test bank for
varcarolis essentials of psychiatric
mental health nursing, 5th edition
by fosbre |chapters 1-28 |100% verified answers
,table of contents
chapter 01: practicing the science and the art of psychiatric nursing....................................................3
chapter 02: mental health and mental illness ......................................................................................3
chapter 03: theories and therapies ................................................................................................... 10
chapter 04: biological basis for understanding psychopharmacology ................................................. 23
chapter 05: settings for psychiatric care ............................................................................................ 35
chapter 06: legal and ethical basis for practice.................................................................................. 46
chapter 07: nursing process and qsen: the foundation for safe and effective care .............................. 58
chapter 08: communication skills: medium for all nursing practice .................................................... 71
chapter 09: therapeutic relationships and the clinical interview ........................................................ 81
chapter 10: trauma and stress-related disorders ............................................................................... 94
chapter 11: anxiety, anxiety disorders, and obsessive-compulsive disorders..................................... 104
chapter 12: somatic system disorders and dissociative disorders ..................................................... 122
chapter 13: personality disorders.................................................................................................... 135
chapter 14: eating disorders ........................................................................................................... 148
chapter 15: mood disorders: depression .......................................................................................... 160
chapter 16: bipolar spectrum disorders ........................................................................................... 175
chapter 17: schizophrenia spectrum disorders and other psychotic disorders ................................... 190
chapter 18: neurocognitive disorders .............................................................................................. 208
chapter 19: substance-related and addictive disorders .................................................................... 221
chapter 20: crisis and mass disaster ................................................................................................ 240
chapter 21: child, partner, and elder violence.................................................................................. 252
chapter 22: sexual violence ............................................................................................................ 264
chapter 23: suicidal thoughts and behavior..................................................................................... 275
chapter 24: anger, aggression, and violence ................................................................................... 288
chapter 25: care for the dying and those who grieve ....................................................................... 303
chapter 26: children and adolescents .............................................................................................. 316
chapter 27: adults .......................................................................................................................... 327
chapter 28: older adults ................................................................................................................. 341
,chapter 01: practicing the science and the art of psychiatric nursing
chapter 02: mental health and mental illness
multiple choice
1. an 86-year-old, previously healthy and independent, falls after an episode of vertigo. which
behavior by this patient best demonstrates resilience? the patient:
a. says, i knew this would happen eventually.
b. stops attending her weekly water aerobics class.
c. refuses to use a walker and says, i dont need that silly thing.
d. says, maybe some physical therapy will help me with my balance.
ans: d
resiliency is the ability to recover from or adjust to misfortune and change. the correct response
indicates that the patient is hopeful and thinking positively about ways to adapt to the vertigo. saying
i knew this would happen eventually and discontinuing healthy activities suggest a hopeless
perspective on the health change.
refusing to use a walker indicates denial.
dif: cognitive level: comprehension (understanding) ref: 14
top: nursing process: assessment msc: nclex: psychosocial integrity
2. a patient is admitted to the psychiatric hospital. which assessment finding best indicates that
thepatient has a mental illness? the patient:
a. describes coping and relaxation strategies used when feeling anxious.
b. describes mood as consistently sad, discouraged, and hopeless.
c. can perform tasks attempted within the limits of own abilities.
d. reports occasional problems with insomnia. ans: b
,a patient who reports having a consistently negative mood is describing a mood alteration. the
incorrect options describe mentally healthy behaviors and common problems that donot indicate
mental illness.
dif: cognitive level: application (applying) ref: 11
top: nursing process: assessment msc: nclex: psychosocial integrity
3. the goal for apatient is to increase resiliency. which outcome should a nurse add to the plan of
care?
within 3 days, the patient will:
a. describe feelings associated with loss and stress.
b. meet own needs without considering the rights of others.
c. identify healthy coping behaviors in response to stressful events.
d. allow others to assume responsibility for major areas of own life. ans: c
the patients ability to identify healthy coping behaviors indicates adaptive, healthy behavior and
demonstrates an increased ability to recover from severe stress. describing feelings associated with
loss and stress does not move the patient toward adaptation. the remaining options are maladaptive
behaviors.
