s s
TEST BANK
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING: CONCEPTS OF CARE IN
EVIDENCE-BASED PRACTICE 8TH EDITION MORGAN, TOWNSEND
ALL CHAPTERS COVERED QUESTIONS AND ANSWERS GRADED A+
NEWEST VERSION.
, s s
Chapter 1. Mental Health and Mental Illness M
s s s s s s s
ultiple Choice s
1. A nurse is assessing a client who is experiencing occasional feelings of sadness because of the rece
s s s s s s s s s s s s s s s s
nt death of a beloved pet. The clients appetite, sleep patterns, and daily routine have not changed. Ho
s s s s s s s s s s s s s s s s s
w should the nurse interpret the clients behaviors?
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1. The clients behaviors demonstrate mental illness in the form of depression.
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2. The clients behaviors are extensive, which indicates the presence of mental illness.
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3. The clients behaviors are not congruent with cultural norms.
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4. The clients behaviors demonstrate no functional impairment, indicating no mental illness.
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ANS: 4 s
Rationale: The nurse should assess that the clients daily functioning is not impaired. The client who e
s s s s s s s s s s s s s s s s
xperiences feelings of sadness after the loss of a pet is responding within normal expectations. Witho
s s s s s s s s s s s s s s s
ut significant impairment, the clients distress does not indicate a mental illness.
s s s s s s s s s s s
Cognitive Level: Analysis Integ s s s
rated Process: Assessment
s s
2. At what point should the nurse determine that a client is at risk for developing a mental illne
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ss?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
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2. When maladaptive responses to stress are coupled with interference in daily functioning.
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3. When a client communicates significant distress.
s s s s s
4. When a client uses defense mechanisms as ego protection.
s s s s s s s s
ANS: 2 s
Rationale: The nurse should determine that the client is at risk for mental illness when responses to str
s s s s s s s s s s s s s s s s s
ess are maladaptive and interfere with daily functioning. The DSM-
s s s s s s s s s
5 indicates that in order to be diagnosed with a mental illness, daily functioning must be significantly i
s s s s s s s s s s s s s s s s s
mpaired. The clients ability to communicate distress would be considered a positive attribute.
s s s s s s s s s s s s
Cognitive Level: Application In s s s
tegrated Process: Assessment s s
3. A nurse is assessing a set of 15-year-
s s s s s s s
old identical twins who respond very differently to stress. One twin becomes anxious and irritable, an
s s s s s s s s s s s s s s s
d the other withdraws and cries. How should the nurse explain these different stress responses to the
s s s s s s s s s s s s s s s s s
parents?
1. Reactions to stress are relative rather than absolute; individual responses to stress vary.
s s s s s s s s s s s s
2. It is abnormal for identical twins to react differently to similar stressors.
s s s s s s s s s s s
3. Identical twins should share the same temperament and respond similarly to stress.
s s s s s s s s s s s
4. Environmental influences to stress weigh more heavily than genetic influences. s s s s s s s s s
, s s
Rationale: The nurse should explain to the parents that, although the twins have identical DNA, there
s s s s s s s s s s s s s s s s
are several other factors that affect reactions to stress. Mental health is a state of being that is relative t
s s s s s s s s s s s s s s s s s s s
o the individual client. Environmental influences and temperament can affect stress reactions.
s s s s s s s s s s s
Cognitive Level: Application Integr s s s
ated Process: Implementation
s s
4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
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1. A Jewish, female social worker.
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2. A Baptist, homeless male.
s s s
3. A Catholic, black male.
s s s
4. A Protestant, Swedish business executive.
s s s s
ANS: 1 s
Rationale: The nurse should anticipate that the client of Jewish culture would place a high importanc
s s s s s s s s s s s s s s s
e on preventative health care and would consider mental health as equally important as physical healt
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h. Women are also more likely to seek treatment for mental health problems than men.
s s s s s s s s s s s s s s
Cognitive Level: Application In s s s
tegrated Process: Planning s s
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be eliminated. Wh
s s s s s s s s s s s s s s
ich is a correct evaluation of this nurses statement?
s s s s s s s s
1. Defense mechanisms can be appropriate responses to stress and need not be eliminated.
s s s s s s s s s s s s
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should alw
s s s s s s s s s s s s s s
ays be eliminated.
