TEST BANK
k
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING: CONCEPTS OF CARE IN
k k k k k k k k k k
EVIDENCE-BASED PRACTICE 8TH EDITION MORGAN, TOWNSEND
k k k k k k k
ALL CHAPTERS COVERED QUESTIONS AND ANSWERS GRADED A+
k k k k k k k k
NEWEST VERSION. k
,Chapter1. MentalHealthandMentalIllness Mk k k
ultipleChoice k
1. Anurse isassessingaclient who isexperiencingoccasionalfeelingsofsadnessbecauseofthe rece
s k k k
ntdeathof a beloved pet. The clients appetite, sleep patterns, and dailyroutine have not changed. Ho
k k k k k k k k k k k k k k k
wshould the nurse interpret the clients behaviors?
k k k k k k k
1. Theclientsbehaviorsdemonstratementalillnessinthe formofdepression. k k
2. Theclientsbehaviorsareextensive, whichindicatesthepresenceofmentalillness. k
3. Theclientsbehaviorsarenot congruent with culturalnorms. k s s
4. Theclientsbehaviorsdemonstratenofunctionalimpairment, indicating nomentalillness. k s k
ANS:4 k
Rationale:Thenurseshouldassessthattheclientsdailyfunctioning isnotimpaired.Theclientwho e
k s k s
kxperiencesfeelingsofsadness aftertheloss ofapetisrespondingwithinnormalexpectations.Witho ut
k k k s k s k k k k k k k k
significant impairment, the clients distress does not indicate a mental illness.
k s k k s k s s k k k
CognitiveLevel:AnalysisInteg k k k
ratedProcess:Assessment
k
2. Atwhatpointshouldthenursedeterminethataclientisat riskfordevelopinga mental illne ss?
k k k s k k
1. Whenthoughts, feelings, and behaviorsarenot reflectiveofthe DSM-5 criteria. k k s s k k
2. Whenmaladaptiveresponses to stressarecoupled withinterference indailyfunctioning. s k k k
3. Whenaclient communicatessignificant distress. k s
4. Whenaclient usesdefensemechanisms as ego protection. k k s k
ANS:2 k
Rationale: Thenurseshoulddeterminethattheclientis at risk formentalillnesswhenresponses to str
k k k k k k
ess aremaladaptive and interfere withdailyfunctioning.TheDSM-
k s k s s k k
5indicatesthat inorderto bediagnosedwithamentalillness,dailyfunctioning must besignificantlyi
k k s k k k k k k s s k
mpaired. The clients ability to communicate distress wouldbe considered a positiveattribute.
k k k k k s k k k k k
CognitiveLevel:ApplicationIn k k k
tegratedProcess:Assessment
k
3. Anurse isassessingaset of15-year- s k
old identicaltwinswhorespond verydifferentlytostress.Onetwinbecomesanxious and irritable,an
s k s k k k k k s s k
dtheotherwithdrawsandcries.Howshouldthenurseexplainthesedifferentstressresponsestothe
k k k k k k k k k k k k k k k
parents?
k
1. Reactionstostressarerelativeratherthanabsolute; individualresponsesto stressvary.
k k k k k
2. It is abnormalforidenticaltwinstoreactdifferentlytosimilarstressors.
k k
3. Identicaltwinsshouldsharethesametemperament andrespond similarlyto stress. k s k
4. Environmentalinfluences tostressweighmoreheavilythangenetic influences. k k k
,Rationale: Thenurseshould explaintotheparents that, althoughthe twinshaveidentical DNA, there
k k k k k k k
areseveralotherfactorsthat affect reactionsto stress. Mentalhealthisastateofbeingthatis relative t
k k s k k k k
othe individual client. Environmental influences and temperament can affect stress reactions.
k k k k k k s s k s k
CognitiveLevel:ApplicationIntegr k k k
atedProcess:Implementation
k k
4.Whichclient shouldthenurseanticipateto bemostreceptive to psychiatrictreatment?
k k s s k
1. AJewish, femalesocialworker. k
2. ABaptist,homelessmale. k
3. ACatholic,black male. k s
4. AProtestant,Swedishbusinessexecutive. k
ANS:1 k
Rationale:The nurseshouldanticipatethat theclientofJewish culture wouldplaceahighimportanc
k s k k k s k k k s s k k k k
eonpreventativehealthcareandwould considermentalhealthasequallyimportantas physical healt
k s k k k k k
h.Womenarealsomorelikelytoseektreatmentformentalhealthproblemsthanmen.
k k k k k k k k k k
CognitiveLevel:ApplicationIn k
tegratedProcess:Planning
k k k
5. Apsychiatricnurseinternstates,This clientsuseofdefense mechanismsshould beeliminated.Wh k s k s k
ich is a correct evaluation ofthis nurses statement?