dif: cognitive level: analysis (analyzing) ref: 14 top: nursing process: outcomes identification msc:
nclex: psychosocial integrity
4. which organization actively seeks to reduce the stigma associated with mental illness through
public presentations such as in our own voice (ioov)?
a. american psychiatric association (apa)
b. national alliance on mental illness (nami)
c. united states department of health and human services (usdhhs)
d. north american nursing diagnosis association international (nanda-i) ans: b
stigma represents the bias and prejudice commonly held regarding mental illness. namiactively seeks
to dispel misconceptions about mental illness. nanda-i defines approved nursing diagnoses.the apa
publishes the dsm 5. the usdhhs regulates and administers health policies.
dif: cognitive level: knowledge (remembering) ref: 19
top: nursing process: evaluation msc: nclex: safe, effective care environment
5. a nursemust assess several new patients at a community mental health center. conclusions
concerning current functioning should be made on the basis of:
a. the degree of conformity of the individual to societys norms.
,b. the degree to which an individual is logical and rational.
c. a continuum from mentally healthy to unhealthy.
d. the rate of intellectual and emotional growth. ans: c
because mental health and mental illness are relative concepts, assessment of functioning is made by
using a continuum. mental health is not based on conformity; some mentally healthy individuals do
not conform to societys norms. most individuals occasionally displayillogical or irrational thinking. the
rate of intellectual and emotional growth is not the most useful criterion to assess mental health or
mental illness.
dif: cognitive level: application (applying) ref: 11
top: nursing process: diagnosis| nursing process: analysis msc: nclex: psychosocial integrity
6. a nurse at a behavioral health clinic sees an unfamiliar psychiatric diagnosis on a patients
insurance form.
which resource should the nurse consult to discern the criteria used to establish this diagnosis?
a. a psychiatric nursing textbook
b. nanda international (nanda-i )
c. a behavioral health reference manual
d. diagnostic and statistical manual of mental disorders (dsm-5) ans: d
the dsm-5 gives the criteria used to diagnose each mental disorder. the nanda-i focuses on nursing
diagnoses. a psychiatric nursing textbook or behavioral health reference manualmay not contain
diagnostic criteria.
dif: cognitive level: application (applying) ref: 12
top: nursing process: analysis| nursing process: diagnosis msc: nclex: safe, effectivecare environment
7. a 40-year-old adult living with parents states, im happy but i dont socialize much. my work is
routine.
when new things come up, my boss explains them a few times to make sure i understand.at home, my
parents make decisions for me, and i go along with them. a nurse should identify interventions to
improve this patients:
a. self-concept.
,b. overall happiness.
c. appraisal of reality.
d. control over behavior. ans: a
the patient feels the need for multiple explanations of new tasks at work and, despite being40 years
of age, allows both parents to make all decisions. these behaviors indicate a poorly developed self-
concept. although the patient reports being happy, the subsequent comments refute that self-
appraisal. the patients comments do not indicate that he/she is out of touch with reality. the patients
needs are broader than control over own behavior.
dif: cognitive level: application (applying) ref: 11
top: nursing process: planning msc: nclex: psychosocial integrity
8. a patient tells a nurse, i have psychiatric problems and am in and out of hospitals all the time. not
one of 9my friends or relatives has these problems. select the nurses best response.
a. comparing yourself with others has no real advantages.
b. why do you blame yourself for having a psychiatric illness?
c. mental illness affects 50% of the adult population in any given year.
d. it sounds like you are concerned that others dont experience the same challenges as you.
ans: d
mental illness affects many people at various times in their lives. no class, culture, or creedis immune
to the challenges of mental illness. the correct response also demonstrates theuse of reflection, a
therapeutic communication technique. it is not true that mental illness affects 50% of the population
in any given year.
asking patients if they blame themselves is an example of probing.dif: cognitive level: application
(applying) ref: 11
top: nursing process: implementation msc: nclex: psychosocial integrity
9. a critical care nurse asks a psychiatric nurse about the difference between a diagnosis in the
diagnostic and statistical manual of mental disorders (dsm-5) and a nursing diagnosis. select the
psychiatric nurses best response.
a. no functional difference exists between the two diagnoses. both serve to identify a human
deviance.
b. the dsm-5 diagnosis disregards culture, whereas the nursing diagnosis includes cultural
variables.
c. the dsm-5 diagnosis profiles present distress or disability, whereas a nursing diagnosis
considers past and present responses to actual mental health problems.
