A Clinical Approach by Margaret Jordan Halter, PhD, APRN
8th Edition Test Bank
MULTIPLE CHOICE
1. A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced
practice nurse to perform which additional intervention? a. Conduct mental health
assessments.
b. Prescribe psychotropic medication.
c. Establish therapeutic relationships.
d. Individualize nursing care plans.
ANS: B
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
prepared at the basic level is permitted to perform mental health assessments, establish
relationships, and provide individualized care planning.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-23 TOP:
Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing
skills.” Select the best response by the mental health nurse.
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient
ratios must be better because of the nature of the patients’ problems.”
b. “Psychiatric nurses use complex communication skills as well as critical thinking to solve
multidimensional problems. I am challenged by those situations.”
c. “That’s a misconception. Psychiatric nurses frequently use high technology monitoring
equipment and manage complex intravenous therapies.”
d. “Psychiatric nurses do not have to deal with as much pain and suffering as medical–
surgical nurses do. That appeals to me.”
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,ANS: B
The practice of psychiatric nursing requires a different set of skills than medical–surgical
nursing, though there is substantial overlap. Psychiatric nurses must be able to help patients
with medical as well as mental health problems, reflecting the holistic perspective these
nurses must have. Nurse–patient ratios and workloads in psychiatric settings have increased,
just like other specialties. Psychiatric nursing involves clinical practice, not just
documentation. Psychosocial pain and suffering are as real as physical pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2, 21 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
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, 3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with mental illness, a group of
nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses
fulfilled?
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice
ANS: C
An advocate defends or asserts another’s cause, particularly when the other person lacks the ability to do that for
self. Examples of individual advocacy include helping patients understand their rights or make decisions. On a
community scale, advocacy includes politicalactivity, public speaking, and publication in the interest of improving the
human condition.
Since funding is necessary to deliver quality programming for persons with mental illness, theletter-writing campaign
advocates for that cause on behalf of patients who are unable to articulate their own needs.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-26 TOP:Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
4. A family has a long history of conflicted relationships among the members. Which familymember’s comment best
reflects a mentally healthy perspective?
a. “I’ve made mistakes but everyone else in this family has also.”
b. “I remember joy and mutual respect from our early years together.”
c. “I will make some changes in my behavior for the good of the family.”
d. “It’s best for me to move away from my family. Things will never change.”
ANS: C
The correct response demonstrates the best evidence of a healthy recognition of the importance of relationships.
Mental health includes rational thinking, communication skills, learning, emotional growth, resilience, and self-esteem.
Recalling joy from earlier in life maybe healthy, but the correct response shows a higher level of mental health. The
other incorrectresponses show blaming and avoidance.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 1-2, 3, 32 (Figure 1-1) TOP: Nursing Process: Assessment MSC:Client Needs:
Psychosocial Integrity
5. Which assessment finding most clearly indicates that a patient may be experiencing a mentalillness? The patient
a. reports occasional sleeplessness and anxiety.
b. reports a consistently sad, discouraged, and hopeless mood.
c. is able to describe the difference between “as if” and “for real.”
d. perceives difficulty making a decision about whether to change jobs.
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, ANS: B
The correct response describes a mood alteration, which reflects mental illness. The
distracters describe behaviors that are mentally healthy or within the usual scope of human
experience.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2 to 4 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
achieved for an adult patient? The patient
a. sees self as capable of achieving ideals and meeting demands.
b. behaves without considering the consequences of personal actions.
c. aggressively meets own needs without considering the rights of others.
d. seeks help from others when assuming responsibility for major areas of own life.
ANS: A
The correct response describes an adaptive, healthy behavior. The distracters describe
maladaptive behaviors.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2 to 4 TOP: Nursing Process: Evaluation
MSC: Client Needs: Psychosocial Integrity
7. A nurse encounters an unfamiliar psychiatric disorder on a new patient’s admission form.
Which resource should the nurse consult to determine criteria used to establish this diagnosis? a.
International Statistical Classification of Diseases and Related Health Problems
(ICD-10)
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
d. A behavioral health reference manual
ANS: C
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline
for diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a
psychiatric illness.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-18, 19 TOP: Nursing Process: Assessment
MSC: Client Needs: Safe, Effective Care Environment
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
would have the most complete information?
a. Nursing Outcomes Classification (NOC)
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice d. ICD-10
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