,Psychiatric Nursing Evidence-Based
Mastery | NCLEX-Style Questions &
Rationales from Townsend 2025
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 1–7)
1. Which statement best describes the primary objective of
understanding stress adaptation in psychiatric nursing?
A. To eliminate all stressors in the client’s environment
B. To promote effective coping and resilience in clients
C. To diagnose mental disorders based solely on stress
levels
D. To teach clients to avoid any stressful situation
o Correct Answer: B
o Rationale: The goal is not to remove stress
completely but to help clients develop coping skills
and resilience.
o Subtopic: Objectives
2. An important objective of this chapter is to help nurses
differentiate between stressors and:
A. Coping mechanisms
B. Pathological anxiety
C. Environmental events
D. Physiological homeostasis
o Correct Answer: A
o Rationale: Nurses must distinguish stressors (triggers)
from coping mechanisms (responses).
, o Subtopic: Objectives
3. One objective of studying stress adaptation is to enable
nurses to:
A. Predict the exact timing of stress responses
B. Identify signs of ineffective coping early
C. Prescribe medication for all stress-related conditions
D. Assess clients only after stress resolution
o Correct Answer: B
o Rationale: Early identification of maladaptive coping
allows timely intervention.
o Subtopic: Objectives
4. Which objective aligns with evidence-based practice in
stress adaptation?
A. Using traditional beliefs to explain stress reactions
B. Applying research-supported interventions for stress
management
C. Relying on anecdotal reports for coping strategies
D. Dismissing client-reported stress unless physiological
signs appear
o Correct Answer: B
o Rationale: Evidence-based practice requires using
interventions validated by research.
o Subtopic: Objectives
,5. An objective of Chapter 1 is to clarify the concept of
stress as:
A. A purely psychological phenomenon
B. A multidimensional process
C. Always harmful to health
D. A rare response to extreme events
o Correct Answer: B
o Rationale: Stress is portrayed as biological,
environmental, and transactional.
o Subtopic: Objectives
6. Which learning objective would help nursing students
understand stress appraisal?
A. Define primary and secondary appraisal processes
B. List all medications used for stress disorders
C. Describe only the fight-or-flight response
D. Compare stress with psychiatric diagnoses
o Correct Answer: A
o Rationale: Appraisal involves primary (threat
evaluation) and secondary (resource evaluation).
o Subtopic: Objectives
7. A core objective is for students to recognize that coping
resources include:
A. Only personal traits
B. Social supports, problem-solving skills, and personal
, traits
C. Environmental stressors
D. Physiological stress responses
o Correct Answer: B
o Rationale: Coping resources span internal and
external supports.
o Subtopic: Objectives
Stress as a Biological Response (Questions 8–14)
8. Hans Selye’s General Adaptation Syndrome (GAS)
includes all stages except:
A. Alarm
B. Resistance
C. Recovery
D. Exhaustion
o Correct Answer: C
o Rationale: GAS comprises alarm, resistance, and
exhaustion; recovery isn’t a defined stage.
o Subtopic: Stress as a Biological Response
9. During the alarm reaction stage, which hormone is
released first?
A. Cortisol
B. Epinephrine
, C. Aldosterone
D. Growth hormone
o Correct Answer: B
o Rationale: Epinephrine from the adrenal medulla
triggers the initial fight-or-flight response.
o Subtopic: Stress as a Biological Response
10. Which physiological change is typical of the
resistance stage?
A. Tachycardia subsides to near baseline
B. Cortisol levels drop below normal
C. The client experiences hypoglycemia
D. Adrenal medulla activity ceases entirely
o Correct Answer: A
o Rationale: The body attempts to adapt; vital signs
normalize but remain ready.
o Subtopic: Stress as a Biological Response
11. Chronic activation of the hypothalamic-pituitary-
adrenal (HPA) axis can lead to:
A. Enhanced immune function
B. Increased risk of infection
C. Elevated insulin sensitivity
D. Decreased blood pressure
o Correct Answer: B
, o Rationale: Prolonged cortisol release suppresses
immunity and increases infection risk.
o Subtopic: Stress as a Biological Response
12. Which neurotransmitter is implicated in the fight-or-
flight response?
A. Serotonin
B. Gamma-aminobutyric acid (GABA)
C. Norepinephrine
D. Dopamine
o Correct Answer: C
o Rationale: Norepinephrine triggers arousal and
alertness under stress.
o Subtopic: Stress as a Biological Response
13. Allostatic load refers to:
A. Improved adaptation to stress over time
B. The cumulative wear and tear on the body
C. Total amount of stressors in the environment
D. Genetic predisposition to stress
o Correct Answer: B
o Rationale: Allostatic load describes physiological
consequences of chronic stress.
o Subtopic: Stress as a Biological Response
14. Which client finding suggests progression into the
exhaustion stage?