s s
3. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not
s s s s s s s s s s s s s s
eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
s s s s s s s s s s s s
ANS: 1 s
Rationale: The nurse should determine that defense mechanisms can be appropriate during times of str
s s s s s s s s s s s s s s
ess. The client with no defense mechanisms may have a lower tolerance for stress, thus leading to anxi
s s s s s s s s s s s s s s s s s
ety disorders. Defense mechanisms should be confronted when they impede the client from developi
s s s s s s s s s s s s s
ng healthy coping skills.
s s s
Cognitive Level: Application In s s s
tegrated Process: Evaluation s s
6. During an intake assessment, a nurse asks both physiological and psychosocial questions. The clie
s s s s s s s s s s s s s
nt angrily responds, Im here for my heart, not my head problems. Which is the nurses best response?
s s s s s s s s s s s s s s s s s
1. Its just a routine part of our assessment. All clients are asked these same questions.
s s s s s s s s s s s s s s
2. Why are you concerned about these types of questions?
s s s s s s s s
3. Psychological factors, like excessive stress, have been found to affect medical conditions. s s s s s s s s s s s
4. We can skip these questions, if you like. It isnt imperative that we complete this section.
s s s s s s s s s s s s s s s
ANS: 3 s
Rationale: The nurse should attempt to educate the client on the negative effects of excessive stress on
s s s s s s s s s s s s s s s s s
medical conditions. It is not appropriate to skip physiological and psychosocial questions, as this wou
s s s s s s s s s s s s s s
ld lead to an inaccurate assessment.
s s s s s
, s s
Cognitive Level: Application Integr s s s
ated Process: Implementation
s s
7. An employee uses the defense mechanism of displacement when the boss openly disagrees wit
s s s s s s s s s s s s s
h suggestions. What behavior would be expected from this employee?
s s s s s s s s s
1. The employee assertively confronts the boss.
s s s s s
2. The employee leaves the staff meeting to work out in the gym.
s s s s s s s s s s s
3. The employee criticizes a coworker.
s s s s
4. The employee takes the boss out to lunch.
s s s s s s s
ANS: 3 s
Rationale: The nurse should expect that the client using the defense mechanism displacement would
s s s s s s s s s s s s s s
criticize a coworker after being confronted by the boss. Displacement refers to transferring feelings f
s s s s s s s s s s s s s s
rom one target to a neutral or less-threatening target.
s s s s s s s s
Cognitive Level: Analysis Integ s s s
rated Process: Assessment
s s
8. A fourth-s
grade boy teases and makes jokes about a cute girl in his class. This behavior should be identified by
s s s s s s s s s s s s s s s s s s s
a nurse as indicative of which defense mechanism?
s s s s s s s
1. Displacement
2. Projection
3. Reaction formation s
4. Sublimation
ANS: 3 s
Rationale: The nurse should identify that the boy is using reaction formation as a defense mechanism.
s s s s s s s s s s s s s s s
Reaction formation is the attempt to prevent undesirable thoughts from being expressed by expressin
s s s s s s s s s s s s s s
g opposite thoughts or behaviors. Displacement refers to transferring feelings from one target to anot
s s s s s s s s s s s s s s
her. Rationalization refers to making excuses to justify behavior. Projection refers to the attribution of
s s s s s s s s s s s s s s
unacceptable feelings or behaviors to another person.
s s s s s s s
Sublimation refers to channeling unacceptable drives or impulses into more constructive, acceptable
s s s s s s s s s s s s
activities.
Cognitive Level: Application In s s s
tegrated Process: Assessment s s
9. Which nursing statement about the concept of neurosis is most accurate?
s s s s s s s s s s
1. An individual experiencing neurosis is unaware that he or she is experiencing distress.
s s s s s s s s s s s s
2. An individual experiencing neurosis feels helpless to change his or her situation.
s s s s s s s s s s s
3. An individual experiencing neurosis is aware of psychological causes of his or her behavior.
s s s s s s s s s s s s s
4. An individual experiencing neurosis has a loss of contact with reality.
s s s s s s s s s s
ANS: 2 s
Rationale: The nurse should define the concept of neurosis with the following characteristics:
s s s s s s s s s s s s
TEST BANK
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING: CONCEPTS OF CARE IN
EVIDENCE-BASED PRACTICE 8TH EDITION MORGAN, TOWNSEND
ALL CHAPTERS COVERED QUESTIONS AND ANSWERS GRADED A+
NEWEST VERSION.
