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Essentials Of Psychiatric Mental Health Nursing 8th Edition
Concepts Of Care In Evidence
Based Practice Morgan Townsend|All Chapters 1-32|With
Ratoinale
,Table of Contents
Chapter 1. Mental Health And Mental Illness Multiple Choice 4
Chapter 2. Biological Implications ........................................ 13
Chapter 3. Ethical And Legal Issues ....................................... 22
Chapter 4. Psychopharmacology .......................................... 33
Chapter 5. Relationship Development And Therapeutic
Communication .................................................................... 48
Chapter 6. The Nursing Process In Psychiatric/Mental Health
Nursing ................................................................................ 60
Chapter 7. Milieu Therapy - Therapeutic Community ............ 70
Chapter 8. Intervention In Groups......................................... 77
Chapter 9. Crisis Intervention ............................................... 87
Chapter 10. The Recovery Model .......................................... 97
Chapter 11. Suicide Prevention ........................................... 106
Chapter 12. Caring For Patients With Mental Illness And
Substance Use Disorders In Generalpractice Settings .......... 115
Chapter 13. Neurocognitive Disorders ................................ 128
Chapter 14. Substance Use And Addictive Disorders ........... 138
Chapter 15. Schizophrenia Spectrum And Other Psychotic
Disorders ............................................................................ 160
Chapter 16. Depressive Disorders ....................................... 183
Chapter 17. Bipolar And Related Disorders ......................... 204
,Chapter 18. Anxiety, Obsessive-Compulsive, And Related
Disorders ............................................................................ 215
Chapter 19. Trauma- And Stressor-Related Disorders ......... 237
Chapter 20. Somatic Symptom And Dissociative Disorders .. 257
Chapter 21. Eating Disorders .............................................. 267
Chapter 22. Personality Disorders ....................................... 276
Chapter 23. Children And Adolescents ................................ 300
Chapter 24. The Aging Individual ........................................ 311
Chapter 25. Survivors Of Abuse And Neglect ....................... 321
Chapter 26. Community Mental Health Nursing ................. 331
Chapter 27. The Bereaved Individual .................................. 340
Chapter 28. Military Families .............................................. 348
Chapter 29. Concepts Of Personality Development ............. 354
Chapter 30. Complementary And Psychosocial Therapies ... 362
Chapter 31. Cultural And Spiritual Concepts Relevant To
Psychiatric Mental Health Nursing ..................................... 371
Chapter 32. Issues Related To Human Sexuality And Gender
Dysphoria ........................................................................... 380
,Chapter 1. Mental Health And Mental Illness Multiple Choice
1. A Nurse Is Assessing A Client Who Is Experiencing Occasional Feelings Of
Sadness Because Of The recent Death Of A Beloved Pet. The Clients Appetite,
Sleep Patterns, And Daily Routine Have Not Changed. How Should The Nurse
Interpret The Clients Behaviors?
1. The Clients Behaviors Demonstrate Mental Illness In The Form Of
Depression.
2. The Clients Behaviors Are Extensive, Which Indicates The Presence Of
Mental Illness.
3. The Clients Behaviors Are Not Congruent With Cultural Norms.
4. The Clients Behaviors Demonstrate No Functional Impairment, Indicating
No Mental Illness.
CORRECT>>>4
RATIONALE: The Nurse Should Assess That The Clients Daily Functioning Is Not
Impaired. The Client Who Experiences Feelings Of Sadness After The Loss Of A
Pet Is Responding Within Normal Expectations. Without Significant Impairment,
The Clients Distress Does Not Indicate A Mental Illness.
Cognitive Level: Analysis Integrated Process:
Assessment
2. At What Point Should The Nurse Determine That A Client Is At Risk For
Developing A Mental Illness?
1. When Thoughts, Feelings, And Behaviors Are Not Reflective Of The DSM-5
Criteria.
2. When Maladaptive Responses To Stress Are Coupled With Interference In
Daily Functioning.
3. When A Client Communicates Significant Distress.
4. When A Client Uses Defense Mechanisms As Ego Protection.
,CORRECT>>>2
RATIONALE: The Nurse Should Determine That The Client Is At Risk For Mental
Illness When responses To Stress Are Maladaptive And Interfere With Daily
Functioning. The DSM-5 Indicates That In Order To Be Diagnosed With A Mental
Illness, Daily Functioning Must Be Significantly Impaired. The Clients Ability To
Communicate Distress Would Be Considered A Positive Attribute.