Mastery | NCLEX-Style Questions &
Rationales from Townsend 2025
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 1–7)
1. Which statement best describes the primary objective of
understanding stress adaptation in psychiatric nursing?
A. To eliminate all stressors in the client’s environment
B. To promote effective coping and resilience in clients
C. To diagnose mental disorders based solely on stress
levels
D. To teach clients to avoid any stressful situation
o Correct Answer: B
o Rationale: The goal is not to remove stress
completely but to help clients develop coping skills
and resilience.
o Subtopic: Objectives
2. An important objective of this chapter is to help nurses
differentiate between stressors and:
A. Coping mechanisms
B. Pathological anxiety
C. Environmental events
D. Physiological homeostasis
o Correct Answer: A
o Rationale: Nurses must distinguish stressors (triggers)
from coping mechanisms (responses).
, o Subtopic: Objectives
3. One objective of studying stress adaptation is to enable
nurses to:
A. Predict the exact timing of stress responses
B. Identify signs of ineffective coping early
C. Prescribe medication for all stress-related conditions
D. Assess clients only after stress resolution
o Correct Answer: B
o Rationale: Early identification of maladaptive coping
allows timely intervention.
o Subtopic: Objectives
4. Which objective aligns with evidence-based practice in
stress adaptation?
A. Using traditional beliefs to explain stress reactions
B. Applying research-supported interventions for stress
management
C. Relying on anecdotal reports for coping strategies
D. Dismissing client-reported stress unless physiological
signs appear
o Correct Answer: B
o Rationale: Evidence-based practice requires using
interventions validated by research.
o Subtopic: Objectives
,5. An objective of Chapter 1 is to clarify the concept of
stress as:
A. A purely psychological phenomenon
B. A multidimensional process
C. Always harmful to health
D. A rare response to extreme events
o Correct Answer: B
o Rationale: Stress is portrayed as biological,
environmental, and transactional.
o Subtopic: Objectives
6. Which learning objective would help nursing students
understand stress appraisal?
A. Define primary and secondary appraisal processes
B. List all medications used for stress disorders
C. Describe only the fight-or-flight response
D. Compare stress with psychiatric diagnoses
o Correct Answer: A
o Rationale: Appraisal involves primary (threat
evaluation) and secondary (resource evaluation).
o Subtopic: Objectives
7. A core objective is for students to recognize that coping
resources include:
A. Only personal traits
B. Social supports, problem-solving skills, and personal
, traits
C. Environmental stressors
D. Physiological stress responses
o Correct Answer: B
o Rationale: Coping resources span internal and
external supports.
o Subtopic: Objectives
Stress as a Biological Response (Questions 8–14)
8. Hans Selye’s General Adaptation Syndrome (GAS)
includes all stages except:
A. Alarm
B. Resistance
C. Recovery
D. Exhaustion
o Correct Answer: C
o Rationale: GAS comprises alarm, resistance, and
exhaustion; recovery isn’t a defined stage.
o Subtopic: Stress as a Biological Response
9. During the alarm reaction stage, which hormone is
released first?
A. Cortisol
B. Epinephrine
, C. Aldosterone
D. Growth hormone
o Correct Answer: B
o Rationale: Epinephrine from the adrenal medulla
triggers the initial fight-or-flight response.
o Subtopic: Stress as a Biological Response
10. Which physiological change is typical of the
resistance stage?
A. Tachycardia subsides to near baseline
B. Cortisol levels drop below normal
C. The client experiences hypoglycemia
D. Adrenal medulla activity ceases entirely
o Correct Answer: A
o Rationale: The body attempts to adapt; vital signs
normalize but remain ready.
o Subtopic: Stress as a Biological Response
11. Chronic activation of the hypothalamic-pituitary-
adrenal (HPA) axis can lead to:
A. Enhanced immune function
B. Increased risk of infection
C. Elevated insulin sensitivity
D. Decreased blood pressure
o Correct Answer: B
, o Rationale: Prolonged cortisol release suppresses
immunity and increases infection risk.
o Subtopic: Stress as a Biological Response
12. Which neurotransmitter is implicated in the fight-or-
flight response?
A. Serotonin
B. Gamma-aminobutyric acid (GABA)
C. Norepinephrine
D. Dopamine
o Correct Answer: C
o Rationale: Norepinephrine triggers arousal and
alertness under stress.
o Subtopic: Stress as a Biological Response
13. Allostatic load refers to:
A. Improved adaptation to stress over time
B. The cumulative wear and tear on the body
C. Total amount of stressors in the environment
D. Genetic predisposition to stress
o Correct Answer: B
o Rationale: Allostatic load describes physiological
consequences of chronic stress.
o Subtopic: Stress as a Biological Response
14. Which client finding suggests progression into the
exhaustion stage?
