,
,Chapter 01: Mental Health and Mental Illness
5r 5r 5r 5r 5r 5r
Halter: Varcarolis’ Foundations of Psychiatric-
5r 5r 5r 5r
Mental Health Nursing: A Clinical Approach, 9th Edition
5r 5r 5r 5r 5r 5r 5r
MULTIPLE CHOICE 5r
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
a. Conducting a mental health assessment. 5r 5r 5r 5r
b. Prescribing psychotropic medication. 5r 5r
c. Establishing a therapeutic relationship. 5r 5r 5r
d. Individualizing a nursing care plan. 5r 5r 5r 5r
ANS: 5 r B
In most states, prescriptive privileges are granted to master‘s-
5r 5r 5r 5r 5r 5r 5r 5r
prepared nurse practitioners and clinical nurse specialists who have taken special courses on p
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
rescribing medication. The nurse prepared at the basic level is permitted to perform mental he
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
alth assessments, establish relationships, and provide individualized care planning.
5r 5r 5r 5r 5r 5r 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Understand (Comprehension) 5r 5r 5r
TOP: 5 r Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
5r 5r 5 r 5r 5r 5r 5r 5r
2. A nursing student expresses concerns that mental health nurses ―lose all their clinical nursing
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
skills.‖ Select the best response by the mental health nurse.
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
a. ―Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
5r 5r 5r 5r 5r 5r 5r 5r 5r
client ratios must be better because of the nature of the clients‘ problems.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
b. ―Psychiatric nurses use complex communication skills as well as critical thinking
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
to solve multidimensional problems. I am challenged by those situations.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
c. ―That‘s a misconception. Psychiatric nurses frequently use high technology
5r 5r 5r 5r 5r 5r 5r 5r 5
monitoring equipment and manage complex intravenous therapies.‖
r 5r 5r 5r 5r 5r 5r
d. ―Psychiatric nurses do not have to deal with as much pain and suffering as
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
medical–surgical nurses do. That appeals to me.‖
5r 5r 5r 5r 5r 5r 5r
ANS: 5 r B
The practice of psychiatric nursing requires a different set of skills than medical–
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help c
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
lients with medical as well as mental health problems, reflecting the holistic perspective these
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
nurses must have. Nurse– 5r 5r 5r
client ratios and workloads in psychiatric settings have increased, just like other specialties. P
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
sychiatric nursing involves clinical practice, not just documentation.
5r 5r 5r 5r 5r 5r 5r
Psychosocial pain and suffering are as real as physical pain and suffering.
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Apply (Application) 5r 5r 5r
TOP: 5 r Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
5r 5r 5 r 5r 5r 5r 5r 5r
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed wit
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
h mental illness, a group of nurses write letters to their elected representatives in opposition
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
to the legislation. Which role have the nurses fulfilled?
5r 5r 5r 5r 5r 5r 5r 5r
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice 5r
, ANS: 5 r C
An advocate defends or asserts another‘s cause, particularly when the other person lacks the
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
ability to do that for self. Examples of individual advocacy include helping clients understand
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
their rights or make decisions. On a community scale, advocacy includes political activity, p
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
ublic speaking, and publication in the interest of improving the human condition. Since fundi
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
ng is necessary to deliver quality programming for persons with mental illness, the letter-
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
writing campaign advocates for that cause on behalf of clients who are unable to articulate t
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
heir own needs. 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Understand (Comprehension) 5r 5r 5r
TOP: 5 r Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
5r 5r 5 r 5r 5r 5r 5r 5r
4. A family has a long history of conflicted relationships among the members. Which family
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
member‘s comment best reflects a mentally healthy perspective?