k s k k k s k k
1. Defensemechanismscan beappropriateresponsesto stressandneednotbeeliminated. k k s k
2. Defensemechanismsareamaladaptiveattemptoftheegotomanageanxietyandshould alw k k
kaysbeeliminated.
k k
3. Defensemechanisms,used byindividualswithweakegointegrity,should bediscouragedand not k s k s k
eliminated.
k
4. Defensemechanismscausedisintegrationofthe ego andshouldbe fosteredand encouraged. k k k k
ANS:1 k
Rationale:Thenurseshoulddeterminethat defensemechanisms canbeappropriateduring times of str
k s k k s k k
ess.Theclientwithno defensemechanisms mayhavealowertoleranceforstress,thusleading toanxi
k k k k k s k s k k k k k k k s k
etydisorders.Defensemechanismsshouldbeconfrontedwhen theyimpedetheclient from developi
k k k k k k k k k k k
nghealthycopingskills.
k
CognitiveLevel:ApplicationIn k k k
tegratedProcess:Evaluation
k k k
6. Duringan intakeassessment,anurseasksbothphysiologicalandpsychosocialquestions.The clie
k s k k k s
ntangrilyresponds, Im here formyheart, not myheadproblems. Which is the nurses best response?
k k k k k k k k s k k k
1. Itsjust aroutinepartofourassessment. Allclients areasked thesesamequestions.
k k k k
2. Whyareyouconcernedaboutthesetypesofquestions? k k k
3. Psychologicalfactors,likeexcessivestress, havebeenfoundtoaffect medicalconditions. k k k s
4. Wecanskipthesequestions,ifyoulike.Itisntimperativethatwecompletethissection.
k k k k k k k k k k
ANS:3 k
Rationale:Thenurse shouldattempt to educatetheclientonthe negative effectsofexcessive stresson
k s k k s s k
medicalconditions.Itisnotappropriatetoskip physiological and psychosocialquestions,asthis wou ldlead to
k k k k k k k k s k s k k k s k k
an inaccurate assessment.
k s k
, CognitiveLevel:ApplicationIntegrk k k
atedProcess:Implementation
k k
7. An employeeusesthedefensemechanismofdisplacement whenthebossopenlydisagrees wit
s k k k
hsuggestions. Whatbehaviorwould be expected from this employee?
k k k k k k k
1. Theemployeeassertivelyconfrontstheboss.
2. Theemployee leavesthe staffmeetingtoworkout inthegym. k k s
3. Theemployeecriticizesacoworker. k k k
4. Theemployeetakesthe bossouttolunch. s k
ANS:3 k
Rationale:Thenurseshouldexpectthattheclientusing thedefensemechanismdisplacementwould
k s k
criticize acoworkerafterbeingconfronted bytheboss.Displacementrefersto transferringfeelingsf romone
k s k k k k s k k k k s k k k
target to a neutral orless-threatening target.
k k k k k k
CognitiveLevel:AnalysisInteg k k k
ratedProcess:Assessment
k
8. Afourth-
grade boyteasesandmakes jokesabouta cutegirlinhisclass. Thisbehaviorshouldbe identified by
s k s k s k
kanurse as indicative of whichdefense mechanism?
k k k k k
1. Displacement
2. Projection
3. Reactionformation
4. Sublimation
ANS:3 k
Rationale:Thenurseshouldidentifythattheboyisusingreactionformationasadefensemechanism.
k k k k k k k k k k k k
Reactionformationis theattempt topreventundesirablethoughtsfrom beingexpressedbyexpressin
k k k s k s k k k k s k
gopposite thoughtsor behaviors. Displacement refers to transferring feelings fromonetargetto anot
k k k k k k k k k k
her.Rationalizationrefers tomakingexcusestojustifybehavior. Projection refers to the attribution of
k k s k k s k s k
unacceptable feelingsor behaviors to another person.
k k k k k k
Sublimationreferstochannelingunacceptabledrives orimpulsesintomoreconstructive,acceptable s k
activities.
