,Clinical Confidence in Mental Health
Nursing | Test Bank from the 11th Edition
(2025 Update)
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).
I. Objectives (10 Questions)
1. Which of the following is an overarching objective of
Chapter 1?
A. Identify stages of group development
B. Describe the concept of stress adaptation ☆
C. List common psychiatric medications
D. Explain cultural competence
Rationale: Chapter 1’s primary aim is to introduce and
clarify the concept of stress adaptation in nursing practice.
Subtopic: Objectives
2. An objective of Chapter 1 is to help students:
A. Develop advanced pharmacologic skills
B. Understand theoretical models of stress ☆
C. Master psychodynamic psychotherapy
D. Conduct mental status exams
Rationale: One objective is to review key theoretical
models explaining stress responses.
Subtopic: Objectives
3. The chapter objectives include all EXCEPT:
A. Outlining stress as a biological response
B. Describing environmental stressors
C. Detailing psychopharmacologic interventions ☆
, D. Explaining stress management techniques
Rationale: Psychopharmacologic interventions are covered
in later chapters, not in Chapter 1.
Subtopic: Objectives
4. By the end of Chapter 1, students should be able to:
A. Diagnose anxiety disorders
B. Apply the transactional model of stress ☆
C. Prescribe SSRIs
D. Perform CBT techniques
Rationale: The transactional model is a core concept
introduced here.
Subtopic: Objectives
5. One learning objective is to differentiate between:
A. Anxiety and depression
B. Stress as an event versus stress as a response ☆
C. Group versus individual therapy
D. Acute and chronic pain
Rationale: Distinguishing stress constructs is essential to
adaptation theory.
Subtopic: Objectives
6. Students reviewing Chapter 1 should be able to:
A. Identify key environmental stressors ☆
B. List all DSM-5 criteria for PTSD
C. Explain the nursing process in great detail
D. Conduct family genograms
Rationale: Recognizing environmental stressors is a stated
, chapter objective.
Subtopic: Objectives
7. Chapter 1’s objectives emphasize understanding:
A. Pharmacokinetics
B. Stress management strategies ☆
C. Psychoanalytic theory
D. Group roles
Rationale: Stress management is one of the five primary
chapter themes.
Subtopic: Objectives
8. A stated objective is to describe:
A. Biochemical pathways of antidepressants
B. The General Adaptation Syndrome ☆
C. Nursing informatics systems
D. Milieu therapy
Rationale: GAS is the classic biological model of stress
covered here.
Subtopic: Objectives
9. Which is NOT an objective of Chapter 1?
A. Understanding the diathesis–stress model
B. Explaining stress as a transaction
C. Reviewing mindfulness practices ☆
D. Defining stress as an environmental event
Rationale: While mindfulness appears later, it’s not a core
chapter objective.
Subtopic: Objectives
, 10. One of Chapter 1’s goals is to:
A. Outline stages of family development
B. Define coping mechanisms ☆
C. Detail eating disorder classifications
D. Describe dream analysis
Rationale: Defining coping is integral to understanding
adaptation and is stated in objectives.
Subtopic: Objectives
II. Stress as a Biological Response (10 Questions)
11. Which hormone is primarily released during the
alarm stage of GAS?
A. Insulin
B. Cortisol ☆
C. Estrogen
D. Prolactin
Rationale: Cortisol is the key “stress hormone” released by
the adrenal cortex under ACTH stimulation.
Subtopic: Stress as a Biological Response
12. Hans Selye’s General Adaptation Syndrome includes
all stages EXCEPT:
A. Alarm
B. Resistance
C. Recovery ☆
D. Exhaustion
, Rationale: The three stages are alarm, resistance, and
exhaustion.
Subtopic: Stress as a Biological Response
13. During the resistance stage of GAS, the body:
A. Fails to respond to further stressors
B. Mobilizes resources to cope with stress ☆
C. Remains in a hyperalert state indefinitely
D. Experiences irreversible organ damage
Rationale: Resistance involves adaptation and coping to
sustain defense mechanisms.
Subtopic: Stress as a Biological Response
14. The “fight-or-flight” response is mediated by which
system?
A. Parasympathetic nervous system
B. Central nervous system
C. Sympathetic nervous system ☆
D. Enteric nervous system
Rationale: Sympathetic activation triggers
epinephrine/norepinephrine release.
Subtopic: Stress as a Biological Response
15. Which neurotransmitter level rises sharply during
acute stress?
A. Serotonin
B. Dopamine
C. Norepinephrine ☆
D. GABA
, Rationale: Norepinephrine from the locus coeruleus
increases vigilance and arousal.
Subtopic: Stress as a Biological Response
16. Prolonged exposure to cortisol can lead to:
A. Enhanced wound healing
B. Immunosuppression ☆
C. Bone density increase
D. Hypoglycemia
Rationale: Chronic cortisol elevation suppresses immune
function and increases glucose.
Subtopic: Stress as a Biological Response
17. Which gland is the “master gland” initiating the
stress response?
A. Thyroid
B. Pituitary ☆
C. Adrenal
D. Pineal
Rationale: The anterior pituitary secretes ACTH in
response to CRH from the hypothalamus.
Subtopic: Stress as a Biological Response
18. The hypothalamic–pituitary–adrenal axis includes:
A. CRH → ACTH → Cortisol ☆
B. CRH → TSH → Thyroxine
C. ACTH → CRH → Epinephrine
D. GnRH → LH → Estrogen
Rationale: CRH from the hypothalamus prompts pituitary
Nursing | Test Bank from the 11th Edition
(2025 Update)
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).