5r 5r 5r 5r 5r 5r 5r 5r
a. ―I‘ve made mistakes but everyone else in this family has also.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
b. ―I remember joy and mutual respect from our early years together.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
c. ―I will make some changes in my behavior for the good of the family.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
d. ―It‘s best for me to move away from my family. Things will never change.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
ANS: 5 r C
The correct response demonstrates the best evidence of a healthy recognition of the importa
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
nce of relationships. Mental health includes rational thinking, communication skills, learning
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
, emotional growth, resilience, and self-
5r 5r 5r 5r 5r
esteem. Recalling joy from earlier in life may be healthy, but the correct response shows a hi
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
gher level of mental health. The other incorrect responses show blaming and avoidance.
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Analyze (Analysis) 5r 5r 5r
TOP: 5 r Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
5r 5r 5 r 5r 5r 5r
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
illness?
5r
a. reporting occasional sleeplessness and anxiety. 5r 5r 5r 5r
b. reporting a consistently sad, discouraged, and hopeless mood.5r 5r 5r 5r 5r 5r 5r
c. being able to describe the difference between ―as if‖ and ―for real.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
d. experiencing difficulty making a decision about whether to change jobs. 5r 5r 5r 5r 5r 5r 5r 5r 5r
ANS: 5 r B
The correct response describes a mood alteration, which reflects mental illness. The distracters
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
describe behaviors that are mentally healthy or within the usual scope of human experience.
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Apply (Application) 5r 5r 5r
TOP: 5 r Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
5r 5r 5 r 5r 5r 5r
6. Which finding best indicates that the goal ―Demonstrate mentally healthy behavior‖ was
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
5r achieved for an adult client? 5r 5r 5r 5r
a. being willing to work towards achieving ideals and meeting demands.
5r 5r 5r 5r 5r 5r 5r 5r 5r
b. behaving without considering the consequences of personal actions.
5r 5r 5r 5r 5r 5r 5r
c. aggressively meeting personal needs without considering the rights of others. 5r 5r 5r 5r 5r 5r 5r 5r 5r
d. seeking help from others to avoid assuming responsibility for major areas of own
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
life. 5r
,Chapter 01: Mental Health and Mental Illness
5r 5r 5r 5r 5r 5r
Halter: Varcarolis’ Foundations of Psychiatric-
5r 5r 5r 5r
Mental Health Nursing: A Clinical Approach, 9th Edition
5r 5r 5r 5r 5r 5r 5r
MULTIPLE CHOICE 5r
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
a. Conducting a mental health assessment. 5r 5r 5r 5r
b. Prescribing psychotropic medication. 5r 5r
c. Establishing a therapeutic relationship. 5r 5r 5r
d. Individualizing a nursing care plan. 5r 5r 5r 5r
ANS: 5 r B
In most states, prescriptive privileges are granted to master‘s-
5r 5r 5r 5r 5r 5r 5r 5r
prepared nurse practitioners and clinical nurse specialists who have taken special courses on p
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
rescribing medication. The nurse prepared at the basic level is permitted to perform mental he
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
alth assessments, establish relationships, and provide individualized care planning.
5r 5r 5r 5r 5r 5r 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Understand (Comprehension) 5r 5r 5r
TOP: 5 r Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
5r 5r 5 r 5r 5r 5r 5r 5r
2. A nursing student expresses concerns that mental health nurses ―lose all their clinical nursing
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
skills.‖ Select the best response by the mental health nurse.
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
a. ―Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
5r 5r 5r 5r 5r 5r 5r 5r 5r
client ratios must be better because of the nature of the clients‘ problems.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
b. ―Psychiatric nurses use complex communication skills as well as critical thinking
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
to solve multidimensional problems. I am challenged by those situations.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
c. ―That‘s a misconception. Psychiatric nurses frequently use high technology
5r 5r 5r 5r 5r 5r 5r 5r 5
monitoring equipment and manage complex intravenous therapies.‖
r 5r 5r 5r 5r 5r 5r
d. ―Psychiatric nurses do not have to deal with as much pain and suffering as
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
medical–surgical nurses do. That appeals to me.‖
5r 5r 5r 5r 5r 5r 5r
ANS: 5 r B
The practice of psychiatric nursing requires a different set of skills than medical–
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help c
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
lients with medical as well as mental health problems, reflecting the holistic perspective these
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
nurses must have. Nurse– 5r 5r 5r
client ratios and workloads in psychiatric settings have increased, just like other specialties. P
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
sychiatric nursing involves clinical practice, not just documentation.