Cognitive Level: Application Integrated Process:
Assessment
3. A Nurse Is Assessing A Set Of 15-Year-Old Identical Twins Who Respond Very
Differently To Stress .One Twin Becomes Anxious And Irritable, And The Other
Withdraws And Cries. How Should The Nurse Explain These Different Stress
Responses To The Parents?
1. Reactions To Stress Are Relative Rather Than Absolute; Individual
Responses To Stress Vary.
2. It Is Abnormal For Identical Twins To React Differently To Similar
Stressors.
3. Identical Twins Should Share The Same Temperament And Respond
Similarly To Stress.
4. Environmental Influences To Stress Weigh More Heavily Than Genetic
Influences.
CORRECT>>>1
RATIONALE: The Nurse Should Explain To The Parents That, Although The Twins
Have Identical DNA, There Are Several Other Factors That Affect Reactions To
Stress. Mental Health Is A State Of Being That Is Relative To The Individual
Client. Environmental Influences And Temperament Can Affect Stress Reactions.
,Cognitive Level: Application Integrated Process:
Implementation
4. Which Client Should The Nurse Anticipate To Be Most Receptive To Psychiatric
Treatment?
1. A Jewish, Female Social Worker.
2. A Baptist, Homeless Male.
3. A Catholic, Black Male.
4. A Protestant, Swedish Business Executive.
CORRECT>>>1
RATIONALE: The Nurse Should Anticipate That The Client Of Jewish Culture
Would Place A High Importance On Preventative Health Care And Would
Consider Mental Health As Equally Important As Physical Health. Women Are
Also More Likely To Seek Treatment For Mental Health Problems Than Men.
Cognitive Level:
Application Integrated Process: Planning
5. A Psychiatric Nurse Intern States, This Clients Use Of Defense Mechanisms Should Be Eliminated.
Which Is A Correct Evaluation Of This Nurses Statement?
1. Defense Mechanisms Can Be Appropriate Responses To Stress And Need Not Be Eliminated.
2. Defense Mechanisms Are A Maladaptive Attempt Of The Ego To Manage Anxiety And Should
Always Be Eliminated.
3. Defense Mechanisms, Used By Individuals With Weak Ego Integrity, Should Be Discouraged And
Not Eliminated.
4. Defense Mechanisms Cause Disintegration Of The Ego And Should Be Fostered And Encouraged.
CORRECT>>>1
RATIONALE: The Nurse Should Determine That Defense Mechanisms Can Be Appropriate During
Times of Stress. The Client With No Defense Mechanisms May Have A Lower Tolerance For Stress, Thus
, Leading To Anxiety Disorders. Defense Mechanisms Should Be Confronted When They Impede The
Client From Developing Healthy Coping Skills.
Cognitive Level:
Application Integrated Process: Evaluation
6. During An Intake Assessment, A Nurse Asks Both Physiological And Psychosocial Questions. The Client
Angrily Responds, Im Here For My Heart, Not My Head Problems. Which Is The Nurses Best Response?
1. Its Just A Routine Part Of Our Assessment. All Clients Are Asked These Same Questions.
2. Why Are You Concerned About These Types Of Questions?
3. Psychological Factors, Like Excessive Stress, Have Been Found To Affect Medical Conditions.
4. We Can Skip These Questions, If You Like. It Isnt Imperative That We Complete This Section.
CORRECT>>>3
RATIONALE: The Nurse Should Attempt To Educate The Client On The Negative Effects Of
Excessive Stress On Medical Conditions. It Is Not Appropriate To Skip Physiological And Psychosocial
Questions, As This Would Lead To An Inaccurate Assessment.
Cognitive Level: Application Integrated Process:
Implementation
7. An Employee Uses The Defense Mechanism Of Displacement When The Boss Openly Disagrees With
Suggestions. What Behavior Would Be Expected From This Employee?
1. The Employee Assertively Confronts The Boss.
2. The Employee Leaves The Staff Meeting To Work Out In The Gym.
3. The Employee Criticizes A Coworker.
4. The Employee Takes The Boss Out To Lunch.
CORRECT>>>3
RATIONALE: The Nurse Should Expect That The Client Using The Defense Mechanism
Displacement Would Criticize A Coworker After Being Confronted By The Boss.
Displacement Refers To Transferring Feelings From One Target To A Neutral Or Less- Threatening Target.
