met.
ANS: A
The question asks about risk. Hearing voices is generally associated with mental illness, but in charismatic
religious groups, hearing the voice of God or a prophet is a desirable event. Cultural norms vary, which makes
it more difficult to make an accurate diagnosis. The individuals described in the other options are less likely to
be labeled mentally ill.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: 4 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
16. A patients relationships are intense and unstable. The patient initially idealizes the significant other and
then devalues him or her, resulting in frequent feelings of emptiness. This patient will benefit from
interventions to develop which aspect of mental health?
a. Effectiveness in work c. Productive activities
b. Communication skills d. Fulfilling relationships
ANS: D
The information given centers on relationships with others that are described as intense and unstable. The
relationships of mentally healthy individuals are stable, satisfying, and socially integrated. Data are not present
to describe work effectiveness, communication skills, or activities.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 2 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
17. Which belief will best support a nurses efforts to provide patient advocacy during a multidisciplinary
patient care planning session?
a. All mental illnesses are culturally determined.
b. Schizophrenia and bipolar disorder are cross-cultural disorders.
c. Symptoms of mental disorders are unchanged from culture to culture.
d. Assessment findings in mental disorders reflect a persons cultural patterns.
,Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 9
ANS: D
A nurse who understands that a patients symptoms are influenced by culture will be able to advocate for the
patient to a greater degree than a nurse who believes that culture is of little relevance. The distracters are untrue
statements.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 4 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
18. A nurse is part of a multidisciplinary team working with groups of depressed patients. Half the patients
receive supportive interventions and antidepressant medication. The other half receives only medication. The
team measures outcomes for each group. Which type of study is evident?
a. Incidence c. Co-morbidity
b. Prevalence d. Clinical epidemiology
ANS: D
Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if there is
no treatment and the problem is left to run its course) of an illness, studies of diagnostic screening tests, and
observational and experimental studies of interventions used to treat people with the illness or symptoms.
Prevalence refers to numbers of new cases. Co-morbidity refers to having more than one mental disorder at a
time.Incidence refers to the number of new cases of mental disorders in a healthy population within a given
period. See related audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 9 TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
19. The spouse of a patient diagnosed with schizophrenia says, I dont understand how events from childhood
have anything to do with this disabling illness. Which response by the nurse will best help the spouse
understand the cause of this disorder?
a. Psychological stress is the basis of most mental disorders.
b. This illness results from developmental factors rather than stress.
c. Research shows that this condition more likely has a biological basis.
d. It must be frustrating for you that your spouse is sick so much of the time.
ANS: C
Many of the most prevalent and disabling mental disorders have strong biological influences. Genetics are only
one part of biological factors. Empathy does not address increasing the spouses level of knowledge about the
cause of the disorder. The other distracters are not established facts.
PTS: 1 DIF: Cognitive Level: Apply (Application)
, Test Bank - Varcarolis' Foundations of Psychiatric Mental Health Nursing (8th Edition) 10
REF: 6 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
20. A category 5 tornado occurred in a community of 400 people resulting in destruction of many homes and
businesses. In the 2 years after this disaster, 140 individuals were diagnosed with posttraumatic stress disorder
(PTSD). Which term best applies to these newly diagnosed cases?
a. Prevalence c. Incidence
b. Co-morbidity d. Parity
ANS: C
Incidence refers to the number of new cases of mental disorders in a healthy population within a given period
of time. Prevalence describes the total number of cases, new and existing, in a given population during a
specific period of time, regardless of when they became ill. Parity refers to equivalence, and legislation
required insurers that provide mental health coverage to offer annual and lifetime benefits at the same level
provided for medical/surgical coverage. Co-morbidity refers to having more than one mental disorder at a time.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 9 TOP: Nursing Process: Planning/Outcomes Identification
MSC: Client Needs: Safe, Effective Care Environment
21. Which component of treatment of mental illness is specifically recognized by Quality and Safety Education
for Nurses (QSEN)?
a. All genomes are unique.
b. Care is centered on the patient.
c. Healthy development is vital to mental health.
d. Recovery occurs on a continuum from illness to health.
ANS: B
The key areas of care promoted by QSEN are patient-centered care, teamwork and collaboration, evidence-
based practice, quality improvement, safety, and informatics.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 8 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
22. Select the best response for the nurse who receives a question from another health professional seeking to
understand the difference between a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis
and a nursing diagnosis.
a. There is no functional difference between the two. Both identify human disorders.