, d. the dsm-5 diagnosis influences the medical treatment; the nursing diagnosis offers a
framework to identify interventions for problems a patient has or may experience.
ans: d
the medical diagnosis, defined according to the dsm-5, is concerned with the patients disease state,
causes, and cures, whereas the nursing diagnosis focuses on the patients response to stress and
possible caring interventions. both the dsm-5 and a nursing diagnosis consider culture. nursing
diagnoses also consider potential problems.
dif: cognitive level: application (applying) ref: 16
top: nursing process: implementation msc: nclex: safe, effective care environment
10.the spouse of a patient diagnosed with schizophrenia says, i dont understand why childhood
experiences have anything to do with this disabling illness. select the nurses response that will best
help the spouse understand this condition.
a. psychological stress is actually at the root of most mental disorders.
b. we now know that all mental illnesses are the result of genetic factors.
c. it must be frustrating for you that your spouse is sick so much of the time.
d. although this disorder more likely has a biological rather than psychological origin, the
support and involvement of caregivers is very important.
ans: d
many of the most prevalent and disabling mental disorders have been found to have strong biological
influences. helping the spouse understand the importance of his or her role as a caregiver is also
important.
empathy is important but does not increase the spouses level of knowledge about the causeof the
patients condition. not all mental illnesses are the result of genetic factors.
psychological stress is not at the root of most mental disorders.dif:
cognitive level: application (applying) ref: 14
top: nursing process: implementation msc: nclex: health promotion and maintenance
11. which belief by a nurse supports the highest degree of patient advocacy during a multidisciplinary
patient care planning session?
a. all mental illnesses are culturally determined.
b. schizophrenia and bipolar disorder are cross-cultural disorders.
c. symptoms of mental disorders are constant from culture to culture.
d. some symptoms of mental disorders may reflect a persons cultural patterns.
ans: d
varcarolis essentials of psychiatric
mental health nursing, 5th edition
by fosbre |chapters 1-28 |100% verified answers
,table of contents
chapter 01: practicing the science and the art of psychiatric nursing....................................................3
chapter 02: mental health and mental illness ......................................................................................3
chapter 03: theories and therapies ................................................................................................... 10
chapter 04: biological basis for understanding psychopharmacology ................................................. 23
chapter 05: settings for psychiatric care ............................................................................................ 35
chapter 06: legal and ethical basis for practice.................................................................................. 46
chapter 07: nursing process and qsen: the foundation for safe and effective care .............................. 58
chapter 08: communication skills: medium for all nursing practice .................................................... 71
chapter 09: therapeutic relationships and the clinical interview ........................................................ 81
chapter 10: trauma and stress-related disorders ............................................................................... 94
chapter 11: anxiety, anxiety disorders, and obsessive-compulsive disorders..................................... 104
chapter 12: somatic system disorders and dissociative disorders ..................................................... 122
chapter 13: personality disorders.................................................................................................... 135
chapter 14: eating disorders ........................................................................................................... 148
chapter 15: mood disorders: depression .......................................................................................... 160
chapter 16: bipolar spectrum disorders ........................................................................................... 175
chapter 17: schizophrenia spectrum disorders and other psychotic disorders ................................... 190
chapter 18: neurocognitive disorders .............................................................................................. 208
chapter 19: substance-related and addictive disorders .................................................................... 221
chapter 20: crisis and mass disaster ................................................................................................ 240
chapter 21: child, partner, and elder violence.................................................................................. 252
chapter 22: sexual violence ............................................................................................................ 264
chapter 23: suicidal thoughts and behavior..................................................................................... 275
chapter 24: anger, aggression, and violence ................................................................................... 288
chapter 25: care for the dying and those who grieve ....................................................................... 303
chapter 26: children and adolescents .............................................................................................. 316
chapter 27: adults .......................................................................................................................... 327
chapter 28: older adults ................................................................................................................. 341
,chapter 01: practicing the science and the art of psychiatric nursing
chapter 02: mental health and mental illness
multiple choice
1. an 86-year-old, previously healthy and independent, falls after an episode of vertigo. which
behavior by this patient best demonstrates resilience? the patient:
a. says, i knew this would happen eventually.
