lO M oA R c PSD|7906827
Essentials of Psychiatric Mental Health Nursing 8th Edition
Concepts of Care in Evidence - Based Practice 8th Edition Morgan
Townsend
Chapter 1. Mental Health and Mental
IllnessMultiple Choice
1. A nurse is assessing a client who is experiencing occasional feelings of sadness because
of therecent death of a beloved pet. The clients appetite, sleep patterns, and daily routine
have not changed. How should the nurse interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of mental illness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no mental
illness.
ANS: 4
Rationale: The nurse should assess that the clients daily functioning is not impaired.
The clientwho experiences feelings of sadness after the loss of a pet is responding within
normal expectations. Without significant impairment, the clients distress does not
indicate a mental illness.
Cognitive Level: Analysis
Integrated Process:
Assessment
2. At what point should the nurse determine that a client is at risk for developing a
mentalillness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
2. When maladaptive responses to stress are coupled with interference in daily
functioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
ANS: 2
Rationale: The nurse should determine that the client is at risk for mental illness when
,responsesto stress are maladaptive and inte r f ere with daily functioning. The DSM-5
l O M o A R c P S D | 7 9 0 6 8 27
indicates that in orderto be diagnosed with a mental illness, daily functioning must be
significantly impaired. The clients ability to communicate distress would be considered
a positive attribute.
Cognitive Level: Application
Integrated Process:
Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently
to stress.One twin becomes anxious and irritable, and the other withdraws and cries.
How should the nurse explain these different stress responses to the parents?
1. Reactions to stress are relative rather than absolute; individual responses to stress
vary.
2. It is abnormal for identical twins to react differently to similar stressors.
3. Identical twins should share the same temperament and respond similarly to stress.
4. Environmental influences to stress weigh more heavily than genetic influences.
, lO M oA R c PSD|7906827
ANS: 1
Rationale: The nurse should explain to the parents that, although the twins have
identical DNA,there are several other factors that affect reactions to stress. Mental
health is a state of being thatis relative to the individual client. Environmental
influences and temperament can affect stress reactions.
Cognitive Level: Application
Integrated Process:
Implementation
4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
1. A Jewish, female social worker.
2. A Baptist, homeless male.
3. A Catholic, black male.
4. A Protestant, Swedish business executive.
ANS: 1
Rationale: The nurse should anticipate that the client of Jewish culture would place a
high importance on preventative health care and would consider mental health as
equally important asphysical health. Women are also more likely to seek treatment for
mental health problems than men.
Cognitive Level:
ApplicationIntegrated
Process: Planning
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be
eliminated.Which is a correct evaluation of this nurses statement?
1. Defense mechanisms can be appropriate responses to stress and need not be
eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety
and shouldalways be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be
discouraged andnot eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged.
ANS: 1
, lO M oA R c PSD|7906827
ANS: 1
Rationale: The nurse should determine that defense mechanisms can be appropriate
during timesof stress. The client with no defense mechanisms may have a lower
tolerance for stress, thus leading to anxiety disorders. Defense mechanisms should be
confronted when they impede the client from developing healthy coping skills.
Cognitive Level:
Application Integrated
Process: Evaluation
6. During an intake assessment, a nurse asks both physiological and psychosocial
questions. Theclient angrily responds, Im here for my heart, not my head problems.
Which is the nurses best response?
1. Its just a routine part of our assessment. All clients are asked these same questions.
2. Why are you concerned about these types of questions?
3. Psychological factors, like excessive stress, have been found to affect medical
conditions.
4. We can skip these questions, if you like. It isnt imperative that we complete this
section.
Essentials of Psychiatric Mental Health Nursing 8th Edition
Concepts of Care in Evidence - Based Practice 8th Edition Morgan
Townsend
Chapter 1. Mental Health and Mental
IllnessMultiple Choice
1. A nurse is assessing a client who is experiencing occasional feelings of sadness because
of therecent death of a beloved pet. The clients appetite, sleep patterns, and daily routine
have not changed. How should the nurse interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of mental illness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no mental
illness.
ANS: 4
Rationale: The nurse should assess that the clients daily functioning is not impaired.
The clientwho experiences feelings of sadness after the loss of a pet is responding within
normal expectations. Without significant impairment, the clients distress does not
indicate a mental illness.
Cognitive Level: Analysis
Integrated Process:
Assessment
2. At what point should the nurse determine that a client is at risk for developing a
mentalillness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
2. When maladaptive responses to stress are coupled with interference in daily
functioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
ANS: 2
Rationale: The nurse should determine that the client is at risk for mental illness when
,responsesto stress are maladaptive and inte r f ere with daily functioning. The DSM-5
l O M o A R c P S D | 7 9 0 6 8 27
indicates that in orderto be diagnosed with a mental illness, daily functioning must be
significantly impaired. The clients ability to communicate distress would be considered
a positive attribute.
Cognitive Level: Application
Integrated Process:
Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently
to stress.One twin becomes anxious and irritable, and the other withdraws and cries.
How should the nurse explain these different stress responses to the parents?
1. Reactions to stress are relative rather than absolute; individual responses to stress
vary.
2. It is abnormal for identical twins to react differently to similar stressors.
3. Identical twins should share the same temperament and respond similarly to stress.
4. Environmental influences to stress weigh more heavily than genetic influences.
, lO M oA R c PSD|7906827
ANS: 1
Rationale: The nurse should explain to the parents that, although the twins have
identical DNA,there are several other factors that affect reactions to stress. Mental
health is a state of being thatis relative to the individual client. Environmental
influences and temperament can affect stress reactions.
Cognitive Level: Application
Integrated Process:
Implementation
4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
1. A Jewish, female social worker.
2. A Baptist, homeless male.
3. A Catholic, black male.
4. A Protestant, Swedish business executive.
ANS: 1
Rationale: The nurse should anticipate that the client of Jewish culture would place a
high importance on preventative health care and would consider mental health as
equally important asphysical health. Women are also more likely to seek treatment for
mental health problems than men.
Cognitive Level:
ApplicationIntegrated
Process: Planning
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be
eliminated.Which is a correct evaluation of this nurses statement?
1. Defense mechanisms can be appropriate responses to stress and need not be
eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety
and shouldalways be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be
discouraged andnot eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged.
ANS: 1
, lO M oA R c PSD|7906827
ANS: 1
Rationale: The nurse should determine that defense mechanisms can be appropriate
during timesof stress. The client with no defense mechanisms may have a lower
tolerance for stress, thus leading to anxiety disorders. Defense mechanisms should be
confronted when they impede the client from developing healthy coping skills.
Cognitive Level:
Application Integrated
Process: Evaluation
6. During an intake assessment, a nurse asks both physiological and psychosocial
questions. Theclient angrily responds, Im here for my heart, not my head problems.
Which is the nurses best response?
1. Its just a routine part of our assessment. All clients are asked these same questions.
2. Why are you concerned about these types of questions?
3. Psychological factors, like excessive stress, have been found to affect medical
conditions.
4. We can skip these questions, if you like. It isnt imperative that we complete this
section.
