,Ultimate NCLEX Test Bank for Psychiatric Mental Health
Nursing – 2025 Edition | Townsend & Morgan's 11th Edition
Mastery
Includes High-Quality NCLEX-Style MCQs per Chapter with
100% Correct Answers and Concise Rationales
Table of Contents for Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based
Practice, 10th Edition by Townsend & Morgan:
I. Basic Concepts in Psychiatric–Mental Health Nursing
1. The Concept of Stress Adaptation
2. Mental Health and Mental Illness: Historical and Theoretical Concepts
II. Foundations for Psychiatric–Mental Health Nursing
3. Concepts of Psychobiology
4. Psychopharmacology
5. Ethical and Legal Issues
III. Therapeutic Approaches in Psychiatric Nursing Care
6. Relationship Development
7. Therapeutic Communication
8. The Nursing Process in Psychiatric–Mental Health Nursing
9. Therapeutic Groups
10. Intervention with Families
11. Milieu Therapy—The Therapeutic Community
12. Crisis Intervention
13. Assertiveness Training
14. Promoting Self-Esteem
, 15. Anger and Aggression Management
16. Suicide Prevention
17. Behavior Therapy
18. Cognitive Behavioral Therapy
19. Electroconvulsive Therapy
20. The Recovery Model
IV. Nursing Care of Patients with Alterations in Psychosocial Adaptation
21. Caring for Patients with Mental Illness and Substance Use Disorders in General Practice
Settings
22. Neurocognitive Disorders
23. Substance-Related and Addictive Disorders
24. Schizophrenia Spectrum and Other Psychotic Disorders
25. Depressive Disorders
26. Bipolar and Related Disorders
27. Anxiety, Obsessive-Compulsive, and Related Disorders
28. Trauma and Stressor-Related Disorders
29. Somatic Symptom and Dissociative Disorders
30. Eating Disorders
31. Personality Disorders
V. Psychiatric/Mental Health Nursing of Special Populations
32. Children and Adolescents
33. The Aging Individual
34. Survivors of Abuse or Neglect
35. Community Mental Health Nursing
36. The Bereaved Individual
37. Military Families
38. Appendices & Additional Resources
, A. Answers to Chapter Review and Clinical Judgment Questions
B. Examples of Answers to Communication Exercises
C. Mental Status Assessment
Glossary
Index
eBook Bonus Chapters
38. Theoretical Models of Personality Development
39. Cultural and Spiritual Concepts Relevant to Psychiatric Mental Health Nursing
40. Complementary and Psychosocial Therapies
41. Relaxation Therapy
42. Issues Related to Human Sexuality and Gender Dysphoria
43. Forensic Nursing
Chapter 1 – The Concept of Stress Adaptation (10th ed.,
Townsend & Morgan).
Objectives (Questions 1–8)
1. Which statement best reflects the primary objective of
Chapter 1 in understanding stress adaptation?
A. To identify the pharmacologic treatments for stress
disorders
B. To explore the genetic determinants of stress
vulnerability
C. To define stress and describe its impact on physiological
and psychological functioning (Correct)
, D. To evaluate the efficacy of alternative medicine in stress
reduction
Rationale: Chapter 1 focuses on defining stress and examining
its effects on mind-body health.
Subtopic: Objectives
2. An objective of the chapter is to enable the nurse to:
A. Prescribe anti-anxiety medications independently
B. Differentiate among models of stress adaptation
(Correct)
C. Diagnose anxiety disorders based on DSM-5 criteria
D. Conduct biofeedback training sessions
Rationale: One goal is understanding theoretical models (e.g.,
Selye, Lazarus) of stress adaptation.
Subtopic: Objectives
3. A key objective is to help students recognize that stress
responses are:
A. Uniform across all individuals
B. Influenced by personal appraisal and coping resources
(Correct)
C. Always pathological in nature
D. Determined solely by environmental threats
Rationale: The chapter emphasizes how appraisal and coping
mediate stress outcomes.
Subtopic: Objectives
, 4. Which learning outcome aligns with Chapter 1?