b. stops attending her weekly water aerobics class.
c. refuses to use a walker and says, i dont need that silly thing.
d. says, maybe some physical therapy will help me with my balance.
ans: d
resiliency is the ability to recover from or adjust to misfortune and change. the correct response
indicates that the patient is hopeful and thinking positively about ways to adapt to the vertigo. saying
i knew this would happen eventually and discontinuing healthy activities suggest a hopeless
perspective on the health change.
refusing to use a walker indicates denial.
dif: cognitive level: comprehension (understanding) ref: 14
top: nursing process: assessment msc: nclex: psychosocial integrity
2. a patient is admitted to the psychiatric hospital. which assessment finding best indicates that
thepatient has a mental illness? the patient:
a. describes coping and relaxation strategies used when feeling anxious.
b. describes mood as consistently sad, discouraged, and hopeless.
c. can perform tasks attempted within the limits of own abilities.
d. reports occasional problems with insomnia. ans: b
,a patient who reports having a consistently negative mood is describing a mood alteration. the
incorrect options describe mentally healthy behaviors and common problems that donot indicate
mental illness.
dif: cognitive level: application (applying) ref: 11
top: nursing process: assessment msc: nclex: psychosocial integrity
3. the goal for apatient is to increase resiliency. which outcome should a nurse add to the plan of
care?
within 3 days, the patient will:
a. describe feelings associated with loss and stress.
b. meet own needs without considering the rights of others.
c. identify healthy coping behaviors in response to stressful events.
d. allow others to assume responsibility for major areas of own life. ans: c
the patients ability to identify healthy coping behaviors indicates adaptive, healthy behavior and
demonstrates an increased ability to recover from severe stress. describing feelings associated with
loss and stress does not move the patient toward adaptation. the remaining options are maladaptive
behaviors.
dif: cognitive level: analysis (analyzing) ref: 14 top: nursing process: outcomes identification msc:
nclex: psychosocial integrity
4. which organization actively seeks to reduce the stigma associated with mental illness through
public presentations such as in our own voice (ioov)?
a. american psychiatric association (apa)
b. national alliance on mental illness (nami)
c. united states department of health and human services (usdhhs)
d. north american nursing diagnosis association international (nanda-i) ans: b
stigma represents the bias and prejudice commonly held regarding mental illness. namiactively seeks
to dispel misconceptions about mental illness. nanda-i defines approved nursing diagnoses.the apa
publishes the dsm 5. the usdhhs regulates and administers health policies.
dif: cognitive level: knowledge (remembering) ref: 19
top: nursing process: evaluation msc: nclex: safe, effective care environment
5. a nursemust assess several new patients at a community mental health center. conclusions
concerning current functioning should be made on the basis of:
a. the degree of conformity of the individual to societys norms.
,b. the degree to which an individual is logical and rational.
c. a continuum from mentally healthy to unhealthy.
d. the rate of intellectual and emotional growth. ans: c
because mental health and mental illness are relative concepts, assessment of functioning is made by
using a continuum. mental health is not based on conformity; some mentally healthy individuals do
not conform to societys norms. most individuals occasionally displayillogical or irrational thinking. the
rate of intellectual and emotional growth is not the most useful criterion to assess mental health or
mental illness.
dif: cognitive level: application (applying) ref: 11
top: nursing process: diagnosis| nursing process: analysis msc: nclex: psychosocial integrity
6. a nurse at a behavioral health clinic sees an unfamiliar psychiatric diagnosis on a patients
insurance form.
which resource should the nurse consult to discern the criteria used to establish this diagnosis?
a. a psychiatric nursing textbook
b. nanda international (nanda-i )
c. a behavioral health reference manual
d. diagnostic and statistical manual of mental disorders (dsm-5) ans: d
the dsm-5 gives the criteria used to diagnose each mental disorder. the nanda-i focuses on nursing
diagnoses. a psychiatric nursing textbook or behavioral health reference manualmay not contain
diagnostic criteria.
dif: cognitive level: application (applying) ref: 12
top: nursing process: analysis| nursing process: diagnosis msc: nclex: safe, effectivecare environment
7. a 40-year-old adult living with parents states, im happy but i dont socialize much. my work is
routine.
when new things come up, my boss explains them a few times to make sure i understand.at home, my
parents make decisions for me, and i go along with them. a nurse should identify interventions to
improve this patients:
a. self-concept.