, s s
Chapter 1. Mental Health and Mental Illness M
s s s s s s s
ultiple Choice s
1. A nurse is assessing a client who is experiencing occasional feelings of sadness because of the rece
s s s s s s s s s s s s s s s s
nt death of a beloved pet. The clients appetite, sleep patterns, and daily routine have not changed. Ho
s s s s s s s s s s s s s s s s s
w should the nurse interpret the clients behaviors?
s s s s s s s
1. The clients behaviors demonstrate mental illness in the form of depression.
s s s s s s s s s s
2. The clients behaviors are extensive, which indicates the presence of mental illness.
s s s s s s s s s s s
3. The clients behaviors are not congruent with cultural norms.
s s s s s s s s
4. The clients behaviors demonstrate no functional impairment, indicating no mental illness.
s s s s s s s s s s
ANS: 4 s
Rationale: The nurse should assess that the clients daily functioning is not impaired. The client who e
s s s s s s s s s s s s s s s s
xperiences feelings of sadness after the loss of a pet is responding within normal expectations. Witho
s s s s s s s s s s s s s s s
ut significant impairment, the clients distress does not indicate a mental illness.
s s s s s s s s s s s
Cognitive Level: Analysis Integ s s s
rated Process: Assessment
s s
2. At what point should the nurse determine that a client is at risk for developing a mental illne
s s s s s s s s s s s s s s s s s
ss?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
s s s s s s s s s s s
2. When maladaptive responses to stress are coupled with interference in daily functioning.
s s s s s s s s s s s
3. When a client communicates significant distress.
s s s s s
4. When a client uses defense mechanisms as ego protection.
s s s s s s s s
ANS: 2 s
Rationale: The nurse should determine that the client is at risk for mental illness when responses to str
s s s s s s s s s s s s s s s s s
ess are maladaptive and interfere with daily functioning. The DSM-
s s s s s s s s s
5 indicates that in order to be diagnosed with a mental illness, daily functioning must be significantly i
s s s s s s s s s s s s s s s s s
mpaired. The clients ability to communicate distress would be considered a positive attribute.
s s s s s s s s s s s s
Cognitive Level: Application In s s s
tegrated Process: Assessment s s
3. A nurse is assessing a set of 15-year-
s s s s s s s
old identical twins who respond very differently to stress. One twin becomes anxious and irritable, an
s s s s s s s s s s s s s s s
d the other withdraws and cries. How should the nurse explain these different stress responses to the
s s s s s s s s s s s s s s s s s
parents?
1. Reactions to stress are relative rather than absolute; individual responses to stress vary.
s s s s s s s s s s s s
2. It is abnormal for identical twins to react differently to similar stressors.
s s s s s s s s s s s
3. Identical twins should share the same temperament and respond similarly to stress.
s s s s s s s s s s s
4. Environmental influences to stress weigh more heavily than genetic influences. s s s s s s s s s
, s s
Rationale: The nurse should explain to the parents that, although the twins have identical DNA, there
s s s s s s s s s s s s s s s s
are several other factors that affect reactions to stress. Mental health is a state of being that is relative t
s s s s s s s s s s s s s s s s s s s
o the individual client. Environmental influences and temperament can affect stress reactions.
s s s s s s s s s s s
Cognitive Level: Application Integr s s s
ated Process: Implementation
s s
4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
s s s s s s s s s s s s s
1. A Jewish, female social worker.
s s s s
2. A Baptist, homeless male.
s s s
3. A Catholic, black male.
s s s
4. A Protestant, Swedish business executive.
s s s s
ANS: 1 s
Rationale: The nurse should anticipate that the client of Jewish culture would place a high importanc
s s s s s s s s s s s s s s s
e on preventative health care and would consider mental health as equally important as physical healt
s s s s s s s s s s s s s s s
h. Women are also more likely to seek treatment for mental health problems than men.
s s s s s s s s s s s s s s
Cognitive Level: Application In s s s
tegrated Process: Planning s s
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be eliminated. Wh
s s s s s s s s s s s s s s
ich is a correct evaluation of this nurses statement?