Essentials Of Psychiatric Mental Health Nursing 8th Edition
Concepts Of Care In Evidence
Based Practice Morgan Townsend|All Chapters 1-32|With
Ratoinale
,Table of Contents
Chapter 1. Mental Health And Mental Illness Multiple Choice 4
Chapter 2. Biological Implications ........................................ 13
Chapter 3. Ethical And Legal Issues ....................................... 22
Chapter 4. Psychopharmacology .......................................... 33
Chapter 5. Relationship Development And Therapeutic
Communication .................................................................... 48
Chapter 6. The Nursing Process In Psychiatric/Mental Health
Nursing ................................................................................ 60
Chapter 7. Milieu Therapy - Therapeutic Community ............ 70
Chapter 8. Intervention In Groups......................................... 77
Chapter 9. Crisis Intervention ............................................... 87
Chapter 10. The Recovery Model .......................................... 97
Chapter 11. Suicide Prevention ........................................... 106
Chapter 12. Caring For Patients With Mental Illness And
Substance Use Disorders In Generalpractice Settings .......... 115
Chapter 13. Neurocognitive Disorders ................................ 128
Chapter 14. Substance Use And Addictive Disorders ........... 138
Chapter 15. Schizophrenia Spectrum And Other Psychotic
Disorders ............................................................................ 160
Chapter 16. Depressive Disorders ....................................... 183
Chapter 17. Bipolar And Related Disorders ......................... 204
,Chapter 18. Anxiety, Obsessive-Compulsive, And Related
Disorders ............................................................................ 215
Chapter 19. Trauma- And Stressor-Related Disorders ......... 237
Chapter 20. Somatic Symptom And Dissociative Disorders .. 257
Chapter 21. Eating Disorders .............................................. 267
Chapter 22. Personality Disorders ....................................... 276
Chapter 23. Children And Adolescents ................................ 300
Chapter 24. The Aging Individual ........................................ 311
Chapter 25. Survivors Of Abuse And Neglect ....................... 321
Chapter 26. Community Mental Health Nursing ................. 331
Chapter 27. The Bereaved Individual .................................. 340
Chapter 28. Military Families .............................................. 348
Chapter 29. Concepts Of Personality Development ............. 354
Chapter 30. Complementary And Psychosocial Therapies ... 362
Chapter 31. Cultural And Spiritual Concepts Relevant To
Psychiatric Mental Health Nursing ..................................... 371
Chapter 32. Issues Related To Human Sexuality And Gender
Dysphoria ........................................................................... 380
,Chapter 1. Mental Health And Mental Illness Multiple Choice
1. A Nurse Is Assessing A Client Who Is Experiencing Occasional Feelings Of
Sadness Because Of The recent Death Of A Beloved Pet. The Clients Appetite,
Sleep Patterns, And Daily Routine Have Not Changed. How Should The Nurse
Interpret The Clients Behaviors?
1. The Clients Behaviors Demonstrate Mental Illness In The Form Of
Depression.
2. The Clients Behaviors Are Extensive, Which Indicates The Presence Of
Mental Illness.
3. The Clients Behaviors Are Not Congruent With Cultural Norms.
4. The Clients Behaviors Demonstrate No Functional Impairment, Indicating
No Mental Illness.
CORRECT>>>4
RATIONALE: The Nurse Should Assess That The Clients Daily Functioning Is Not
Impaired. The Client Who Experiences Feelings Of Sadness After The Loss Of A
Pet Is Responding Within Normal Expectations. Without Significant Impairment,
The Clients Distress Does Not Indicate A Mental Illness.
Cognitive Level: Analysis Integrated Process:
Assessment
2. At What Point Should The Nurse Determine That A Client Is At Risk For
Developing A Mental Illness?
1. When Thoughts, Feelings, And Behaviors Are Not Reflective Of The DSM-5
Criteria.
2. When Maladaptive Responses To Stress Are Coupled With Interference In
Daily Functioning.
3. When A Client Communicates Significant Distress.
4. When A Client Uses Defense Mechanisms As Ego Protection.
,CORRECT>>>2
RATIONALE: The Nurse Should Determine That The Client Is At Risk For Mental
Illness When responses To Stress Are Maladaptive And Interfere With Daily
Functioning. The DSM-5 Indicates That In Order To Be Diagnosed With A Mental
Illness, Daily Functioning Must Be Significantly Impaired. The Clients Ability To
Communicate Distress Would Be Considered A Positive Attribute.