A. Describe neurotransmitter imbalances in depression
B. Explain how stress can be both adaptive and
maladaptive (Correct)
C. List all psychiatric medications for anxiety
D. Perform a comprehensive family therapy session
Rationale: Understanding adaptive vs. maladaptive stress
responses is central to the chapter.
Subtopic: Objectives
5. One objective is for the student to apply which model to
clinical practice?
A. Kubler-Ross’s stages of grief
B. Selye’s General Adaptation Syndrome (Correct)
C. Freud’s psychosexual stages
D. Maslow’s hierarchy of needs
Rationale: GAS model by Selye is foundational for stress
adaptation theory.
Subtopic: Objectives
6. Chapter 1 aims to enable the nurse to assess a client’s:
A. Financial stressors exclusively
B. Biological, psychological, and social stress factors
(Correct)
C. Only physiological signs of stress
D. Need for surgical interventions
,Rationale: A holistic biopsychosocial assessment is taught.
Subtopic: Objectives
7. A stated objective is to analyze how ineffective coping
leads to:
A. Improved self-esteem
B. Maladaptive behaviors and illness (Correct)
C. Enhanced social support
D. Reduction in stress hormones
Rationale: Ineffective coping can precipitate physical/mental
health problems.
Subtopic: Objectives
8. Which of these is NOT an objective of the chapter?
A. Discuss physiologic stress responses
B. Identify stress-management techniques
C. Teach advanced psychotherapeutic methods (Correct)
D. Illustrate the transactional model of stress
Rationale: Advanced psychotherapy is beyond Chapter 1’s
scope.
Subtopic: Objectives
Stress as a Biological Response (Questions 9–16)
9. Hans Selye’s concept of the General Adaptation
Syndrome describes which sequence?
A. Alarm → Resistance → Exhaustion (Correct)
B. Resistance → Alarm → Exhaustion
, C. Exhaustion → Resistance → Alarm
D. Alarm → Exhaustion → Resistance
Rationale: GAS phases are alarm, resistance, then exhaustion
when stress is prolonged.
Subtopic: Stress as a Biological Response
10. Which hormone is released during the alarm stage
of GAS?
A. Insulin
B. Cortisol (Correct)
C. Thyroxine
D. Melatonin
Rationale: The HPA axis triggers cortisol release to mobilize
energy.
Subtopic: Stress as a Biological Response
11. During prolonged stress, which physiologic change is
most likely?
A. Decreased blood pressure
B. Immunosuppression (Correct)
C. Increased wound healing
D. Reduced glucose production
Rationale: Chronic cortisol elevation suppresses immune
function.
Subtopic: Stress as a Biological Response
12. Which structure in the brain activates the
sympathetic nervous system in stress?
, A. Hippocampus
B. Prefrontal cortex
C. Hypothalamus (Correct)
D. Cerebellum
Rationale: The hypothalamus initiates the fight-or-flight
response.
Subtopic: Stress as a Biological Response
13. Allostatic load refers to:
A. The ideal stress level for peak performance
B. Cumulative wear and tear on the body from chronic
stress (Correct)
C. A single acute stress response
D. A measure of immune function
Rationale: Allostatic load quantifies long-term physiologic cost
of stress.
Subtopic: Stress as a Biological Response
14. Which physiological finding indicates activation of
the parasympathetic rebound?
A. Tachycardia
B. Hypertension
C. Bradycardia (Correct)
D. Hyperglycemia
Rationale: After acute stress, parasympathetic response slows
heart rate.
Subtopic: Stress as a Biological Response
, 15. The “fight-or-flight” response primarily involves:
A. Parasympathetic nervous system
B. Limbic system exclusively
C. Sympathetic nervous system (Correct)
D. Somatic nervous system
Rationale: The sympathetic branch readies the body for action.
Subtopic: Stress as a Biological Response
16. Which cytokine increase is associated with chronic
stress?
A. IL-10
B. IL-6 (Correct)
C. TGF-β
D. Erythropoietin
Rationale: IL-6 is a proinflammatory cytokine elevated under
chronic stress.