k
CognitiveLevel:ApplicationIn k k k
tegratedProcess:Assessment
k
9. Whichnursingstatement about theconceptofneurosis ismost accurate? s k k k
1. Anindividualexperiencingneurosis isunawarethatheorshe isexperiencingdistress.
k k k
2. Anindividualexperiencingneurosisfeelshelplessto changehisorhersituation.
k k
3. Anindividualexperiencing neurosis is awareofpsychologicalcausesofhisorherbehavior.
k k k k
4. Anindividualexperiencingneurosis hasalossofcontact with reality.
k k s s
ANS:2 k
Rationale:Thenurseshoulddefinetheconceptofneurosiswiththe following characteristics:
k k s
k
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING: CONCEPTS OF CARE IN
k k k k k k k k k k
EVIDENCE-BASED PRACTICE 8TH EDITION MORGAN, TOWNSEND
k k k k k k k
ALL CHAPTERS COVERED QUESTIONS AND ANSWERS GRADED A+
k k k k k k k k
NEWEST VERSION. k
,Chapter1. MentalHealthandMentalIllness Mk k k
ultipleChoice k
1. Anurse isassessingaclient who isexperiencingoccasionalfeelingsofsadnessbecauseofthe rece
s k k k
ntdeathof a beloved pet. The clients appetite, sleep patterns, and dailyroutine have not changed. Ho
k k k k k k k k k k k k k k k
wshould the nurse interpret the clients behaviors?
k k k k k k k
1. Theclientsbehaviorsdemonstratementalillnessinthe formofdepression. k k
2. Theclientsbehaviorsareextensive, whichindicatesthepresenceofmentalillness. k
3. Theclientsbehaviorsarenot congruent with culturalnorms. k s s
4. Theclientsbehaviorsdemonstratenofunctionalimpairment, indicating nomentalillness. k s k
ANS:4 k
Rationale:Thenurseshouldassessthattheclientsdailyfunctioning isnotimpaired.Theclientwho e
k s k s
kxperiencesfeelingsofsadness aftertheloss ofapetisrespondingwithinnormalexpectations.Witho ut
k k k s k s k k k k k k k k
significant impairment, the clients distress does not indicate a mental illness.
k s k k s k s s k k k
CognitiveLevel:AnalysisInteg k k k
ratedProcess:Assessment
k
2. Atwhatpointshouldthenursedeterminethataclientisat riskfordevelopinga mental illne ss?
k k k s k k
1. Whenthoughts, feelings, and behaviorsarenot reflectiveofthe DSM-5 criteria. k k s s k k
2. Whenmaladaptiveresponses to stressarecoupled withinterference indailyfunctioning. s k k k
3. Whenaclient communicatessignificant distress. k s
4. Whenaclient usesdefensemechanisms as ego protection. k k s k
ANS:2 k
Rationale: Thenurseshoulddeterminethattheclientis at risk formentalillnesswhenresponses to str
k k k k k k
ess aremaladaptive and interfere withdailyfunctioning.TheDSM-
k s k s s k k
5indicatesthat inorderto bediagnosedwithamentalillness,dailyfunctioning must besignificantlyi
k k s k k k k k k s s k
mpaired. The clients ability to communicate distress wouldbe considered a positiveattribute.
k k k k k s k k k k k
CognitiveLevel:ApplicationIn k k k
tegratedProcess:Assessment
k
3. Anurse isassessingaset of15-year- s k
old identicaltwinswhorespond verydifferentlytostress.Onetwinbecomesanxious and irritable,an
s k s k k k k k s s k
dtheotherwithdrawsandcries.Howshouldthenurseexplainthesedifferentstressresponsestothe
k k k k k k k k k k k k k k k
parents?
k
1. Reactionstostressarerelativeratherthanabsolute; individualresponsesto stressvary.
k k k k k
2. It is abnormalforidenticaltwinstoreactdifferentlytosimilarstressors.
k k
3. Identicaltwinsshouldsharethesametemperament andrespond similarlyto stress. k s k
4. Environmentalinfluences tostressweighmoreheavilythangenetic influences. k k k
,Rationale: Thenurseshould explaintotheparents that, althoughthe twinshaveidentical DNA, there
k k k k k k k
areseveralotherfactorsthat affect reactionsto stress. Mentalhealthisastateofbeingthatis relative t
k k s k k k k
othe individual client. Environmental influences and temperament can affect stress reactions.
k k k k k k s s k s k
CognitiveLevel:ApplicationIntegr k k k
atedProcess:Implementation
k k
4.Whichclient shouldthenurseanticipateto bemostreceptive to psychiatrictreatment?
k k s s k
1. AJewish, femalesocialworker. k
2. ABaptist,homelessmale. k
3. ACatholic,black male. k s
4. AProtestant,Swedishbusinessexecutive. k
ANS:1 k
Rationale:The nurseshouldanticipatethat theclientofJewish culture wouldplaceahighimportanc
k s k k k s k k k s s k k k k
eonpreventativehealthcareandwould considermentalhealthasequallyimportantas physical healt
k s k k k k k
h.Womenarealsomorelikelytoseektreatmentformentalhealthproblemsthanmen.
k k k k k k k k k k
CognitiveLevel:ApplicationIn k
tegratedProcess:Planning
k k k
5. Apsychiatricnurseinternstates,This clientsuseofdefense mechanismsshould beeliminated.Wh k s k s k
ich is a correct evaluation ofthis nurses statement?