,b. overall happiness.
c. appraisal of reality.
d. control over behavior. ans: a
the patient feels the need for multiple explanations of new tasks at work and, despite being40 years
of age, allows both parents to make all decisions. these behaviors indicate a poorly developed self-
concept. although the patient reports being happy, the subsequent comments refute that self-
appraisal. the patients comments do not indicate that he/she is out of touch with reality. the patients
needs are broader than control over own behavior.
dif: cognitive level: application (applying) ref: 11
top: nursing process: planning msc: nclex: psychosocial integrity
8. a patient tells a nurse, i have psychiatric problems and am in and out of hospitals all the time. not
one of 9my friends or relatives has these problems. select the nurses best response.
a. comparing yourself with others has no real advantages.
b. why do you blame yourself for having a psychiatric illness?
c. mental illness affects 50% of the adult population in any given year.
d. it sounds like you are concerned that others dont experience the same challenges as you.
ans: d
mental illness affects many people at various times in their lives. no class, culture, or creedis immune
to the challenges of mental illness. the correct response also demonstrates theuse of reflection, a
therapeutic communication technique. it is not true that mental illness affects 50% of the population
in any given year.
asking patients if they blame themselves is an example of probing.dif: cognitive level: application
(applying) ref: 11
top: nursing process: implementation msc: nclex: psychosocial integrity
9. a critical care nurse asks a psychiatric nurse about the difference between a diagnosis in the
diagnostic and statistical manual of mental disorders (dsm-5) and a nursing diagnosis. select the
psychiatric nurses best response.
a. no functional difference exists between the two diagnoses. both serve to identify a human
deviance.
b. the dsm-5 diagnosis disregards culture, whereas the nursing diagnosis includes cultural
variables.
c. the dsm-5 diagnosis profiles present distress or disability, whereas a nursing diagnosis
considers past and present responses to actual mental health problems.
, d. the dsm-5 diagnosis influences the medical treatment; the nursing diagnosis offers a
framework to identify interventions for problems a patient has or may experience.
ans: d
the medical diagnosis, defined according to the dsm-5, is concerned with the patients disease state,
causes, and cures, whereas the nursing diagnosis focuses on the patients response to stress and
possible caring interventions. both the dsm-5 and a nursing diagnosis consider culture. nursing
diagnoses also consider potential problems.
dif: cognitive level: application (applying) ref: 16
top: nursing process: implementation msc: nclex: safe, effective care environment
10.the spouse of a patient diagnosed with schizophrenia says, i dont understand why childhood
experiences have anything to do with this disabling illness. select the nurses response that will best
help the spouse understand this condition.
a. psychological stress is actually at the root of most mental disorders.
b. we now know that all mental illnesses are the result of genetic factors.
c. it must be frustrating for you that your spouse is sick so much of the time.
d. although this disorder more likely has a biological rather than psychological origin, the
support and involvement of caregivers is very important.
ans: d
many of the most prevalent and disabling mental disorders have been found to have strong biological
influences. helping the spouse understand the importance of his or her role as a caregiver is also
important.
empathy is important but does not increase the spouses level of knowledge about the causeof the
patients condition. not all mental illnesses are the result of genetic factors.
psychological stress is not at the root of most mental disorders.dif:
cognitive level: application (applying) ref: 14
top: nursing process: implementation msc: nclex: health promotion and maintenance
11. which belief by a nurse supports the highest degree of patient advocacy during a multidisciplinary
patient care planning session?
a. all mental illnesses are culturally determined.
b. schizophrenia and bipolar disorder are cross-cultural disorders.
c. symptoms of mental disorders are constant from culture to culture.
d. some symptoms of mental disorders may reflect a persons cultural patterns.
ans: d