Subtopic: Stress as a Biological Response
Stress as an Environmental Event (Questions 17–24)
17. An environmental stressor is defined as:
A. A chemical imbalance within the body
B. Any external demand requiring adaptation (Correct)
C. A personality trait
D. A coping mechanism
Nursing – 2025 Edition | Townsend & Morgan's 11th Edition
Mastery
Includes High-Quality NCLEX-Style MCQs per Chapter with
100% Correct Answers and Concise Rationales
Table of Contents for Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based
Practice, 10th Edition by Townsend & Morgan:
I. Basic Concepts in Psychiatric–Mental Health Nursing
1. The Concept of Stress Adaptation
2. Mental Health and Mental Illness: Historical and Theoretical Concepts
II. Foundations for Psychiatric–Mental Health Nursing
3. Concepts of Psychobiology
4. Psychopharmacology
5. Ethical and Legal Issues
III. Therapeutic Approaches in Psychiatric Nursing Care
6. Relationship Development
7. Therapeutic Communication
8. The Nursing Process in Psychiatric–Mental Health Nursing
9. Therapeutic Groups
10. Intervention with Families
11. Milieu Therapy—The Therapeutic Community
12. Crisis Intervention
13. Assertiveness Training
14. Promoting Self-Esteem
, 15. Anger and Aggression Management
16. Suicide Prevention
17. Behavior Therapy
18. Cognitive Behavioral Therapy
19. Electroconvulsive Therapy
20. The Recovery Model
IV. Nursing Care of Patients with Alterations in Psychosocial Adaptation
21. Caring for Patients with Mental Illness and Substance Use Disorders in General Practice
Settings
22. Neurocognitive Disorders
23. Substance-Related and Addictive Disorders
24. Schizophrenia Spectrum and Other Psychotic Disorders
25. Depressive Disorders
26. Bipolar and Related Disorders
27. Anxiety, Obsessive-Compulsive, and Related Disorders
28. Trauma and Stressor-Related Disorders
29. Somatic Symptom and Dissociative Disorders
30. Eating Disorders
31. Personality Disorders
V. Psychiatric/Mental Health Nursing of Special Populations
32. Children and Adolescents
33. The Aging Individual
34. Survivors of Abuse or Neglect
35. Community Mental Health Nursing
36. The Bereaved Individual
37. Military Families
38. Appendices & Additional Resources
, A. Answers to Chapter Review and Clinical Judgment Questions
B. Examples of Answers to Communication Exercises
C. Mental Status Assessment
Glossary
Index
eBook Bonus Chapters
38. Theoretical Models of Personality Development
39. Cultural and Spiritual Concepts Relevant to Psychiatric Mental Health Nursing
40. Complementary and Psychosocial Therapies
41. Relaxation Therapy
42. Issues Related to Human Sexuality and Gender Dysphoria
43. Forensic Nursing
Chapter 1 – The Concept of Stress Adaptation (10th ed.,
Townsend & Morgan).
Objectives (Questions 1–8)
1. Which statement best reflects the primary objective of
Chapter 1 in understanding stress adaptation?
A. To identify the pharmacologic treatments for stress
disorders
B. To explore the genetic determinants of stress
vulnerability
C. To define stress and describe its impact on physiological
and psychological functioning (Correct)
, D. To evaluate the efficacy of alternative medicine in stress
reduction
Rationale: Chapter 1 focuses on defining stress and examining
its effects on mind-body health.
Subtopic: Objectives
2. An objective of the chapter is to enable the nurse to:
A. Prescribe anti-anxiety medications independently
B. Differentiate among models of stress adaptation
(Correct)
C. Diagnose anxiety disorders based on DSM-5 criteria
D. Conduct biofeedback training sessions
Rationale: One goal is understanding theoretical models (e.g.,
Selye, Lazarus) of stress adaptation.
Subtopic: Objectives
3. A key objective is to help students recognize that stress
responses are:
A. Uniform across all individuals
B. Influenced by personal appraisal and coping resources
(Correct)
C. Always pathological in nature
D. Determined solely by environmental threats
Rationale: The chapter emphasizes how appraisal and coping
mediate stress outcomes.
Subtopic: Objectives
, 4. Which learning outcome aligns with Chapter 1?
A. Describe neurotransmitter imbalances in depression
B. Explain how stress can be both adaptive and
maladaptive (Correct)
C. List all psychiatric medications for anxiety
D. Perform a comprehensive family therapy session
Rationale: Understanding adaptive vs. maladaptive stress
responses is central to the chapter.