k s k k k s k k
1. Defensemechanismscan beappropriateresponsesto stressandneednotbeeliminated. k k s k
2. Defensemechanismsareamaladaptiveattemptoftheegotomanageanxietyandshould alw k k
kaysbeeliminated.
k k
3. Defensemechanisms,used byindividualswithweakegointegrity,should bediscouragedand not k s k s k
eliminated.
k
4. Defensemechanismscausedisintegrationofthe ego andshouldbe fosteredand encouraged. k k k k
ANS:1 k
Rationale:Thenurseshoulddeterminethat defensemechanisms canbeappropriateduring times of str
k s k k s k k
ess.Theclientwithno defensemechanisms mayhavealowertoleranceforstress,thusleading toanxi
k k k k k s k s k k k k k k k s k
etydisorders.Defensemechanismsshouldbeconfrontedwhen theyimpedetheclient from developi
k k k k k k k k k k k
nghealthycopingskills.
k
CognitiveLevel:ApplicationIn k k k
tegratedProcess:Evaluation
k k k
6. Duringan intakeassessment,anurseasksbothphysiologicalandpsychosocialquestions.The clie
k s k k k s
ntangrilyresponds, Im here formyheart, not myheadproblems. Which is the nurses best response?
k k k k k k k k s k k k
1. Itsjust aroutinepartofourassessment. Allclients areasked thesesamequestions.
k k k k
2. Whyareyouconcernedaboutthesetypesofquestions? k k k
3. Psychologicalfactors,likeexcessivestress, havebeenfoundtoaffect medicalconditions. k k k s
4. Wecanskipthesequestions,ifyoulike.Itisntimperativethatwecompletethissection.
k k k k k k k k k k
ANS:3 k
Rationale:Thenurse shouldattempt to educatetheclientonthe negative effectsofexcessive stresson
k s k k s s k
medicalconditions.Itisnotappropriatetoskip physiological and psychosocialquestions,asthis wou ldlead to
k k k k k k k k s k s k k k s k k
an inaccurate assessment.
k s k
, CognitiveLevel:ApplicationIntegrk k k
atedProcess:Implementation
k k
7. An employeeusesthedefensemechanismofdisplacement whenthebossopenlydisagrees wit
s k k k
hsuggestions. Whatbehaviorwould be expected from this employee?
k k k k k k k
1. Theemployeeassertivelyconfrontstheboss.
2. Theemployee leavesthe staffmeetingtoworkout inthegym. k k s
3. Theemployeecriticizesacoworker. k k k
4. Theemployeetakesthe bossouttolunch. s k
ANS:3 k
Rationale:Thenurseshouldexpectthattheclientusing thedefensemechanismdisplacementwould
k s k
criticize acoworkerafterbeingconfronted bytheboss.Displacementrefersto transferringfeelingsf romone
k s k k k k s k k k k s k k k
target to a neutral orless-threatening target.
k k k k k k
CognitiveLevel:AnalysisInteg k k k
ratedProcess:Assessment
k
8. Afourth-
grade boyteasesandmakes jokesabouta cutegirlinhisclass. Thisbehaviorshouldbe identified by
s k s k s k
kanurse as indicative of whichdefense mechanism?
k k k k k
1. Displacement
2. Projection
3. Reactionformation
4. Sublimation
ANS:3 k
Rationale:Thenurseshouldidentifythattheboyisusingreactionformationasadefensemechanism.
k k k k k k k k k k k k
Reactionformationis theattempt topreventundesirablethoughtsfrom beingexpressedbyexpressin
k k k s k s k k k k s k
gopposite thoughtsor behaviors. Displacement refers to transferring feelings fromonetargetto anot
k k k k k k k k k k
her.Rationalizationrefers tomakingexcusestojustifybehavior. Projection refers to the attribution of
k k s k k s k s k
unacceptable feelingsor behaviors to another person.
k k k k k k
Sublimationreferstochannelingunacceptabledrives orimpulsesintomoreconstructive,acceptable s k
activities.
k
CognitiveLevel:ApplicationIn k k k
tegratedProcess:Assessment
k
9. Whichnursingstatement about theconceptofneurosis ismost accurate? s k k k
1. Anindividualexperiencingneurosis isunawarethatheorshe isexperiencingdistress.
k k k
2. Anindividualexperiencingneurosisfeelshelplessto changehisorhersituation.
k k
3. Anindividualexperiencing neurosis is awareofpsychologicalcausesofhisorherbehavior.
k k k k
4. Anindividualexperiencingneurosis hasalossofcontact with reality.
k k s s
ANS:2 k
Rationale:Thenurseshoulddefinetheconceptofneurosiswiththe following characteristics:
k k s