s s s s s s s s
1. Defense mechanisms can be appropriate responses to stress and need not be eliminated.
s s s s s s s s s s s s
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should alw
s s s s s s s s s s s s s s
ays be eliminated.
s s
3. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not
s s s s s s s s s s s s s s
eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
s s s s s s s s s s s s
ANS: 1 s
Rationale: The nurse should determine that defense mechanisms can be appropriate during times of str
s s s s s s s s s s s s s s
ess. The client with no defense mechanisms may have a lower tolerance for stress, thus leading to anxi
s s s s s s s s s s s s s s s s s
ety disorders. Defense mechanisms should be confronted when they impede the client from developi
s s s s s s s s s s s s s
ng healthy coping skills.
s s s
Cognitive Level: Application In s s s
tegrated Process: Evaluation s s
6. During an intake assessment, a nurse asks both physiological and psychosocial questions. The clie
s s s s s s s s s s s s s
nt angrily responds, Im here for my heart, not my head problems. Which is the nurses best response?
s s s s s s s s s s s s s s s s s
1. Its just a routine part of our assessment. All clients are asked these same questions.
s s s s s s s s s s s s s s
2. Why are you concerned about these types of questions?
s s s s s s s s
3. Psychological factors, like excessive stress, have been found to affect medical conditions. s s s s s s s s s s s
4. We can skip these questions, if you like. It isnt imperative that we complete this section.
s s s s s s s s s s s s s s s
ANS: 3 s
Rationale: The nurse should attempt to educate the client on the negative effects of excessive stress on
s s s s s s s s s s s s s s s s s
medical conditions. It is not appropriate to skip physiological and psychosocial questions, as this wou
s s s s s s s s s s s s s s
ld lead to an inaccurate assessment.
s s s s s
, s s
Cognitive Level: Application Integr s s s
ated Process: Implementation
s s
7. An employee uses the defense mechanism of displacement when the boss openly disagrees wit
s s s s s s s s s s s s s
h suggestions. What behavior would be expected from this employee?
s s s s s s s s s
1. The employee assertively confronts the boss.
s s s s s
2. The employee leaves the staff meeting to work out in the gym.
s s s s s s s s s s s
3. The employee criticizes a coworker.
s s s s
4. The employee takes the boss out to lunch.
s s s s s s s
ANS: 3 s
Rationale: The nurse should expect that the client using the defense mechanism displacement would
s s s s s s s s s s s s s s
criticize a coworker after being confronted by the boss. Displacement refers to transferring feelings f
s s s s s s s s s s s s s s
rom one target to a neutral or less-threatening target.
s s s s s s s s
Cognitive Level: Analysis Integ s s s
rated Process: Assessment
s s
8. A fourth-s
grade boy teases and makes jokes about a cute girl in his class. This behavior should be identified by
s s s s s s s s s s s s s s s s s s s
a nurse as indicative of which defense mechanism?
s s s s s s s
1. Displacement
2. Projection
3. Reaction formation s
4. Sublimation
ANS: 3 s
Rationale: The nurse should identify that the boy is using reaction formation as a defense mechanism.
s s s s s s s s s s s s s s s
Reaction formation is the attempt to prevent undesirable thoughts from being expressed by expressin
s s s s s s s s s s s s s s
g opposite thoughts or behaviors. Displacement refers to transferring feelings from one target to anot
s s s s s s s s s s s s s s
her. Rationalization refers to making excuses to justify behavior. Projection refers to the attribution of
s s s s s s s s s s s s s s
unacceptable feelings or behaviors to another person.
s s s s s s s
Sublimation refers to channeling unacceptable drives or impulses into more constructive, acceptable
s s s s s s s s s s s s
activities.
Cognitive Level: Application In s s s
tegrated Process: Assessment s s
9. Which nursing statement about the concept of neurosis is most accurate?
s s s s s s s s s s
1. An individual experiencing neurosis is unaware that he or she is experiencing distress.
s s s s s s s s s s s s
2. An individual experiencing neurosis feels helpless to change his or her situation.
s s s s s s s s s s s
3. An individual experiencing neurosis is aware of psychological causes of his or her behavior.
s s s s s s s s s s s s s
4. An individual experiencing neurosis has a loss of contact with reality.
s s s s s s s s s s
ANS: 2 s
Rationale: The nurse should define the concept of neurosis with the following characteristics:
s s s s s s s s s s s s