Subtopic: Objectives
5. One objective is for the student to apply which model to
clinical practice?
A. Kubler-Ross’s stages of grief
B. Selye’s General Adaptation Syndrome (Correct)
C. Freud’s psychosexual stages
D. Maslow’s hierarchy of needs
Rationale: GAS model by Selye is foundational for stress
adaptation theory.
Subtopic: Objectives
6. Chapter 1 aims to enable the nurse to assess a client’s:
A. Financial stressors exclusively
B. Biological, psychological, and social stress factors
(Correct)
C. Only physiological signs of stress
D. Need for surgical interventions
,Rationale: A holistic biopsychosocial assessment is taught.
Subtopic: Objectives
7. A stated objective is to analyze how ineffective coping
leads to:
A. Improved self-esteem
B. Maladaptive behaviors and illness (Correct)
C. Enhanced social support
D. Reduction in stress hormones
Rationale: Ineffective coping can precipitate physical/mental
health problems.
Subtopic: Objectives
8. Which of these is NOT an objective of the chapter?
A. Discuss physiologic stress responses
B. Identify stress-management techniques
C. Teach advanced psychotherapeutic methods (Correct)
D. Illustrate the transactional model of stress
Rationale: Advanced psychotherapy is beyond Chapter 1’s
scope.
Subtopic: Objectives
Stress as a Biological Response (Questions 9–16)
9. Hans Selye’s concept of the General Adaptation
Syndrome describes which sequence?
A. Alarm → Resistance → Exhaustion (Correct)
B. Resistance → Alarm → Exhaustion
, C. Exhaustion → Resistance → Alarm
D. Alarm → Exhaustion → Resistance
Rationale: GAS phases are alarm, resistance, then exhaustion
when stress is prolonged.
Subtopic: Stress as a Biological Response
10. Which hormone is released during the alarm stage
of GAS?
A. Insulin
B. Cortisol (Correct)
C. Thyroxine
D. Melatonin
Rationale: The HPA axis triggers cortisol release to mobilize
energy.
Subtopic: Stress as a Biological Response
11. During prolonged stress, which physiologic change is
most likely?
A. Decreased blood pressure
B. Immunosuppression (Correct)
C. Increased wound healing
D. Reduced glucose production
Rationale: Chronic cortisol elevation suppresses immune
function.
Subtopic: Stress as a Biological Response
12. Which structure in the brain activates the
sympathetic nervous system in stress?
, A. Hippocampus
B. Prefrontal cortex
C. Hypothalamus (Correct)
D. Cerebellum
Rationale: The hypothalamus initiates the fight-or-flight
response.
Subtopic: Stress as a Biological Response
13. Allostatic load refers to:
A. The ideal stress level for peak performance
B. Cumulative wear and tear on the body from chronic
stress (Correct)
C. A single acute stress response
D. A measure of immune function
Rationale: Allostatic load quantifies long-term physiologic cost
of stress.
Subtopic: Stress as a Biological Response
14. Which physiological finding indicates activation of
the parasympathetic rebound?
A. Tachycardia
B. Hypertension
C. Bradycardia (Correct)
D. Hyperglycemia
Rationale: After acute stress, parasympathetic response slows
heart rate.
Subtopic: Stress as a Biological Response
, 15. The “fight-or-flight” response primarily involves:
A. Parasympathetic nervous system
B. Limbic system exclusively
C. Sympathetic nervous system (Correct)
D. Somatic nervous system
Rationale: The sympathetic branch readies the body for action.
Subtopic: Stress as a Biological Response
16. Which cytokine increase is associated with chronic
stress?
A. IL-10
B. IL-6 (Correct)
C. TGF-β
D. Erythropoietin
Rationale: IL-6 is a proinflammatory cytokine elevated under
chronic stress.
Subtopic: Stress as a Biological Response
Stress as an Environmental Event (Questions 17–24)
17. An environmental stressor is defined as:
A. A chemical imbalance within the body
B. Any external demand requiring adaptation (Correct)
C. A personality trait
D. A coping mechanism
