PSYCHIATRIC-MENTAL HEALTH NURSING
10TH EDITION
• AUTHOR(S)SHEILA L. VIDEBECK
TEST BANK
UNIT 1 — CURRENT THEORIES & PRACTICE
1
Reference: Ch. 1 — Introduction / Mental Health and Mental
Illness
Stem: A 28-year-old man is admitted to the psychiatric unit
after an emergency department visit for acute psychosis. He is
alert but disorganized, reports hearing voices that tell him to
“avoid the nurses,” and is suspicious of staff. As the assigned
nurse, which initial nursing action best reflects a therapeutic,
safety-focused approach while establishing rapport?
,A. Immediately confront the patient about the voices and insist
they describe the content.
B. Introduce yourself, explain your role, offer a quiet area, and
ask permission to sit at eye level.
C. Tell the patient the voices are not real and encourage him to
ignore them.
D. Ask other staff to leave the room and rapidly proceed with a
full psychosocial history.
Correct answer: B
Rationale — Correct: Introducing yourself, clarifying your role,
offering a low-stimulation environment, and requesting
permission to sit at eye level respects the patient’s autonomy
and safety while beginning a therapeutic relationship. This
approach reduces anxiety, models respectful communication,
and allows assessment of reality testing and risk without
escalating distress. It aligns with foundational psychiatric
nursing practice emphasizing safety and rapport.
Rationale — Incorrect:
A. Confronting the patient immediately about voices is likely to
increase distress and distrust; it is premature without rapport.
C. Telling the patient the voices are not real dismisses the
patient’s experience and can damage trust and therapeutic
alliance.
D. Removing others and rapidly completing a full history may
feel coercive and overwhelming; assessment should be paced
and collaborative.
,Teaching point: Start with respectful introduction, safety, and
permission-based engagement before in-depth assessment.
Citation: Videbeck, S. L. (2025). Psychiatric–Mental Health
Nursing (10th ed.). Ch. 1.
2
Reference: Ch. 1 — Mental Health and Mental Illness
Stem: A primary care provider refers a 45-year-old woman for
psychiatric nursing follow-up because she reports persistent
sadness, reduced energy, and loss of interest for two weeks
after recently losing her job. The patient expresses guilt but
denies suicidal ideation and maintains activities of daily living.
Which assessment approach by the psychiatric nurse best
differentiates bereavement from a major depressive episode?
A. Document the symptoms and schedule a follow-up in four
weeks without further assessment.
B. Ask about the duration, intensity of depressive cognitions,
functional impairment, and presence of suicidal ideation.
C. Immediately initiate antidepressant medication because
symptoms meet DSM time criteria.
D. Advise that sadness after a loss is normal and avoid further
exploration.
Correct answer: B
, Rationale — Correct: Differentiating bereavement from major
depressive disorder requires assessment of duration, intensity,
functional impairment, cognitive symptoms (e.g.,
worthlessness), and safety. Asking targeted questions about
suicidality and impairment allows clinical judgment and
appropriate care planning (monitoring versus initiation of
treatment). This aligns with evidence-based assessment and
DSM-informed evaluation.
Rationale — Incorrect:
A. Waiting without targeted assessment risks missing worsening
symptoms or safety concerns.
C. Immediate pharmacologic treatment is premature without
full assessment and consideration of bereavement vs.
depressive disorder.
D. Minimizing the patient’s distress by only normalizing it may
neglect clinical signs of pathological depression or suicide risk.
Teaching point: Evaluate duration, impairment, cognition, and
safety to distinguish bereavement from major depression.
Citation: Videbeck, S. L. (2025). Psychiatric–Mental Health
Nursing (10th ed.). Ch. 1.
3
Reference: Ch. 1 — Diagnostic and Statistical Manual of Mental
Disorders (DSM)
10TH EDITION
• AUTHOR(S)SHEILA L. VIDEBECK
TEST BANK
UNIT 1 — CURRENT THEORIES & PRACTICE
1
Reference: Ch. 1 — Introduction / Mental Health and Mental
Illness
Stem: A 28-year-old man is admitted to the psychiatric unit
after an emergency department visit for acute psychosis. He is
alert but disorganized, reports hearing voices that tell him to
“avoid the nurses,” and is suspicious of staff. As the assigned
nurse, which initial nursing action best reflects a therapeutic,
safety-focused approach while establishing rapport?
,A. Immediately confront the patient about the voices and insist
they describe the content.
B. Introduce yourself, explain your role, offer a quiet area, and
ask permission to sit at eye level.
C. Tell the patient the voices are not real and encourage him to
ignore them.
D. Ask other staff to leave the room and rapidly proceed with a
full psychosocial history.
Correct answer: B
Rationale — Correct: Introducing yourself, clarifying your role,
offering a low-stimulation environment, and requesting
permission to sit at eye level respects the patient’s autonomy
and safety while beginning a therapeutic relationship. This
approach reduces anxiety, models respectful communication,
and allows assessment of reality testing and risk without
escalating distress. It aligns with foundational psychiatric
nursing practice emphasizing safety and rapport.
Rationale — Incorrect:
A. Confronting the patient immediately about voices is likely to
increase distress and distrust; it is premature without rapport.
C. Telling the patient the voices are not real dismisses the
patient’s experience and can damage trust and therapeutic
alliance.
D. Removing others and rapidly completing a full history may
feel coercive and overwhelming; assessment should be paced
and collaborative.
,Teaching point: Start with respectful introduction, safety, and
permission-based engagement before in-depth assessment.
Citation: Videbeck, S. L. (2025). Psychiatric–Mental Health
Nursing (10th ed.). Ch. 1.
2
Reference: Ch. 1 — Mental Health and Mental Illness
Stem: A primary care provider refers a 45-year-old woman for
psychiatric nursing follow-up because she reports persistent
sadness, reduced energy, and loss of interest for two weeks
after recently losing her job. The patient expresses guilt but
denies suicidal ideation and maintains activities of daily living.
Which assessment approach by the psychiatric nurse best
differentiates bereavement from a major depressive episode?
A. Document the symptoms and schedule a follow-up in four
weeks without further assessment.
B. Ask about the duration, intensity of depressive cognitions,
functional impairment, and presence of suicidal ideation.
C. Immediately initiate antidepressant medication because
symptoms meet DSM time criteria.
D. Advise that sadness after a loss is normal and avoid further
exploration.
Correct answer: B
, Rationale — Correct: Differentiating bereavement from major
depressive disorder requires assessment of duration, intensity,
functional impairment, cognitive symptoms (e.g.,
worthlessness), and safety. Asking targeted questions about
suicidality and impairment allows clinical judgment and
appropriate care planning (monitoring versus initiation of
treatment). This aligns with evidence-based assessment and
DSM-informed evaluation.
Rationale — Incorrect:
A. Waiting without targeted assessment risks missing worsening
symptoms or safety concerns.
C. Immediate pharmacologic treatment is premature without
full assessment and consideration of bereavement vs.
depressive disorder.
D. Minimizing the patient’s distress by only normalizing it may
neglect clinical signs of pathological depression or suicide risk.
Teaching point: Evaluate duration, impairment, cognition, and
safety to distinguish bereavement from major depression.
Citation: Videbeck, S. L. (2025). Psychiatric–Mental Health
Nursing (10th ed.). Ch. 1.
3
Reference: Ch. 1 — Diagnostic and Statistical Manual of Mental
Disorders (DSM)