I. Objectives (10 Questions)
1. Which of the following is an overarching objective of
Chapter 1?
A. Identify stages of group development
B. Describe the concept of stress adaptation ☆
C. List common psychiatric medications
D. Explain cultural competence
Rationale: Chapter 1’s primary aim is to introduce and
clarify the concept of stress adaptation in nursing practice.
Subtopic: Objectives
2. An objective of Chapter 1 is to help students:
A. Develop advanced pharmacologic skills
B. Understand theoretical models of stress ☆
C. Master psychodynamic psychotherapy
D. Conduct mental status exams
Rationale: One objective is to review key theoretical
models explaining stress responses.
Subtopic: Objectives
3. The chapter objectives include all EXCEPT:
A. Outlining stress as a biological response
B. Describing environmental stressors
C. Detailing psychopharmacologic interventions ☆
, D. Explaining stress management techniques
Rationale: Psychopharmacologic interventions are covered
in later chapters, not in Chapter 1.
Subtopic: Objectives
4. By the end of Chapter 1, students should be able to:
A. Diagnose anxiety disorders
B. Apply the transactional model of stress ☆
C. Prescribe SSRIs
D. Perform CBT techniques
Rationale: The transactional model is a core concept
introduced here.
Subtopic: Objectives
5. One learning objective is to differentiate between:
A. Anxiety and depression
B. Stress as an event versus stress as a response ☆
C. Group versus individual therapy
D. Acute and chronic pain
Rationale: Distinguishing stress constructs is essential to
adaptation theory.
Subtopic: Objectives
6. Students reviewing Chapter 1 should be able to:
A. Identify key environmental stressors ☆
B. List all DSM-5 criteria for PTSD
C. Explain the nursing process in great detail
D. Conduct family genograms
Rationale: Recognizing environmental stressors is a stated
, chapter objective.
Subtopic: Objectives
7. Chapter 1’s objectives emphasize understanding:
A. Pharmacokinetics
B. Stress management strategies ☆
C. Psychoanalytic theory
D. Group roles
Rationale: Stress management is one of the five primary
chapter themes.
Subtopic: Objectives
8. A stated objective is to describe:
A. Biochemical pathways of antidepressants
B. The General Adaptation Syndrome ☆
C. Nursing informatics systems
D. Milieu therapy
Rationale: GAS is the classic biological model of stress
covered here.
Subtopic: Objectives
9. Which is NOT an objective of Chapter 1?
A. Understanding the diathesis–stress model
B. Explaining stress as a transaction
C. Reviewing mindfulness practices ☆
D. Defining stress as an environmental event
Rationale: While mindfulness appears later, it’s not a core
chapter objective.
Subtopic: Objectives
, 10. One of Chapter 1’s goals is to:
A. Outline stages of family development
B. Define coping mechanisms ☆
C. Detail eating disorder classifications
D. Describe dream analysis
Rationale: Defining coping is integral to understanding
adaptation and is stated in objectives.
Subtopic: Objectives
II. Stress as a Biological Response (10 Questions)
11. Which hormone is primarily released during the
alarm stage of GAS?
A. Insulin
B. Cortisol ☆
C. Estrogen
D. Prolactin
Rationale: Cortisol is the key “stress hormone” released by
the adrenal cortex under ACTH stimulation.
Subtopic: Stress as a Biological Response
12. Hans Selye’s General Adaptation Syndrome includes
all stages EXCEPT:
A. Alarm
B. Resistance
C. Recovery ☆
D. Exhaustion
, Rationale: The three stages are alarm, resistance, and
exhaustion.
Subtopic: Stress as a Biological Response
13. During the resistance stage of GAS, the body:
A. Fails to respond to further stressors
B. Mobilizes resources to cope with stress ☆
C. Remains in a hyperalert state indefinitely
D. Experiences irreversible organ damage
Rationale: Resistance involves adaptation and coping to
sustain defense mechanisms.
Subtopic: Stress as a Biological Response
14. The “fight-or-flight” response is mediated by which
system?
A. Parasympathetic nervous system
B. Central nervous system
C. Sympathetic nervous system ☆
D. Enteric nervous system
Rationale: Sympathetic activation triggers
epinephrine/norepinephrine release.
Subtopic: Stress as a Biological Response
15. Which neurotransmitter level rises sharply during
acute stress?
A. Serotonin
B. Dopamine
C. Norepinephrine ☆
D. GABA
, Rationale: Norepinephrine from the locus coeruleus
increases vigilance and arousal.
Subtopic: Stress as a Biological Response
16. Prolonged exposure to cortisol can lead to:
A. Enhanced wound healing
B. Immunosuppression ☆
C. Bone density increase
D. Hypoglycemia
Rationale: Chronic cortisol elevation suppresses immune
function and increases glucose.
Subtopic: Stress as a Biological Response
17. Which gland is the “master gland” initiating the
stress response?
A. Thyroid
B. Pituitary ☆
C. Adrenal
D. Pineal
Rationale: The anterior pituitary secretes ACTH in
response to CRH from the hypothalamus.
Subtopic: Stress as a Biological Response
18. The hypothalamic–pituitary–adrenal axis includes:
A. CRH → ACTH → Cortisol ☆
B. CRH → TSH → Thyroxine
C. ACTH → CRH → Epinephrine
D. GnRH → LH → Estrogen
Rationale: CRH from the hypothalamus prompts pituitary