Cognitive Level: Application Integrated Process:
Assessment
3. A Nurse Is Assessing A Set Of 15-Year-Old Identical Twins Who Respond Very
Differently To Stress .One Twin Becomes Anxious And Irritable, And The Other
Withdraws And Cries. How Should The Nurse Explain These Different Stress
Responses To The Parents?
1. Reactions To Stress Are Relative Rather Than Absolute; Individual
Responses To Stress Vary.
2. It Is Abnormal For Identical Twins To React Differently To Similar
Stressors.
3. Identical Twins Should Share The Same Temperament And Respond
Similarly To Stress.
4. Environmental Influences To Stress Weigh More Heavily Than Genetic
Influences.
CORRECT>>>1
RATIONALE: The Nurse Should Explain To The Parents That, Although The Twins
Have Identical DNA, There Are Several Other Factors That Affect Reactions To
Stress. Mental Health Is A State Of Being That Is Relative To The Individual
Client. Environmental Influences And Temperament Can Affect Stress Reactions.
,Cognitive Level: Application Integrated Process:
Implementation
4. Which Client Should The Nurse Anticipate To Be Most Receptive To Psychiatric
Treatment?
1. A Jewish, Female Social Worker.
2. A Baptist, Homeless Male.
3. A Catholic, Black Male.
4. A Protestant, Swedish Business Executive.
CORRECT>>>1
RATIONALE: The Nurse Should Anticipate That The Client Of Jewish Culture
Would Place A High Importance On Preventative Health Care And Would
Consider Mental Health As Equally Important As Physical Health. Women Are
Also More Likely To Seek Treatment For Mental Health Problems Than Men.
Cognitive Level:
Application Integrated Process: Planning
5. A Psychiatric Nurse Intern States, This Clients Use Of Defense Mechanisms Should Be Eliminated.
Which Is A Correct Evaluation Of This Nurses Statement?
1. Defense Mechanisms Can Be Appropriate Responses To Stress And Need Not Be Eliminated.
2. Defense Mechanisms Are A Maladaptive Attempt Of The Ego To Manage Anxiety And Should
Always Be Eliminated.
3. Defense Mechanisms, Used By Individuals With Weak Ego Integrity, Should Be Discouraged And
Not Eliminated.
4. Defense Mechanisms Cause Disintegration Of The Ego And Should Be Fostered And Encouraged.
CORRECT>>>1
RATIONALE: The Nurse Should Determine That Defense Mechanisms Can Be Appropriate During
Times of Stress. The Client With No Defense Mechanisms May Have A Lower Tolerance For Stress, Thus
, Leading To Anxiety Disorders. Defense Mechanisms Should Be Confronted When They Impede The
Client From Developing Healthy Coping Skills.
Cognitive Level:
Application Integrated Process: Evaluation
6. During An Intake Assessment, A Nurse Asks Both Physiological And Psychosocial Questions. The Client
Angrily Responds, Im Here For My Heart, Not My Head Problems. Which Is The Nurses Best Response?
1. Its Just A Routine Part Of Our Assessment. All Clients Are Asked These Same Questions.
2. Why Are You Concerned About These Types Of Questions?
3. Psychological Factors, Like Excessive Stress, Have Been Found To Affect Medical Conditions.
4. We Can Skip These Questions, If You Like. It Isnt Imperative That We Complete This Section.
CORRECT>>>3
RATIONALE: The Nurse Should Attempt To Educate The Client On The Negative Effects Of
Excessive Stress On Medical Conditions. It Is Not Appropriate To Skip Physiological And Psychosocial
Questions, As This Would Lead To An Inaccurate Assessment.
Cognitive Level: Application Integrated Process:
Implementation
7. An Employee Uses The Defense Mechanism Of Displacement When The Boss Openly Disagrees With
Suggestions. What Behavior Would Be Expected From This Employee?
1. The Employee Assertively Confronts The Boss.
2. The Employee Leaves The Staff Meeting To Work Out In The Gym.
3. The Employee Criticizes A Coworker.
4. The Employee Takes The Boss Out To Lunch.
CORRECT>>>3
RATIONALE: The Nurse Should Expect That The Client Using The Defense Mechanism
Displacement Would Criticize A Coworker After Being Confronted By The Boss.
Displacement Refers To Transferring Feelings From One Target To A Neutral Or Less- Threatening Target.