5r 5r 5r 5r 5r 5r 5r
Psychosocial pain and suffering are as real as physical pain and suffering.
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Apply (Application) 5r 5r 5r
TOP: 5 r Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
5r 5r 5 r 5r 5r 5r 5r 5r
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed wit
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
h mental illness, a group of nurses write letters to their elected representatives in opposition
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
to the legislation. Which role have the nurses fulfilled?
5r 5r 5r 5r 5r 5r 5r 5r
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice 5r
, ANS: 5 r C
An advocate defends or asserts another‘s cause, particularly when the other person lacks the
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
ability to do that for self. Examples of individual advocacy include helping clients understand
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
their rights or make decisions. On a community scale, advocacy includes political activity, p
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
ublic speaking, and publication in the interest of improving the human condition. Since fundi
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
ng is necessary to deliver quality programming for persons with mental illness, the letter-
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
writing campaign advocates for that cause on behalf of clients who are unable to articulate t
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
heir own needs. 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Understand (Comprehension) 5r 5r 5r
TOP: 5 r Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
5r 5r 5 r 5r 5r 5r 5r 5r
4. A family has a long history of conflicted relationships among the members. Which family
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
member‘s comment best reflects a mentally healthy perspective?
5r 5r 5r 5r 5r 5r 5r 5r
a. ―I‘ve made mistakes but everyone else in this family has also.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
b. ―I remember joy and mutual respect from our early years together.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
c. ―I will make some changes in my behavior for the good of the family.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
d. ―It‘s best for me to move away from my family. Things will never change.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
ANS: 5 r C
The correct response demonstrates the best evidence of a healthy recognition of the importa
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
nce of relationships. Mental health includes rational thinking, communication skills, learning
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
, emotional growth, resilience, and self-
5r 5r 5r 5r 5r
esteem. Recalling joy from earlier in life may be healthy, but the correct response shows a hi
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
gher level of mental health. The other incorrect responses show blaming and avoidance.
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Analyze (Analysis) 5r 5r 5r
TOP: 5 r Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
5r 5r 5 r 5r 5r 5r
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
illness?
5r
a. reporting occasional sleeplessness and anxiety. 5r 5r 5r 5r
b. reporting a consistently sad, discouraged, and hopeless mood.5r 5r 5r 5r 5r 5r 5r
c. being able to describe the difference between ―as if‖ and ―for real.‖
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
d. experiencing difficulty making a decision about whether to change jobs. 5r 5r 5r 5r 5r 5r 5r 5r 5r
ANS: 5 r B
The correct response describes a mood alteration, which reflects mental illness. The distracters
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
describe behaviors that are mentally healthy or within the usual scope of human experience.
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
PTS: 5 r 5 r 1 DIF: Cognitive Level: Apply (Application) 5r 5r 5r
TOP: 5 r Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
5r 5r 5 r 5r 5r 5r
6. Which finding best indicates that the goal ―Demonstrate mentally healthy behavior‖ was
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
5r achieved for an adult client? 5r 5r 5r 5r
a. being willing to work towards achieving ideals and meeting demands.
5r 5r 5r 5r 5r 5r 5r 5r 5r
b. behaving without considering the consequences of personal actions.
5r 5r 5r 5r 5r 5r 5r
c. aggressively meeting personal needs without considering the rights of others. 5r 5r 5r 5r 5r 5r 5r 5r 5r
d. seeking help from others to avoid assuming responsibility for major areas of own
5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r 5r
life. 5r
